Health Care in The Wall of Silence

Question 1 

Gibson & Singh (2003) provide a case of Elizabeth, who is an eight-year-old wise beyond her years, that complained about her kidney cancer recurring. However, regardless of the complaints by the young girl, the doctor downplayed and even went ahead to cancer, an MRI arguing that the claim by the girl was purely psychological. Gibson & Singh (2003) indicate, in their analysis of the case that, "But the little girl's doctors dismissed her complaints as psychological, stemming from her fear of cancer recurring" (p.22). The doctors refused to give Elizabeth treatment on the basis that her cancer was not recurring. After some time, it was confirmed that indeed, her cancer had spread to her spine and brain. Even though chemotherapy and stem cell transplant was able to save her life, she remained paralyzed from the waist down.

The underlying cause of the medical error was the fact that the doctors failed to administer treatment even though the patient was complaining of excruciating pain. Schumann (2017) indicates that quality initiative taken to prevent such medical errors ensures that health professionals receive all information given by the patient seriously and undertake relevant tests to determine the validity of the information provided. In this initiative, it is expected that health professionals would listen to their patients concerning the information that they present without due discrimination. The fact that the Elizabeth's doctors discriminated against her because of her age led to her symptoms being ignored with the doctors believing that she was manipulative. The outcome of the case was that she experienced severe consequences from her cancer spreading to different parts of the body.

Question 3 

It is a common occurrence to encounter instances where nurses fail to report errors due to a negative culture created within the health institutions that do not build on the need for safety. The potential consequence of not reporting such errors is that they end up having severe impacts on the safety of the patient's health, as can be seen from the case of Elizabeth. In cases where facilities are facing nursing shortages, the outcome is that the few nurses available find it hard or challenging to provide quality care at all times. The impact that this has on the safety of the patient is that it increases the chances of being exposed to severe health risks. The importance of quality improvement works towards enhancing the health care environment with the focus being towards ensuring that the health facilities provide patient-centred care.

Question 5 

The 'culture of cover up’ refers to a culture where health professionals seek to hide information relating to a medical error that may have occurred in the health setting to minimize their risk of legal exposure (Wager, Lee, & Glaser, 2017). Gibson & Singh (2003) reflect on the fact that the culture of cover-up often manifests itself at the patient's bedside immediately after a mistake has occurred. The consequence associated with this culture on patients, families and the public is that it leads to an instance where information relating to the occurrence of a medical error is distorted. In such cases, the patient may find it hard in seeking treatment to help in reversing the mistake due to the lack of such information. For the health care facilities, the culture exposes them to severe risks of legal lawsuits in cases where the cover-ups are discovered.

Question 6 

Health care consumers can use local government health agencies to gather information on the providers and facilities. Local health agencies have a crucial role in ensuring that they store all relevant details touching on investigations that may have been conducted concerning reports on medical errors focusing on specific providers or facilities. Through the government agencies, patients would get a clear picture of whether the providers or facilities have been involved in medical errors and the rate at which these errors are occurring. In the event that a specific health provider or facility has had a significant number of complaints touching on medical mistakes, that would serve as a clear indication of the fact that indeed patients face a high risk when seeking services from the provider.

Question 7 

The main benefit of a voluntary reporting system for internal use is that it will help create the need for employees to report any possible errors without running the risk of being identified. Gibson & Singh (2003) indicate that "With no names attached, employees would be afraid of reprisal if they report a mistake or a near miss" (p.164). That means that employees will always be willing to share such information to help improve quality outcomes. The information and data collected can be utilized for quality improvement by seeking to identify some of the critical areas where errors are most likely to occur. The expectation is that this will help in the adoption of effective mitigation measures that would help in minimizing some of these risks while seeking to improve on the quality of care being provided.

Question 8 

The need for health care providers to use information and technology is driven by the need for having to improve on quality while seeking to minimize possible errors. Mackert, Mabry-Flynn, Champlin, Donovan, & Pounders (2016) take note of the fact that the adoption of information technology as part of the health care industry helps in ensuring that all health professionals have access to patient data in a manner that is effective. That means that the health professionals will find themselves in a much better position through which to provide the expected quality of care while using the information. Information technology has helped in information sharing; thus, making it much easier to minimize the possibility of medical errors. The use of data and technology allows for communication of patient data rapidly and legibly while ensuring that the different health professionals can retrieve such data. The outcome is that this allows for an improvement in the general quality of care; thus, reducing patient risks.

Question 9 

Gibson & Singh (2003) engage their readers in trying to understand how the health care and aviation industry can be considered as being similar or different, primarily focusing on areas of safety and quality. An analysis of the two sectors indicates that they are seen as being related, taking into account the safety expectations that are to be put in place. Any negation from the safety expectation is likely to have severe implications for a significant number of people. Gibson & Singh (2003) highlight the need for health facilities to embrace the approach that has been taken by the FAA in which it engages in the process of continuous improvement while seeking to deal with any mistakes or near misses that are reported. A significant difference that has been noted that is the aviation industry has taken higher precautions in seeking to track aeroplane crash fatalities while making the information public. However, the health care industry faces a key challenge in attempting to present information on medical errors attributed to the culture of cover-up within the industry.

References

Gibson, R., & Singh, J. P. (2003).  Wall of silence: the untold story of the medical mistakes that kill and injure millions of Americans . Regnery Publishing.

Mackert, M., Mabry-Flynn, A., Champlin, S., Donovan, E. E., & Pounders, K. (2016). Health literacy and health information technology adoption: the potential for a new digital divide.  Journal of medical Internet research ,  18 (10), e264.

Schumann, M. J. (2017). Policy implications are driving national quality and safety initiatives. Quality and safety in nursing: A competency approach to improving outcomes , 21-42.

Wager, K. A., Lee, F. W., & Glaser, J. P. (2017).  Health care information systems: a practical approach for health care management . John Wiley & Sons.