Discuss about the Clinical Risk Management in Hospitals.
The success of health system is dependent on delivery of safe and evidence-based care. But due to various disparities in the system, health organization fails to implement safe and evidenced based care both nationally and internationally. This report gives detail on a public inquiry into the Mid Staffordshire Trust. It answers the question posed in the two modules of clinical governance and quality and safety in relation to the selected trust. It mainly explains the factors that lead to system failure in Mid Staffordshire Trust.
The Mid Staffordshire trust came into news after hundreds of patients died in two hospitals because of substandard care and staff failure ("Mid Staffordshire Trust inquiry: how the care scandal unfolded", 2016).Clinical governance is essential in the health system which involves a system by which managers, clinicians and medical staff share responsibility and are accountable for minimizing risk and promoting an environment of excellence for patients (Ellis & Johnson, 2013). But Mid Staffordshire Trust might have failed in clinical governance due to faulty system related to continuity of care and faulty execution of roles and responsibilities.
The Mid Staffordshire Trust failed in its responsibility of providing quality and safe care to patients. Patients came to the hospital to be treated well with utmost care, but they were left starving and with soiled bedclothes. Patients would call nursing staff continuously, and nobody came to address their response. Doctors forgot about their role in Stafford hospital and decision to treat a patient was made by the receptionist. Everything was against the clinical governance framework which aggravated the problems of the patient in the hospital. Critically ill patients needed to be treated by an experienced physician, but they were put in charge of inexperienced junior doctors. The nurse at the hospital also lacked competency in handling medical equipment and they would off instrument abruptly. The situation was pathetic for patients and was a great risk to their lives. Instead of being an institution for the care of patients, it became a risky place for patient’s health. The failure by the health care staff to properly carry out their responsibility lead to loss of four members in one family and a newborn baby. Patients were left screaming with pain, and it was a shameful act by those who were supposed to provide relief to them ("Mid Staffordshire Trust inquiry: how the care scandal unfolded", 2016).
The continuity of high standard care was compromised in the hospital because managers tried to cut cost and meet Labour’s central target. The wanted to achieve a foundation status for trust and in the quest of these things, they undermined the quality of care at the hospital. This was a serious offence and persons responsible for risking and harming lives of the patient will face fine and execution. The managers kept very few medical staff than required, and so there were never enough senior physicians to guide junior doctors. Certain targets were imposed on physicians and nurses, and failure to meet the target meant losing their jobs. There was also target to admit or discharge patients within four hours (Campbell, 2013). So doctors and nurse left critically ill patients and started treating minor patients in the emergency department to avoid breaching the four-hour time limit ("Mid Staffordshire Trust inquiry: how the care scandal unfolded", 2016). The integrity of care is also important in the hospital setting, but the nurse was asked to report falsely that they address patient complaint promptly than what was the actual scenario. This explains how continuity of care was breached at the hospital, and care at the hospital became appalling.
Some strategies that the Mid Staffordshire Trust could have implemented to prevent system failure are as follows:
Credentiality: Credential can be maintained when a high quality clinical physician with required qualification and competency is present in health care organization (Coventry et al., 2014). Mid Stafford Shire Trust could have worked in this regard to have that physician and nurses who have updated knowledge about different treatment procedures. In hospital setting having an adequate number of staff to look after the needs of all kind of patients is important. It helps in the prompt delivery of care to patients with different ailments (Briner et al., 2013). The staffs at Mid Staffordshire trust breached the credentiality code by falsely reporting that they answer to patients call immediately. They were liable to failure in providing appropriate care. Instead of focusing on labor's target, they should have focused more on the competency of health care staff to provide a high standard of care.
Reporting and acting- Systematic reporting and immediate actions in case of any complexities help in maintaining the quality of care. Staffs at Mid Staffordshire Trust left elderly and other patients agonizing with pain. But majority mistake was made by the provider trust board as they did not look after problems of patient or staff. They did not take any action regarding correction of deficiencies in the hospital. An ideal approach would have been to engage managers with the responsibility to promote that high standard of care and prioritizing complete recovery of a patient from their ailments (Harris, 2013).
Accountability-The report on Mid Staffordshire Trust failure highlighted that they failed even to provide basic facilities required in health care. Patients who wanted relief immediately were left neglected whereas food and drinks were also not available to patients on time. Hygiene is crucial part of health care facility; even that was neglected at the hospital. They could have managed the situation by being accountable for the risk and strictly maintain hygiene and a basic standard of care (Huber, 2013). Instead of sacking staff for the four-hour target, their focus should be on minimizing the second visit to the hospital for same patients. The Trust could have focused on quality and arranging adequate resource for efficient delivery of care (Ovseiko et al., 2014).
Focus on organizational performance- Mid Staffordshire Trust should have implemented strategies to promote discipline and alignment between hospitals objectives and risk activities. To improve performance, they should have identified threats and took the better decision to effective allocation of resources (Hopkin, 2014).
Implementation of the above risk management strategy could have changed the outcome in Mid Staffordshire Trust as it would help in addressing issues of malpractice in the hospitals. It would have helped the trust to maintain a safe system of care designed to reduce adverse events in health care and improve the quality of care and competency in health care staff (Middleton et al., 2013).
Thus the report on public inquiry in to Mid Staffordshire Trust brought into the forefront grave issues of medical negligence that was present in the hospital. It highlighted the reasons and factors that lead to failure of the health system and many deaths in the hospital. Finally, through different strategies for risk management, it suggested ways that the trust could have taken to minimize risk and improve the quality of care.
Briner, M., Manser, T., & Kessler, O. (2013). Clinical risk management in hospitals: strategy, central coordination and dialogue as key enablers.Journal of evaluation in clinical practice, 19(2), 363-369.
Campbell, D. (2013). Mid Staffs hospital scandal: the essential guide. the Guardian. Retrieved 17 August 2016, from https://www.theguardian.com/society/2013/feb/06/mid-staffs-hospital-scandal-guide
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Mid Staffordshire Trust inquiry: how the care scandal unfolded. (2016).Telegraph.co.uk. Retrieved 17 August 2016, from https://www.telegraph.co.uk/news/health/news/9851763/Mid-Staffordshire-Trust-inquiry-how-the-care-scandal-unfolded.html
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