The Patient's Perspective in Adverse Events

Adverse events, while unintentional still cause hundreds of thousands of injuries, illnesses, and even deaths annually in the United States (Attarian, 2008). Adverse events for the most part are caused by human error or systematic error that causes human error (Attarian, 2008). Evidence-based medicine (EBM) exists to help prevent these issue yet they still occur. So why do we still rely on EBM? Should we not ask patients as they are the recipients of medicine and they can first feel adverse affects?

In the opinion of this writer, EBM should be the primary determinant of adverse events. While it is a tragedy that patients are harmed due to medical error, the proportion is relatively small in comparison to the amount of patients. Placing that amount of pressure on patients is unfair. The purpose of healthcare providers is to take care of patients. They are trained and educated for that task. Experience helps hone these skills and improve the care patients receive. Patients are already nervous about other health issues and worrying about dying due to medical error can create a hyper-vigilant state to the point of paranoia. Furthermore, with the influx of medical information available on the internet, patients may wrongly perceive symptoms or develop hypochondriac tendencies. In addition, not all patients will be able to perceive adverse events (Ransome, Joshi, Nash, & Ransome, 2011, p. 244). For example, patients in surgery my not immediately feel the left over cotton ball in their body until much later.

This topic is the responsibility of medical providers. Facilities know the causes of human errors, such as fatigue, failure to follow procedure or incorrect information. These need to be addressed to prevent adverse events from re-occurring. In this way, facilities can help ensure the safety of both patients and employees. If a tired nurse is making mistakes, instead of blaming the nurse, allow him to rest before continuing work and prevent self-injury and injury to others.

Adverse events are preventable and facilities need to ensure they are doing all possible measures to prevent them from happening.

Attarian, D. E. (2008, May). www.aaos.org. (S. T. Canale, Ed.) Retrieved June 19, 2012, from American Academy of Orthopaedic Surgeons: http://www.aaos.org/news/aaosnow/may08/managing6.asp

Ransom, E. R., Joshi, M. S., Nash, D. B., & Ransom, S. B. (2011). The healthcare quality book: Vision, strategy and tools (2nd ed.). Chicago: Health Administration Press.

Quality and Cultural Competency

I recently read a pretty interesting article about quality, the CAHPS® (The Consumer Assessment of Healthcare Providers and Systems) questionnaire and other quality surveys. If you are interested in reading it, I will provide the citation information and if you are student, I am sure you can search your school library’s article database for a copy. However, I digress.

The article was about the quality surveys and questionnaires that facilities use and how they are not providing an accurate view of quality. Why is this important? Well, someone will write a general survey or questionnaire. However, different races/ethnicities will have different notions of what healthcare quality is and if they received it or not. For example, I, a black female, have different experiences than you. Even if you are a black female, you still have had a very different life experience from me. You are from a specific culture and have different influences on your expectations and opinions on what is quality care from a provider.

So how can health administrators get an accurate view of quality from surveys and questionnaires? The article state “with the exception of whites, participants across all of the [minority] groups noted the importance of cultural competency in facilitating communication” (Bagchi, af Ursin, & Leonard, 2012). And of course, everyone has their own ideas of what constitutes as cultural competency (Bagchi, af Ursin, & Leonard, 2012). So what is an administrator to do when a frustrated physician has a Haitian patient that describes their ailments with sounds? (My Haitian grandmother does it all the time). Should we just have a file of all different groups served for providers to reference?

This article is something for administrators to think about. For facilities that serve diverse populations, cultural competency and excellent communication is imperative. Patients need to be able to feel comfortable and respected to give providers with accurate medical information. Yes, I know, it is a two-way street but I believe that providers ear more responsibility. And while the facility may have a diverse staff, not everyone will be covered. So, what can we do?

Bagchi, A. D., af Ursin, R., & Leonard, A. (2012). Assessing cultural perspectives on healthcare quality. Journal of Immigrant Minority Health, 14, 175-182.