Discussion: Culture of Accountability HCA 675

Discussion: Culture of Accountability HCA 675

Discussion: Culture of Accountability HCA 675

What are the differences you see between a culture of accountability, where people are held accountable for the mistakes they make, and the Just Culture approach, where mistakes are not punished, but seen as methods of learning? What are the pros and cons of each?

The approach of Just Culture in an organization includes “Adopting one model of shared accountability, learning from mistakes vs. blaming individuals, managing behavioral choices (human error, at-risk behavior, reckless behavior), designing safety into all clinical systems and processes, Commitment of organization/leadership to shared goals” (Allyn, 2019, key components of just culture). With this type of culture there is an increase in the number of reporting issues which leads to increased safety, as one is not punished, but looked at as an opportunity for learning to occur (Allyn, 2019). This type of culture allows people to speak up without fear of being reprimanded. When people feel safe to report issues without being reprimanded, they tend not to cover up or hide details associated with error (Allyn, 2019). For some, learning and change may not occur without consequences.

We have adopted the just culture approach in my organization. Since the implementation of the just culture approach, we have seen a huge increase in reporting which has allowed us to provide further education or perhaps a change in the process. Prior to this is was an “us against them” mentality, staff against management, where people would not report, cover-up for other staff when issues occurred. However, this never allowed management to correct the issues through education and process changes. I will also add, it did take some time to make the transition, but as people in the organization began to see that issues brought up were looked at as an opportunity to improve versus punitive, reporting increased so that positive changes through education and process could be made.

The culture of accountability holds people accountable for their actions and mistakes. Culture of accountability can have a positive impact through the production of “organizational success, human fulfillment and the creation of real value” (Partners in Leadership, 2010). “When healthcare organizations hold themselves and their employees accountable, they can learn from mistakes and continuously improve operations. A culture of accountability in healthcare improves doctor-patient trust, reduces the misuse of resources, and helps organizations provide better quality care” (PowerDMS, 2018). However, with the culture of accountability people may not bring forth issues for fear of punishment or the punishment of a co-worker. When issues are not brought forth, they cannot be resolved. The fault may not lie on the person who is assumed to have made the mistake, it may be a process issue or a combination of events that lead to the issue/incident.

References

Allyn, J. (2019). Just culture: balancing accountability with quality and safety. Retrieved from https://www.rsna.org/en/news/2019/February/Just-Culture-Background

Partners in Leadership. (2010). A culture of accountability. Retrieved from https://www.partnersinleadership.com/insights-publications/a-culture-of-accountability/

PowerDMS. (2018). Creating a culture of accountability in healthcare. Retrieved from https://www.powerdms.com/blog/creating-culture-accountability-healthcare/

HCA 675 Grand Canyon Week 4 Discussion 2

What are the risks of revealing mistakes in an open culture, as a way of being transparent with patients and families? What are the risks of concealing mistakes and errors?

Re: Topic 4 DQ 2

A history of concern exists when revealing medical errors to patients related to liability, financial, and reputational. However, overall most agree that it is an ethical obligation to disclose medical errors to patients Moffatt-Bruce, Ferdinand & Fann, 2016). Financial and reputational concerns stem from the belief that if error is disclosed the public will become aware, ruining the reputation, then clinical volumes will decline negatively affecting the financial aspect. Hospital leaders worry that liability cost will rise due to error disclosure (Mofatt-Bruce, et al., 2016). Which I believe would be true if the disclosure is not handled in the appropriate manner.

Organizations that choose to reduce risk through addressing error in order to better systems can be challenging. People may continue to see these errors as individual failure instead of relating it to the system (Mofatt-Bruce, et al., 2016). This is where the importance of a just culture within the system proves beneficial. That the reporting of human error will not lead to consequences of punishment (Mofatt-Bruce, et al., 2016). This will lead to improvement in process creating a safer environment. “Organizations may benefit from involving patients and surgeons in a structured communication process around disclosure, thereby addressing their concerns in real time. Without these steps, transparency efforts and risk mitigation may backfire if clinicians avoid discussion for fear of feeling exposed or if patients and families become aggravated by a perceived lack of information exchange” (Mofatt-Bruce, et al., 2016, para.5). The disclosure of errors may “result in substantial reduction in medical malpractice lawsuits, lower litigation costs, and a more safety conscious environment” (Mofatt-Bruce, et al., 2016, para. 9). Through the communication-and-resolution program, health systems and liability insurers are supporting the disclosure of errors in order to proactively seek a resolution. During this transparency with the patient, an apology is provided and compensation if appropriate (Mofatt-Bruce, et al., 2016).

References

Moffatt-Bruce, S., Ferdinand, F. & Fann, J. (2016). Patient safety: disclosure of medical errors and risk mitigation. Retrieved from https://www.sts.org/sites/default/files/documents/patient_safety/DisclosureofMedicalErrors.pdf

HCA 675 Grand Canyon Week 4 Assignment

Process of Care Paper

Access the Hospital Compare website (.hospitalcompare.hhs.gov/”>www.Hospitalcompare.hhs.gov) and select a local hospital. Look at the hospital’s publically reported indicators for Process of Care.

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Write a paper of 1,000-1,200 words that analyzes how the selected hospital performs on these indicators versus two of its competitors. Include your thoughts on the pros and cons of publically reporting these data sets.

Refer to the website and incorporate specific examples and details into your paper.

Prepare this assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a grading rubric. Instructors will be using the rubric to grade the assignment; therefore, students should review the rubric prior to beginning the assignment to become familiar with the assignment criteria and expectations for successful completion of the assignment

You must proofread your paper. But do not strictly rely on your computer’s spell-checker and grammar-checker; failure to do so indicates a lack of effort on your part and you can expect your grade to suffer accordingly. Papers with numerous misspelled words and grammatical mistakes will be penalized. Read over your paper – in silence and then aloud – before handing it in and make corrections as necessary. Often it is advantageous to have a friend proofread your paper for obvious errors. Handwritten corrections are preferable to uncorrected mistakes.

Use a standard 10 to 12 point (10 to 12 characters per inch) typeface. Smaller or compressed type and papers with small margins or single-spacing are hard to read. It is better to let your essay run over the recommended number of pages than to try to compress it into fewer pages.

Likewise, large type, large margins, large indentations, triple-spacing, increased leading (space between lines), increased kerning (space between letters), and any other such attempts at “padding” to increase the length of a paper are unacceptable, wasteful of trees, and will not fool your professor.

The paper must be neatly formatted, double-spaced with a one-inch margin on the top, bottom, and sides of each page. When submitting hard copy, be sure to use white paper and print out using dark ink. If it is hard to read your essay, it will also be hard to follow your argument.