Medical errors are public health concerns that are very challenging as uncovering a consistent cause to develop a plan that minimizes the reoccurrence of the problem is very difficult (Rodziewicz & Hipskind, 2020). Establishing a culture that works towards safety in the healthcare organization is necessary. This essay describes types of errors, the SEIPS model, and compares it to Donabedian’s model. It also describes the relationship between CQI and SEIPS in ensuring quality in healthcare institutions.
Errors
Surgical
The surgical errors occur in the operating rooms with many happening after and before the surgical procedures. Around 4000 surgical errors occur every year in America (Rodziecz & Hipskind, 2020). Surgical errors such as wrong-site surgery can result from the communication gap between the patient and surgeons, lack of standardized rules, and other human factors. To enhance patient safety and prevent the surgical errors adoption of a checklist highlighting all the activities, confirmation of the patient’s identity, the procedure type, surgery site is necessary.
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Diagnostic
Inaccurate diagnosis occurs with radiologists, clinicians, and the pathologists with most cases arising from solo practices due to colleagues' cross-reference incapability and large workloads (Rodziecz & Hipskind, 2020). In the primary care settings, the common diagnostic errors are follow-up failures, failure in ordering appropriate tests, and interpretation fault (Rodziecz & Hipskind, 2020). Prevention of the diagnostic errors is achievable by the creation of awareness of the common misdiagnosis, thus the need for extra precautions in confirming the diagnosis.
Medication
Medication errors result from any medication misuse that is associated with packaging, monitoring, and any healthcare-related products (Rodziecz & Hipskind, 2020). The medication errors occur when there is a failure in storages of the medications, and mixing various medications. Unintentional children overdose is a sample of medication error (Rodziecz & Hipskind, 2020). To reduce medical errors, hospitals can adopt the standardized units of measurements, use electronic medical records, ensuring the pharmacist availability to facilitate the calculation of the right dosage and avoidance of units of measure confusion.
Tubing misconnection
In healthcare institutions, errors from catheter and tube connections are a common occurrence. Misconnections result from accidental or deliberate catheter application for unintended purposes including the use of the IV extension tubing for drains (Rodziecz & Hipskind, 2020). Education of the clinicians and the support staff is the main technique of preventing the tubing errors, as it involves the creation of awareness of the serious injuries that are likely to develop from incorrect placement of the various tubes (Rodziecz & Hipskind, 2020.
Equipment and device errors
They are mistakes that occur due to mishandling, flaws, malfunction, and user-error problems in the medical equipment. The device-related errors are intensified by inadequate maintenance, and poor technology design (Rodziecz & Hipskind, 2020). Medical equipment errors include the malfunction of the pacemakers and shunts implanted in a patient that result in life-threatening events. In preventing the medical equipment errors, healthcare professionals ought to confirm whether the devices are well maintained and carry-out the proactive risk assessments (Rodziecz & Hipskind 2020).
Communication
Ineffective communication processes result in medical errors. Verbal errors are common due to hierarchy issues, disruptive behaviors, and environmental noise (Rodziecz & Hipskind, 2020). Therefore, developing the joint educational programs in which support staff and help providers develop relations as well as learning their roles to improve safety can help prevent the occurrences of communication errors.
Information technology error
The electronic health records are associated with errors such as the accidental charting information to the wrong clients. The electronic record tends to limit the clinician's efficiency through the creation of constant distractions in the implementation, transition, and mature phase in medical practices (Rodziecz & Hipskind, 2020). For example, in the mature phase Intranet failures interferes with the documentation processes. Therefore, computerizing decision support, order entry, prompt warnings for any allergy, provision of information that is drug-specific can help prevents the information technology errors.
SEIPS model
The SEIPS model is based on the subspecialty of human factors, which focus on human's interactions with their environment contributing to performance, working life quality, health and safety, and the produced goods or services (Carayon et al., 2006). The SEIPS model of work system comprises a person, physical environment, tasks, organizational conditions, tools, and technologies (Carayon et al., 2006). A person in the work system model can be a care provider, or a unit clerk employing various technologies, and tools to perform certain tasks in a physical environment guided by organizational conditions (Carayon et al., 2006). In a healthcare organization, the work system model affects clinical processes and work, thus the outcomes. The work system model allows the identification of the points in a healthcare system requiring interventions or improvements.
Donabedian SPO (structure-process-outcome) is a traditional quality assurance technique, which assesses clinical procedures and care outcomes. It connects the healthcare structure and care processes to the subsequent client results (Carayon et al., 2006). The SEIPS model is more developed elaborating how the design of the work system is connected to the safety of the patients through the various care procedures. Donabedian model focuses on the healthcare providers as a measure of quality (Carayon et al., 2006). In contrast, the SEIPS model focuses more on the structural aspect in which it addresses elements such as organizational climate and culture, physical environment, work design, and error reporting (Carayon et al., 2006).
The Donabedian model is applicable in the assessment of a healthcare provider’s working towards healthcare safety while the SEIPS model evaluates the effectiveness of the whole structure in ensuring patient’s safety. SEIPS tool in a high-risk healthcare setting informs the intervention researchers on the most effective approach to the problem that is considerate to all factors in the hospital as well as in the identification of the potential predictors (Carayon et al., 2006). Nonetheless, the model guides the success measuring process by pointing to the areas that require change, thus an indication of failure or success.
SEIPS model borrows from the processes and philosophies of continuous quality improvement (CQI) especially, the broad-based approaches (McCalman, Bailie, Bainbridge, McPhail-Bell, Percival, Askew, Fagan & Tsey, 2018). It employs the techniques as guidance in which they apply their specific change method. For example, the SEIPS model adopts the quality improvement collaborative as a framework in which various improvement techniques are based on measuring and initiating further strategies to ensure quality care in the hospital setting (McCalman et al., 2018). The patient-centric focus helps to attain the optimum benefits across the system in which comprehensive services in primary healthcare are enabled through the integration of the community members and governments while linking with other sectors. Therefore, most medical errors are preventable by modifying the healthcare system.
References
Carayon, P., Hundt, A. S., Karsh, B. T., Gurses, A. P., Alvarado, C. J., Smith, M., & Brennan, P. F. (2006). Work system design for patient safety: the SEIPS model. BMJ Quality & Safety , 15 (suppl 1), i50-i58.
McCalman, J., Bailie, R., Bainbridge, R., McPhail-Bell, K., Percival, N., Askew, D., ... & Tsey, K. (2018). Continuous quality improvement and comprehensive primary health care: a systems framework to improve service quality and health outcomes. Frontiers in public health , 6 , 76.
Rodziewicz, T. L., & Hipskind, J. E. (2020). Medical error prevention. In StatPearls [Internet] . StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK499956/
