The System Engineering Initiative for Patient Safety model (SEIPS) is a tool that applies the systems engineering, human aspects engineering, and quality approaches for engineering in the healthcare environment. The model mainly focuses on the work system's interactions that involve people, organization, tools, environment, technology, and roles. It enables the understanding of elements that jeopardize safety, including errors and recommendations on the ways organizations can reduce the risks to enhance quality. This paper focuses on describing the errors likely to occur in a healthcare environment, the SEIPS tool's framework, the importance of the SEIPS tool, and the relationship between CQI and SEIPS in producing quality outcomes.
Types of Errors Likely to Occur in a Healthcare Environment
There are surgical errors that have been shown to occur at a high rate. Research shows 4,000 surgical errors in the US annually (Rodziewicz & Hipskind, 2020). The primary sources of errors include operating on an incorrect body part and robotic surgery, which causes accidental hemorrhage. The causes include communication gaps in the people involved, human factors, rush, and incompetent systems. Additionally, there are diagnostic errors that account for around 40,000 deaths and injuries. The solo practice mainly causes it. There are devices and equipment errors due to poor design, low maintenance, and inadequate standardization.
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Moreover, there are medication errors that are caused by the wrong medication or deterioration of medication. The information technology errors lead to placing the wrong information on patients (Rodziewicz & Hipskind, 2020). Others are communication errors, which are classified as verbal and non-verbal. There are errors involving tubing and catheter connections. When the misconnections are not corrected early, they may lead to deaths and other adverse events.
Prevention of Errors in the Health Care Environment Diagnostic
The errors are preventable. Preventing surgical errors requires the adoption of the checklists of the activities to be conducted before the induction of the anesthesia. There should also be another identification of the patient and procedure (Rodziewicz & Hipskind, 2020). Additionally, after completing the surgery, healthcare professionals should conclude the instruments and the patients' status. The diagnostic errors should be prevented by enhancing the knowledge of the most misdiagnosed conditions while taking precautions to confirm a diagnosis. In avoiding device and equipment error, healthcare professionals should be involved in setting and assessing the policies regarding technology. They should also ensure the technology meets the set quality and safety standards. There should be policies to ensure maintenance, training and monitoring of the devices and equipment.
Medication errors are prevented using the systems such as electronic medical records, standardization of unit measures and calculation of the accurate dose. There should be a review of medication and dosage before the prescription. Information technology errors are avoided by providing up to date information regarding drugs, providing drugs’ information, and computerizing order entry (Rodziewicz & Hipskind, 2020). Communication Errors are preventable by avoiding abbreviations and following protocols that guide care and communication. Tubing and catheter insertion errors are inhibited by providing proper education to the nursing staff involved in the insertion. They should also trace lines to the origin before connection.
SEIPS Tool Framework and its Use within the Health Care Environment
The SEIPS tool framework is based on the factors affecting the safety of a medication. The approach assesses the work system concepts relating to its components: technology, tasks, people, physical and external environment, and data to guide data gathering (Wooldridge et al., 2017). It describes the interactions between its components and various system levels. The person component involves the individuals at the core of the system who include patients, nurses, physicians, or the healthcare team. The organization component includes rules, procedures, and culture. Besides, the technology involves tools such as health information technology while the physical environment includes layout and workstation design. Tasks are goal-oriented activities, while the external environment includes legislation and standards.
The tool is based on the structure-process-outcome model. The structure includes all the components. The process is entrenched in the work system, with each step having a task that involves people utilizing tools and technologies in an environment inside the organization (Wooldridge et al., 2017). The outcomes comprise of the patient outcomes as well as quality care and patients safety. Besides, there are organizational outcomes, including satisfaction and stress. The feedback is the loop between the system's processes and outcomes involved in quality improvement and learning.
The SEIPS tool is used to enhance patient safety through a focus on the design of work systems. It also guides in analyzing hazards and guiding the system design. Besides, the tool helps guide the investigations for patients and employee injuries (Wooldridge et al., 2017). It also provides a framework for patient safety researchers to establish research questions and comprehend the variables for measuring a study that aims to improve patient safety.
Another error reduction strategy is the Reason model. The model is different from SEIPS in that SEIPS focuses on the system's design, while the Reason model focuses on the occurrence of accidents (Wooldridge et al., 2017). The reason model is used for describing the contributing factors while SEIPS focuses on the processes, structure, system and interactions among the components. The Reason model is mostly used to reduce accidental errors while the SEIPS model reduces the errors related to the design of work.
Positive Effect of the SEIPS Tool in Reduction of Errors
The SEIPS tool helps in the identification of the system factors that contribute to medication errors. It also provides information that the researchers and the system designers may use to develop recommendations for improving healthcare processes and quality (Wooldridge et al., 2017). It helps in the identification of the design deficiencies. It further helps in the identification of the health hazards related to surgery. Besides, the model is significant in improving patient safety and communication that ensures minimal errors and excellent flow of the processes.
Relationship between CQI and SEIPS in Producing Quality Outcomes
The Continuous Quality Improvement (CQI) involves an organizational process that includes people planning and executing a continuous improvement in providing quality healthcare. The key elements include implementation in a healthcare facility, collection of qualitative and quantitative data on the impact of an intervention, health outcomes, and an aim to change how healthcare is delivered (Wooldridge et al., 2017) . Both CQI and SEIPS relate to each other as they aim at improving the quality of care. CQI monitors the quality of care while comparing the outcomes in different centers. SEIPS identifies the factors that contribute to errors leading to improved quality care. They both aim at eliminating the errors that may occur in the healthcare environment. They also provide new knowledge regarding the process outcomes.
Impact of Patient-Centric Focus
A patient-centric focus involves an approach where the healthcare systems establish a relationship with the patients, their families and the practitioners to ensure the decisions align with the patient's wants, needs, and preferences. The impact includes improved treatment adherence and positive health outcomes (Lamberti & Awatin, 2017) . Adherence to treatment leads to a positive outcome while eliminating the level of illness and the worsening of the long term effects. Additionally, it leads to increased job satisfaction among the practitioners due to the positive outcomes. The built relationship between the nursing staff and patients helps create a good relationship between them, positive results. It also leads to enhanced knowledge among the patients regarding their health and well-being, leading to better care after discharge. It increases the patients’ quality of life as it focuses on the patient.
Conclusion
The errors that occur in the healthcare facility include medical, surgical, tubing misconnections, equipment and device errors. The SEIPS model helps in reducing the errors by involving components that include technology, tasks, person, physical, and external environment. Other models for reducing errors include the Reason model. The patient-centric focus enhances quality care by focusing on the preferences of the patient. It leads to a good relationship between the practitioners and the patients while enhancing treatment adherence.
References
Lamberti, M. J., & Awatin, J. (2017). Mapping the landscape of patient-centric activities within clinical research. Clinical Therapeutics , 39 (11), 2196-2202. https://doi.org/10.1016/j.clinthera.2017.09.010
Rodziewicz, T. L., & Hipskind, J. E. (2020). Medical error prevention. In StatPearls [Internet] . StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK499956/
Wooldridge, A. R., Carayon, P., Hundt, A. S., & Hoonakker, P. L. (2017). SEIPS-based process modeling in primary care. Applied Ergonomics , 60 , 240-254. https://doi.org/10.1016/j.apergo.2016.11.010
