Healthcare patient safety measures and outcomes

Healthcare/Patient Safety
Question 1
At present, Langley Mason Health (LMH) is in the process of sourcing for funds to actualize the facilities master plan (FMP). The funds that have been sourced so far are insufficient. For this reason, and as has been pointed out in the case study, LMH is seeking to raise additional funds from “revenue bonds, growth strategies, philanthropic efforts, and strong operational performance over the next ten years.” This effectively leaves LMH with very little it can do in the medium-term because a significant portion of routine capital funds are also being diverted towards this same endeavor. Thus, the amount to be spent on not only equipment, but also technology acquisition and other routine maintenance concerns is very limited.
At present, there have been efforts to replace LMH aging pumps with a smart IV pump. There is sufficient evidence to suggest that such a pump would come in handy in seeking to minimize administration errors – and thus reduce patient harm. In that regard, a proposal has been floated to spend a total of $4.9 million towards this very endeavor during the next fiscal year. The problem is that as it has been pointed out in the case study, “this expenditure would consume roughly half of all the available capital dollars for that fiscal year.” Two of LMH’s top executives have opposing viewpoints on how to proceed given the concerns identified above. While one is convinced of the need to adopt a holistic perspective of the new technology implementation, and thus have it as part and parcel of the patent safety strategic plan, the other is of the opinion that an approach of this nature would be long-drawn. In the second executive’s opinion, the implementation of this technology ought to be undertaken immediately as its relevance towards the promotion of patient safety cannot be overstated.
Question 2
It is important to note that for the massive facilities expansion to proceed as planned, the hospital ought to raise a total of $1 billion. Given that only a total of $496 million was secured in general obligation bonds, the rest of the money – as it has been pointed out in the case study – has to be secured from other sources, i.e. enhanced operational performance, philanthropic efforts, growth strategies, as well as revenue bonds. This effectively means that LMH has to ‘up its game’ on the operational front in an attempt to not only enhance its bottom-line, but also delight and interest would-be funders. One way to do this would be by way of making improvements in the environment of care (i.e. via the enhancement of efficiency and patient safety) – which would most likely have a positive impact on patient satisfaction. For this reason, I’m persuaded to embrace Paul Robinson’s approach.
Paul Robinson is the director of pharmacy. In his opinion, “the smart IV pumps are critical to patient safety and that LMH doesn’t have time to go through a long, drawn-out planning process that could take years to implement and the process of gaining board support.” I am in agreement. Despite the fact that the available capital dollars to be expended in the purchase of a smart IV pump are minimal, LMH does not have to shelve continuous improvement efforts indefinitely or until such a time whereby the huge capital outlay for the new facilities will be offset. Replacing the health system’s pump would have an ongoing effect on the further enhancement of patient safety and, thus the promotion of patient outcomes. It is the improved patient outcomes that would most likely positively impact LMH’s operational performance as well as growth strategies even as it seeks to bring on board a sponsor as part of its efforts to address the funds gap. This is more so the case given that “smart pumps have been shown to significantly reduce medication administration errors, thus reducing patient harm.”
It should, however, be noted that spending on a smart IV pump would effectively ‘eat’ into the routine capital set aside in the next fiscal year to aid in efforts aimed at offsetting the significant capital outlay. This is more so the case given that as it has been pointed out in the case study, expenditures associated with the purchase of a smart IV pump would effectively use up 50% of the routine capital set aside. What this means is that LMH’s FMP risks being derailed. However, this is a concern that could be effectively addressed by seeing to it that spending in the other LMH facilities is minimized so as to skim off the relevant amount from the $10 million of routine capital funds that remains after the diversion of the $5 million to offset the capital outlay for the relevant FMP undertaking.
It is also important to note that Marilyn Chen’s approach also has some pros. Chen is the CIO. This is more so the case given that her proposal is largely all-inclusive and seeks to ensure that the issue of patient safety is approached holistically. This is an approach that deems the purchase of a smart IV pump as part and parcel of the larger patient safety strategic plan that should be managed just as other strategic change effort are managed, i.e. via an assessment of the readiness of the organization to embrace desired changes. If implemented, her approach is likely to encounter fewer barriers to change. Further, thanks to the holistic approach, her approach is also likely to seamlessly integrate with other technologies implemented at the facility going forward.
It should, however, be noted that at present, LMH may not have funds at its disposal to implement all of the suggested technologies. This effectively means that despite having “been shown to significantly reduce administration errors, thus reducing patient harm”, the implementation of a smart IV pump would have to wait for an indefinite period of time. During this time, LMH would have to function with the aging pumps. It is important to note that “not only does patient harm impose significant burden on patients and their loved ones, it also generates a considerable strain on health system finances” (Spath, 2011, p. 14). According to the authors, this is more so the case given that when adverse effects are encountered, healthcare institutions often have to expend significant resources in not only the ensuing treatment efforts, but also in other mitigation efforts to minimize the impact of the harm occasioned. Efforts to minimize patient harm should therefore be prioritized. This is more so the case at this moment whereby LMH is seeking to actualize the FMP.
Question 3
Mediating for a consensus in this case is not likely to be an easy undertaking. This is more so the case given the nature of the proposals made and the prevailing circumstances. With this in mind, therefore, I would first seek to ensure that the opposing parties familiarize themselves with the basic concepts of each other’s proposals/suggestions. This would come in handy in seeking to promote understanding of the unique aspects of each other’s point of view. Next, I would ensure that the strengths as well as weaknesses of each approach are identified and discussed comprehensively. This would be followed by a merger of the alternatives that the two executives formulate if they do not reach a consensus.







References
Spath, P. (2011). Error Reduction in Health Care: A Systems Approach to Improving Patient Safety (2nd ed.). Hoboken, NJ: John Wiley & Sons.