Critical Decision Making for Providers
Grand Canyon University
Critical Decision Making for Providers
Mike is a lab technician who is running late for work again even though he left 20 minutes early; however ran into an accident which has caused him to be running behind. This was not the first time he was running late; his supervisor had warned that any more tardiness that it would lead to possible job termination. Mike loves his job which is the sole provider for his family as his wife just had a baby. On arrival at work, he finds a spill on the floor located in the lobby. If he has any more delay especially if clearing the spill means he will further delay clocking in and risk losing his job. Thinking to himself, this is not part of his job. The spill can still be cleaned up as he is clocking in by the people responsible after he calls them. He is in a dilemma of whether to ignore the spill or clock in on time.
Failure to Report
If Mike were to report the spill, the hospital would be free of litigation. Mike could call his supervisor from the lobby and inform him he has to clean-up a spill that he found. He however is afraid his job may get terminated if he does not clock in on time.
Mike is so afraid of losing his job that he ignores the spill and proceeds to clock in on time. However, failure to report the spill has adverse consequences especially to patients and other staff. After clocking in and getting ready for the day; Mike finds out that the patient he was attending to had fallen at the lobby that morning and was in serious pain. Come to find out that patient slipped on a spill in the lobby and now the patient has a hip injury. Mike feels guilty of his failure to clean the spill that led to the patients fall. Now Mike faces a new dilemma, should he admit to his supervisor that he had seen the spill earlier? His admission could still result in him losing his job still.
Impacting Decision of Mike’s Choices
Mikes decision to report the problem would ensure that the hospital is safe. If he reports the problem, the risk of anyone falling as a result of the slippery floor is eliminated. He could inform the supervisor that he delayed clearing the spill and make up for lost time at the end of his shift.
If Mike does not clear the spill, patient safety is compromised. The result is patients visiting the health facility falling as a consequence of the spill that makes the floor slippery. The fall can cause suffering and pain to the patient. It may also limit function resulting in a burden on the family. This will result in financial losses for the health care facility. The facility will use their resources for treating injuries caused by in-hospital falls. This is an incentive for health care providers to implement safety in the health facilities (Jorgensen, 2019).
Mike’s failure to report and clean the spill has legal consequences on him and the hospital. Apart from losing his job, as a professional and by association with the hospital, the patient could sue for damages. The hospital environment is expected to be safe for use. The hospital staff is expected to observe due diligence in ensuring a safe environment for their visitors.
The organization’s quality metrics will be adversely affected. The general expectation by the public is that the hospital is safe and promotes health. Customer expectations are not met as indicated by the patient who got injured. Trust and customer loyalty is now lost.
Mike’s decision to ignore the spill also increases the workload of other medical departments. Falls increase the patients need for healthcare. Prolonged hospitalization is workload on nurses and the doctors. The hip injury will require doctors, X-rays and more nurses. Extra medication is probably needed. All of these interventions will increase the cost of care, on the hospitals dime.
Recommendations regarding the Issue
The first step is to create awareness on personal responsibility. Everyone working in a hospital has the responsibility to correct any situation that is unsafe to patients, co-workers, and the staff in general. Taking a step to ensure that a slippery floor is dried should be emphasized in the same way as the role of ensuring a patient has taken the right medication. Patient and staff safety should trump anything else.
The need for application of critical thinking in assessing situations is necessary. Mike ignored the spill out of fear of losing his job. Rules are important in any organization. However, as professionals, the hospital staff needs to rely more on a critical assessment of situations. The ability to question and make a rational decision is more important than following rules. Routines and orders from authorities if followed blindly are costly to an organization and stakeholders. A way to achieve this is by brainstorming on all ideas and options using relevant cases. By exploring all ideas relevant to a case, the professionals are left to make informed decisions. Open discussions should be encouraged (Fetherston, 2015). As Mike’s manager, I will have an open discussion with the staff regarding the situation. I would encourage everyone to bring forth any suggestions they may have to avoid any further occurrences that will lead to a similar situation. I would stress the importance of critical thinking. Patient and staffs safety are priority and should be the concern as you walk into the hospital.
Taking personal blame is the other step towards ensuring that individuals handle patient safety. In the event that a professional failed in their part of ensuring the patients are safe, the professional should carry the individual blame. Every hospital has guidelines. These guidelines should be followed on the course of action regarding staff involved. Punishments should apply accordingly (World Health Organization, 2015). This should encourage other staff to report instances that are risky for patients. Punishment should not be used as a plan of correction. Punishment will only instill fear and discourage other staff from reporting issues to management.
Human error, and unsafe procedures and equipment, underlie many of the disasters which occur. Everyone makes mistakes. It is part of being human. Good doctors and good nurses make mistakes (Fetherston, 2015). The culture of reporting such situations needs to be promoted. “Reporting is aimed at improving responsibility and eliminating risk.” The reporting should be accompanied by a detailed discussion of facts relating to an incident. The affected areas should also be discussed in case there is an inherent risk present. The risk can then be eliminated.
Mike failed to clear the spill simply because he did not want to get fired because he would have been late clocking in and that there is somebody who is responsible for spills. The management needs to instill a team working spirit on the staff. They should work together and help each other in roles. Also, they should support each other ensuring their colleagues are not overloaded. Teamwork must be encouraged. Without teamwork, staff moral will be low resulting to poor performance and decreased job satisfaction. Also needs to instill that patient and staff safety is priority and that should trump anything else.
Fetherston, T. (2015). The importance of critical incident reporting – and how to do it. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4675258/.
Jorgensen, J. (2019, October 3). Special Supplement to American Nurse Today – Best Practices for Falls Reduction: A Practical Guide. Retrieved from https://www.americannursetoday.com/special-supplement-to-american-nurse-today-best-practices-for-falls-reduction-a-practical-guide/.
World Health Organization;. (2015). Understanding and Managing Clinical Risk. Retrieved October 10, 2019, from WHO Safety Curriculum: http://www.who.int/patientsafety/education/curriculum/who_mc_topic-6.pdf.
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