Systems Thinking in Health Care - Case Study Example

Systems Thinking in Health Care - Case study Systems Thinking in Health Care - Case study Hospital Acquired Infections (HAIs) also known as the nosocomial infections are defined as those “infections that are acquired in the hospital by patients who were admitted for reasons other than the infection (Republic of Ireland, 2012; p. 01).” Patients are usually provided with health care programs and facilities that ranging from technology and equipped clinics; however, in some cases, they still acquire certain infections other than those that took them to the same health cares or hospitals (Toy, 2013; p. 24). Notably, public and private health care systems have progressed in providing measures to reduce chances of patients acquiring such infections, but such infections continue to manifest and develop among the hospitalized patients. It should be noted that these infections are also threat to the hospital staffs. It should be noted that many factors have since been considered to be contributing to the hospital acquired infections. Among these factors include decreased immunity among the patients, increased and varied medical techniques practiced on patients, as well as varied invasive techniques applied on patients as medical procedures. Additionally, transmitting drug resistant bacteria to a crowded hospital populations with poor infection monitoring and control practices are also likely routes to acquiring infection in hospitals (Great Britain, 2000; p. 88). Therefore, since nearly all route cause or factors that contribute to hospital acquired infections are known, the hospital management and nurses must consider rethinking techniques towards addressing these factors towards reducing or eliminating the hospital acquired infections. These infections usually increase chances of patient to die; hence, it is vital for the health care systems and the concern parties to work out ways towards reducing these infections. As listed above, the health care systems must evaluate the kinds of technology that they use on patients. Not all technologies are worth applying on patients. Moreover, there must be rethinking to how to use these technologies on patients towards reducing their chance to create problems other than their originally intended purpose. Additionally, nurses must boost the immune systems of patients before they are hospitalized. This will reduce their chances of acquiring other infections on hospitalization (Chalmers, Pletz, Aliberti, and Welte, 2014; p. 132). Furthermore, nurses among other medical practitioners must reduce medical procedures on patients as well as invasive techniques that are likely to create potential route of infections. Finally in the above factors, health care systems must ensure that patients are not treated or drugs are not administered on patient in crowded areas. Crowd concentration thereby prompting acquisition of infections across different patients. SSM- A Rich Picture In cases where the hospital management have noted an occurrence of hospital acquired infections, there are need to act on such infections in order to avoid occurrence of such or any other infections among their patients. Notably, different hospital acquired infections require different response mechanisms; therefore, it is upon all health care systems to understand the nature of the infections so that they can employ a right response mechanism for the same (Toy, Liu, and Campbell, 2012; p. 180). Nonetheless, it is worth noting that the most common nosocomial infections are those related urinary track, surgical wounds, and the lower respiratory tract infection (LRTI). It is also vital to note that most of the hospital acquired infections usually occur in the acute surgical wards, intensive care units, and orthopaedic wards. Patients who are highly susceptible to age, chemotherapy, and underlying diseases are at high risk than other patients under the same conditions. As presented in the figure below, all issues within a health care systems is directed to the hospital’s administration. Therefore, it is the responsibility of the hospital’s administration to work out the strategies that will help them cub any situation that might rise from hospital acquired infections. However, the nurses are the ones responsible for the infections. On the other hand, the administrations of the health care systems have also failed to provide lasting solutions or strategies to handle health care problems that they know their existence. Therefore, there are need to “think differently” towards handing these infections whenever they occur or to evade them completely. Fig. 1: SSM- A Rich Picture Thinking differently now calls for all stakeholders of the health care systems to work on ways that will help in reducing or eliminating these infections. It should be noted that involving all stakeholder is vital since each one has a role to play in developing strategies towards finding solutions that will help in fixing the hospital acquired infections (Toy, 2012; p. 22). This problem has affected the health care system for years, and working and finding its solution will be a great achievement to the health care system. SSM-Analyses 1, 2 and 3 Analysis 1 In a research that was conducted HSE – Health Protection Surveillance Center (HPSC) involved different participants who are directly affected and those who are affected indirectly (Toy, 2014; p. 97). The research was also conducted on different hospitals including fifty acute hospitals constituted with 42 public hospitals, seven private hospital, and one specialist private hospital. Involvement of numerous and different types of hospitals was a means gathering data from all kinds of settings of the health care systems. The research also involved 9,030 patients slotted for 510 hospital wards for 50 acute hospitals. Among the patients, 7,898 (87%) where from the public hospital while the rest were from private hospital, 1,132 (13%). It should be noted that public hospitals are usually visited by many patients than private hospitals. Therefore, numerous and different experiences form their main characteristic. Additionally, most private hospital practitioners are usually slightly more careful than their public hospital counterparts (Toy, Briscoe and Britton, 2012; p. 187). Therefore, it is prudent to collect HAIs’ infection experience from the public than private hospitals. Additionally, being attended by many, public hospitals have the possibility of being congested compared to the private hospitals. Practitioners and the hospital administrations were also involved in the study. The practitioners are directly involved with the patients; therefore, they are in better position to explain factors that are likely to be the fueling factors toward hospital acquisition infections (Ducel, Fabry, and Nicolle, 2002; p. 151). On other hand, the hospital administration will explain what elements or strategies they have put in place to reduce or curb situations that might arise to HAI. Analysis 2 Among all the involved hospital, apparently one hospital reported that they have no prevention and control nurse (IPM). However, all other remaining private and public hospitals reported that they have at least 0.70 whole time equivalent (WTE) IPCN for every 100 beds. It should be noted that IPCD are highly important personnel in hospitals (Toy, 2006; p. 265). These doctors are specialized in in training and responding to infections towards controlling and preventing such infections. Hence, these doctors are very vital towards preparing and responding for any HAI infections. Their lack in any health system would mean disaster for that hospital. The characteristic of wards was also vital for the study since it gives the visibility test of how likely the infection can spread or the room can remain intoxicated in case of bacterial outbreak. The nature of wards and the patients’ population in such wards is very important in planning or strategizing HAIs. Additionally, it is worth noting the HAIs are prone to certain group of patients (Wilson, and Salyers, 2011; p. 72); therefore, the patients must be distributed according to this classification that include age, sex, and susceptibility. At the wards, admitting consultant specialized must at all time slot patients wards according to the specification. Since at some cases, the practitioners in health care systems usually forget or ignore admission according to the above classifications thereby increasing the chances of patients acquiring infections on hospitalization. Therefore, there are need of thinking differently among the medical practitioners towards avoiding simple mistakes that often put the health life of patients in danger. Analysis 3 This analysis will concentrate on the actual data obtained from the research work. The results indicate that nearly half the sampled patients (46.0%) were taken through medical consultants and only slightly above one quarter the number (26.0%) were taken through surgical consultant. Consultant Specialty Patients N % Medical 4,157 46.0 Surgical 2,346 26.0 Obstetrics/ Gynecology 887 9.8 Paediatrics 642 7.1 Psychiatric 460 5.1 Care of the Elderly 76 4.2 Intensive Care (Neonatal) 120 1.3 Rehabilitation 17 0.2 Other Specialty 25 0.3 Total 9,030 100 Table 1: result from the case study (Republic of Ireland, 2012; p. 12) From the above statistics, it is apparent that most of the medical practitioners are taking their work granted or rather overlooking vital aspects of their work (Pozgar and Santucci, 2009; p. 77). Therefore, increase in cases of hospital acquired infection can be blamed mainly on the medical practitioners and the hospital administrations. It should be the routine responsibility of the hospital administration to be conducting survey into the patient’s medical records or just conducting surveys towards understanding the nature of services offered to patients (Delbeke and Israel, 2010; p. 284). In the same manner they should be looking into their staff’s records on patient, these modes of supervision will reveal such degree of negligence thereby working on ways of curbing the same before enormous medical problems are taken down to patients. SSM-A Purposeful Activity Model These are activities that can be effected by the SSM practitioners towards understanding what tools they must put in place towards understanding and analyzing situations that may help them correct the behaviors towards quality health care provision or towards reducing hospital acquired infections (Graves, Jarvis, and Halton, 2009’ p. 362). Some of the activities that the practitioners under the case study must incorporate include proper consultation of the patient at reception. For instance, the patients with problems may be prevented from acquiring infection by separating such patients in accordance with their susceptibility. Patients with urinary infection must trained on positive urination culture, this will protect them from acquiring other related bacteria from the environment (Wilcox, 2009; p. 416). Patients with respiratory infections must not be subjected to harsh condition and those that have symptoms including cough must controlled to hinder them spreading the same to other patient. In other words, practitioners must diagnose the patients with patience without making susceptible to acquiring other infections. After diagnosis, the patients must be grouped according to their medical conditions but without crowding them (Republic of Ireland, 2012; p. 15). From diagnosis, practitioners must identify patient with low immune system within the same group and boost the same so that they may not acquire other infections from the hospital environment. If these thinking different and breaking from bad medical practices, hospital acquired infections will remain threat to the medical care systems and patients. Fig. 2 SSM-A Purposeful Activity Model Positive and Negative Feedback Loops It should be noted that accepting implementing changes within any system is usually difficult since such changes usually find resistance within the system. Nonetheless, the HIAs usually contribute to poor quality of health care services; therefore, all programs that are geared towards their reduction or elimination must be implement despite the degree of resistance they often receive (Great Britain, 2005; p. 819). The positive ends of the loop are the achievements that will be arrived at when such initiated programs are implemented while the negative parts of the loops are the challenges that such programs will face for them to be rolled. Nonetheless, there are needs to concentrate on the positive sides of the program and limit the negativity they are likely to face. Worked Example It is worth noting that implementing “thinking differently” strategies within the health care system usually takes the normal mode of problem solving where the first step is accepting that there is a problem. After noting the existence of the problem, then there is need to bring stakeholders on board so they may help in drafting the possible solutions to the problem. After developing the right strategies, the same are implement and the outcome analyzed for achievements or failures. These problem solving steps can be applied in solving the problem that was under case study. In this case, there is need to accept that the negligence of medical practitioners increases the likelihood of patients contracting hospital acquired infections (Filetoth, 2002; p. 363). After accepting this fact, all the stakeholder are brought on board with the aim of understanding how the medical practitioners may be contributing to increased hospital acquired infections among patients. Following the analyzing the different ways, the affected hospital’s management drafts the possible solutions to the underlying problems. These solutions are then implemented and results examined for failures or success; otherwise, they are adopted towards improving health care services to patients. List of References BENNETT, J. V., JARVIS, W. R., & BRACHMAN, P. S. (2007). Bennett & Brachmans hospital infections. Philadelphia, Wolters Kluwer Health/Lippincott Williams & Wilkins. Case Studies of Lower Respiratory Tract Infections: CHALMERS, J. D., PLETZ, M. W., ALIBERTI, S., & WELTE, T. (2014). Community-acquired pneumonia. Sheffield, European Respiratory Society. DELBEKE, D., & ISRAEL, O. (2010). Hybrid PET/CT and SPECT/CT imaging: a teaching file. New York, Springer. DUCEL, G., FABRY, J., & NICOLLE, L. E. (2002). Prevention of hospital-acquired infections: a practical guide. Geneva, World Health Organization. File, T. M. (). Community-Acquired Pneumonia. 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Bacterial pathogenesis: a molecular approach. Washington, DC, ASM Press. Read More