Healthcare Six Sigma Essay

Awareness should be built among the doctors and nurses on the risks of medical errors owing to miscommunications. This can be done by periodically doing policy review sessions on patient safety.

The driving factors for a success or failure of implementing Six Sigma is largely dependent on the inputs set forth at the conception and duration of the integration. This whitepaper will compare and contrast these critical inputs for a successful deployment. In order to accomplish this five various companies: GE Electric, W.R. Grace, Royal Chemicals, Diversified Paper and Lemforder. Some of these organizations had very successful results while others failed to reach their full potential. What is clear is the similarities of those that succeed and those that failed.

In healthcare systems, there is a concept of fair and just culture. That concept is important to manage the risk. In any organization, errors can happen. But, the best first tool to understand the error is to report it when it happens. Reporting error in healthcare contributes to minimize the risk of recurring.

Poor communication puts patients in danger because it can lead to medical errors and adverse events. For example, a medication error can occur if a physician’s orders are not updated in time or if the outgoing nurse does not provide the correct time in which a dose was administered last. Thus it is crucial to communicate any recent treatment that has been implemented. In this way, nurses and physicians can facilitate the prevention of errors. Another consequence of ineffective communication is that it can decrease morale and increase work-related stress among members of the healthcare team. If nurses and physicians are not understanding each other’s actions, conflict ensues. It can cause toxic interpersonal relationships. This, in turn, will affect the level of patient care because it is difficult to focus amidst emotional strain and

“Errors in communication give rise to substantial clinical morbidity and mortality (Riesenberg, Leitzsch, & Cunningham, 2010).” As a result, the Joint Commission has identified effective communication as one of its National Patient Safety Goals (Dunsford, 2009).

It is shocking to know that every year 98000 patients die from medical errors that can be prevented(Kohn, L. T., Corrigan, J. M., & Donaldson, M. S. (Eds.), 2000). Medical errors are not a new issue in our healthcare system; these have been around for a long time. Hospitals have been trying to improve quality care and patients safety by implementing different strategies to prevent and reduce medical errors for past thirty years. Medical errors are the third leading cause of death after heart disease and cancer in America (Allen, 2013). In addition medical errors are costing our healthcare system an estimated $735 billion to $980 billion (Andel, Davidow, Hollander, & Moreno, 2012).

The third leading cause of death in America may surprise you. Hospitals and healthcare organizations dedicate their branding to reflect a place of hope, comfort, and healing when ones health is compromised. Sadly, medical errors do exists in the realm of healthcare. The National Center for Biotechnology Information defines medical error as “an act of omission or commission in planning or execution that contributes to or could contribute to an unintended result.” Medical errors may include incorrect record keeping, administering incorrect medication to a patient, misdiagnosis, failing to remove all surgical instruments and performing surgery on the incorrect site. The Agency for Healthcare Research and Quality identified eight factors that contribute to the cause of medical errors. These factors include “communication problems, inadequate information flow, human problems, patient-related issues, organizational transfer of knowledge, staffing patterns, technical failures and inadequate policies and procedures.”

On many occasions, I have seen situations in which effective communication involving the professional healthcare team played a vital role in the positive outcome of patient care. On the other hand, there have been miscommunication between the healthcare team resulting in situations that could have been tragic to the patient.

According to the Institute of Medicine (IOM) report, To Err Is Human, the majority of medical errors result from faulty systems and processes, not individuals (Hughes, 2008). However, due to processes that are inefficient and variable, multiple health insurance, differences in provider education and experience, and other factors that contribute to the complexity of health care the IOM has put together six aims of health care that is effective, safe, patient-centered, timely, efficient, and equitable (Hughes, 2008).

New innovations are being created every year to help improve and protect patients from reckless and preventable errors. As healthcare providers, it is our duty to provide care ethically and to do no harm to our patients. On the contrary, “the culture of cover-up” still continues to exist today and although technology and informatics has progressively increased quality care, it has not completely eradicated errors. Integrity is the key component for every healthcare provider, along with other characteristics. Therefore, disclosing medical errors with our patients is imperative and our patients and their families deserve to know what occurred during their time of care. Technology is not able to prevent every mishap that causes patients harm (Gibson & Singh, 2003). On the other hand, communication and learning from the mistake can. As Gibson and Singh (2003) so eloquently stated, “…wise people learn form their mistakes, and those who don’t are bound to repeat

Disclosing medical errors is considered necessary by patients and practitioners. They are advised to disclose in the form of an apology when necessary and appropriate. When a medical error causes damage to the patient, it seen as not acceptable because a patient goes for treatment in order to get better not to get worse therefore it calls for the situation to be addressed. When a medical error is not disclosed, the fellow peers who have witnessed the error must decide whether they should remain silent and keep the error to themselves or reveal the error to the higher up, although it would be in good faith to report the medical error to a higher up, unless it has caused harm or long-term damage to the patient. (Youngson. p. 69) There are many hospitals that the practitioners keep the errors made to themselves and do not disclose the medical errors to the families of patients or the patients themselves. Medical errors become a topic of conversation if the family of a patient or the patient themselves become aware about the error. Medical errors are something that should be disclosed in a good faith manner

Due to ineffective management systems, inefficiency is increasing, which often leads to congested emergency rooms, customer complaints, and lost revenue. Over the past seven years, Six Sigma concepts are increasingly being implemented in the healthcare industry. Despite the challenges of adopting these concepts, the healthcare industry uses them to improve services rendered quality, increase efficiency and reduce fatal human errors. Primarily because Six Sigma is based on a comprehensive approach on improving the human and transactional aspects of the process (human performance and task completion). In the case of JPS, the factors that determine quality and efficiency are the flow of information and interaction with the patients. Using the Six Sigma DMAIC process improvement approach, JPS Emergency Department should be able to streamline information flow and achieve strategic business results (p.

I spent two years on a cardiac progressive critical care unit. On this unit, we prepared patients for the operating room and would take care of them postoperatively. As I was reading this article and how effective the Healthcare Lean Six Sigma System was in the proposed case study, I immediately could think of several wasteful moments that occurred throughout my time spent on this unit. Staff did not have personal work phones and the unit still used an overhead to address phone calls and other important messages. This alone required staff to consistently stop what they were doing to go up front and answer the phone. The computerized documentation system was outdated and not cross-linked with other units. These are examples of ineffective communication

With its success in manufacturing and other service industries, and because of new payment models and a shift in focus to better outcomes, there is no doubt the healthcare community will embrace Six Sigma techniques as a way to stay competitive in an ever-shifting landscape. And, because the main basis of health care reform is to eliminate underperformers in an effort to redesign the healthcare delivery system toward value-based medicine, eliminating waste in every internal process becomes even more critical.

In today's modern world with plenty of technology, it is hard to believe that we cannot figure out how to reduce Medical errors. The issue of medical error is not new in health care organizations. It has been in spot light since 1990's, when government did research on sudden increase in number of death in the hospitals. According to Lester, H., & Tritter, J. (2001), "Medical error is an actual or potential serious lapse in the standard of care provided to a patient, or harm caused to a patient through the performance of a health service or health care professional." Medical errors