The Best Practices : How The New Quality Movement Is Transforming Health Care

In the United States alone there are 98,000 deaths per year caused by low quality health care (Ignatavicius & Workman, 2013, pg. 2). This statistic is disturbing because the errors that resulted in death were errors that were preventable. The intent of this chapter is to bring awareness to health care providers that are able to make a change in the quality of health care. In current practice patients are subjected to medication errors, preventable hospitalizations, premature death, and poor care provided due to racial, ethical, or low-income factors.

Atul Gawande in his article “When the Doctor Makes Mistakes” exposes the mystery, uncertainty and fallibility of medicine in true stories that involve real patients. In a society where attorneys protect hospitals and physicians from zealous trials from clients following medical errors, doctors make mistakes is a testimony that Gawande a representative of other doctors speak openly about failures within the medical fields. In this article, Gawande exposes those errors with an intention of showing the entire society and specifically those within the medicine field that when errors are hidden, learning is squelched and those within the system are provided with an opportunity to continue committing the same errors. What you find when you critically analyse Gawande, “When Doctors Make Mistakes essay is how messy and uncertain medicine turns out to be. Throughout the entire article you experience the havoc within the medicine field as the inexperienced doctor misapplies a central line in a patient.

By 2001 it was brutally apparent that the U.S. Health Care system was in dire need of a reform in regards to quality and patient safety. Following two separate reports issued by The Institute of Medicine (IOM), To Err is Human (1999) and Crossing the Quality Chasm: A New Health Care System for the 21st Century(2001) the U.S. Congress requested the IOM review quality processes across multiple government funded health care programs. And understandably, “these reports described America’s healthcare system as a tangled, highly fragmented web that often wastes resources by duplicating efforts, leaving unaccountable gaps in coverage, and failing to build on the strengths of all health professionals” (Brown J., p. I – 15, 2013). Thus, the Committee on the Quality of Health Care in America released 6 aims to address key dimensions that require improvement in our health care system. These aims propose that our system needs to strive to be more Safe, Effective, Patient-Centered, Timely, Efficient, and Equitable (STEEEP). All of which were created to help overhaul our current health care system and, more importantly, narrow the quality chasm.

The main objective of healthcare professionals is to provide the best quality of patient care and the highest level of patient safety. To achieve that objective, there are many organizations that help improve the quality of care. One of the best examples is the Joint Commission. Unfortunately, the healthcare system is not free from total risks. In healthcare activities, there are possible errors, mistakes, near miss and adverse events. All of those negative events are preventable. But, it is clear that errors caused in healthcare result in thousands of deaths in the United States.

"Johns Hopkins patient safety experts have calculated that more than 250,000 deaths per year are due to medical error…" (John Hopkins Medicine). This soaring number has caused medical errors to become the third leading cause of death in the United States. For many people, medicine seems foreign and unknown. People who have lost loved ones due to medical error desperately look for a reason, and many times that blame falls upon doctors. Media has put a negative connotation on doctors as well, causing their reputation to plummet whenever a hospital procedure turns badly. A renown surgeon and author, Atul Gawande, uses his knowledge and experience to give people a new perspective on medicine. In the article "When Doctors Make Mistakes," Gawande uses rhetorical appeals: ethos, pathos, and logos to prove the need for a change in the medical systems and procedures. He analyzes how the public looks at doctors, giving a new perspective to enlighten the reader that even the best doctors can make mistakes.

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).

Keeping patients safe is essential in today’s health care system, but patient safety events that violate that safety are increasing each year. It was only recently, that the focus on patient safety was reinforced by a report prepared by Institute of medicine (IOM) entitled ” To err is human, building a safer health system”(Wakefield & Iliffe,2002).This report found that approx-imately 44,000 to 98,000 deaths occur each year due to medical errors and that the majority was preventable. Deaths due to medical errors exceed deaths due to many other causes such as like HIV infections, breast cancer and even traffic accidents (Wakefield & Iliffe, 2002). After this IOM reports, President Clinton established quality interagency

According to the Institute of Medicine, “At least 44,000 people, and perhaps as many as 98,000 people, die in hospitals each year as a result of medical errors” (Kohn et al.). Despite the unfortunate consequences, medical errors provide an important foundation for medicine. An immense uncertainty envelopes the medical field, and frequent leaps must be made. Some of these ventures are prosperous; however, many render unsuccessful. In Complications, Atul Gawande crafts an alluring view of the medical unknown using tales of his personal medical mistakes. Through the use of ethos, logos, and pathos, Atul Gawande argues that medicine’s vast uncertainty has beneficial influence upon society.

West Florida Regional Medical Center (WFRMC) located on the north side of Pensacola, Florida competed strongly with sacred heart and Baptist hospitals for patients. WFRMC’s CEO John Kausch was an active member of the Total Quality Council of the Pensacola Area Chamber of Commerce (PATQC) (McLaughlin, C.P., Johnson, J.K., & Sollecito, 2012).. PATQC’s vision was to develop the Pensacola, Florida area into a total quality community by promoting productivity, quality and economic developments in all area organizations both public and private (McLaughlin, et, al., 2012). John

Definitions of the quality of medical care are no longer left to clinicians who decide for themselves what technical performance constitutes “good care.” What are the other dimensions of quality care and why are they important? What has changed since the days when “doctor knows best?”

Medical errors are avoidable mistakes in the health care. These errors can take place in any type of health care institution. Medical errors can happen during medical tests and diagnosis, administration of medications, during surgery, and even lab reports, such as the mixing of two patients’ blood samples. These errors are usually caused by the lack of communication between doctors, nurses and other staff. A medical error could cause a severe consequence to the patient in cases consisting of severe injuries or cause/effect any health conditions, and even death. According to recent studies medical errors are not the third leading cause of death in the United States. (Walerius. 2016)

Quality measures are strategies that gauge, evaluate or compute health care processes, results, discernments, patient insight, and administrative structure. In addition, quality measures are frameworks that are connected with the capacity to deliver first-class health care and/or that are able to identify with one or more quality objectives for medicinal services. These objectives include: compelling, protected, effective, quiet focused, impartial, and opportune consideration. Quality measures can be used to measure quality improvement, public reporting, and pay-for-reporting programs specific for health care providers (CMS.gov, 2016). There are an assortment of quality measures in which health care organizations can use to determine the status of the care they are delivering. Many are appropriate, but few are chosen for this research paper. Among them are: National Health Care Surveys, Hospital IQR Programs, Scorecards, and Political, Power, and Perception/Data for Decision-making tools.

Quality indicators enable the health care system to identify inferior care in both process or outcome and structure while enhancing quality improvement in health care (De Vos et. al, 2009, p.1).

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

Quality is one of the most essential elements of healthcare. As stated by the Agency of Health Research and Quality, “Everyday, millions of Americans receive high-quality health care that helps to maintain or restore their health and ability to function” (Agency of Health Research and Quality, 2014). Improvements have become vital to the success of health care organizations and in the Healthcare Quality Book, it is explained that quality in the U.S. healthcare system is not at the standard that it should be (Ransom, Joshi, Nash & Ransom, 2008). Although this has been a reoccurring issue, attempts to fix the insufficiency have been less successful than expected.