Week 6: Systems-Structure and Function
Many of you have experience in complex adaptive systems whether you realize it or not. Thinking about your future
... [Show More] practice specialty area, identify an issue or concern common to your future practice setting. (Note: This can be the same practice issue identified in Week 5.) In your initial response, please identify your specialty track, as well as the issue or concern. Discuss how this issue or concern impacts the system at the micro, meso, and macro levels. How will you address this issue or concern at the microsystem level? What is the expected impact of your solution on the meso- and macrosystems?
Remember you can use an information technology-based solution to address the issue or concern.
References
Disch, J. (2006). Clinical microsystems: The building blocks of patient safety. Creative Nursing, 12(3), 13-14.
Likosky, D. S. (2014). Clinical Microsystems: A Critical Framework for Crossing the Quality Chasm. The Journal of Extra-Corporeal Technology, 46(1), 33–37.
Sollecito, W. A., & Johnson, J. K. (2013). Continuous quality improvement in health care (4th ed.). Burlington, MA: Jones & Bartlett Learning.
World Health Organization. (2016). Technical Series on Safer Primary Care. Medication Errors, 1-28.
My specialty track is Family nurse practitioner, I am focused on making an impact on my patient’s health and offering the latest research as treatment options while providing patient’s a safe environment. Healthcare is full of barriers affecting patent safety and outcomes one that I am passionate about is medications errors. This issue affects healthcare worldwide and are most commonly preventable. According to World Health Organization, there are approximately 6-7% of hospital admissions are medication related, and more than two-thirds of these errors could have been avoided (World Health Organization, 2016).
The clinical microsystem within a healthcare system comprises those health professionals who work with patients and families directly. This microsystem is typically the location of medical mistakes and errors essentially due to poor communication among care providers (Likosky, 2014). A few examples of a clinical microsystem include a patient care unit, a heart failure clinic, or even a night shift working in the emergency room (Disch, 2006). According to Sollecito & Johnson (2013) explain that a vast majority of “near misses” or sentinel events occur within this clinical microsystem. When the clinical microsystem is working well, then most events will be prevented. It is at this level that improvements or process changes can be implemented and the greatest impact will be seen regarding patient care and safety (Sollecito & Johnson, 2013).
Multiple efforts have been undertaken to make improvements and develop innovative ideas to increase the communication between healthcare professionals. Within the last several years, informal care coordination meetings have been established. These small teams of professionals
work together on a regular basis to provide care. This is known as the microsystem and is considered the most influential in the healthcare model. The actual interactions between the professionals is known as the mesosystem (Likosky, 2014). These meetings are held on a daily basis in which care teams come together and discuss patient information and options. The whole care team can then come together and discuss any concerns or issues, along with brainstorming for patient treatment needs. These types of multi-disciplinary meetings are improving the lines of communication between providers and identifying “near misses” which in return provides better patient care (Sollecito & Johnson, 2013).
This type of communication leads to a macrosystem, which includes organizational sup- port, patient focus, staff focus, interdependence of care team, information and information technology, process improvement, and performance patterns (Likosky, 2014). While developing these strategic patient care plans the macro and microsystem maintain feedback loops so new information can flow forward into the future macrosystem planning (Likosky, 2014). Increasing communication between providers is essential to patient safety and catching medication errors.
Response #2
How would you, as the master's- prepared executive nurse, present your solutions for system changes to others? Would your issue be resolved?
Dr. D,
As a mastered prepared nurse, I will be educated to help initiate change and lead professionals in newer processes by incorporating new technology to advance patient care. As a professional staying involved in medical advances involves good communication between multidisciplinary teams. This is not only imperative to patient information but to help alleviate possible medical errors (World Health Organization, 2016). The American Nurses Association defines nursing as the protection, promotion, and optimization of health and abilities, prevention of illness and injury, facilitation of healing, alleviation of suffering through the diagnosis and treatment of human response, and advocacy in the care of individuals, families, groups, communities, and populations (2014). Communication is the key to making this definition a success and assuring that healthcare professionals are providing adequate care.
As a leader in the healthcare profession, we must initiate the process in which change is made. I believe in multidisciplinary teams, and the knowledge it brings to the table. These informal care coordination meetings have not only improved patient care but have helped to eliminate many "near misses" (Sollecito, 2013). This information is then developed into a strategic medical plan, and taken back into patient care. All of these factors can significantly impact the quality of care. As professionals, we need to be innovative with patient care by providing the newest research and technologies available. Through these multidisciplinary meetings, professionals can discuss the new advances and what benefits they may have for the patient. With this being said, I believe that fewer errors will be made, and patients will have better outcomes.
References
American Association of Colleges of Nursing. (AACN). (2014) Mission and Values. http://www.aacn.nche.edu/about-aacn/mission-values
Sollecito, W. A., & Johnson, J. K. (2013). Continuous quality improvement in health care (4th ed.). Burlington, MA: Jones & Bartlett Learning.
World Health Organization. (2016). Technical Series on Safer Primary Care. Medication Errors, 1-28.
Response #3 Michelle,
I really enjoyed your discussion and agree with so many things that you brought up.
Providing quality care in today’s medical system has a variety of barriers, and can affect treatment. Compliance is a huge barrier in patients today, and with treatment. Non- compliance patients make it difficult to treat and properly diagnosis patient conditions.
This is not only a medical concern but non-compliant patients can a financial burden on the healthcare system, and the patient.
Professionally treating patients who are non-compliant can feel very defeating. These patients make it complicated to get them in the best physical health and stay in this place. Many of these patients come in so critically ill that not only did they have one complication they now have several to overcome.
I believe that early intervention with non-compliant patients is the only way to help control their overall health. Coordinating a team between professional, and parent to share accountability is a benefit to the patient. By using multidisciplinary teams’ professionals are brainstorming and developing the best treatment options. Communication is again a key component in providing better patient outcomes.
Great insight and over thought, thanks for sharing your thought [Show Less]