Abstract
This paper discusses how collaboration among various players in a health care delivery process can be promoted. It initially emphasizes on the manner in which various tasks in health care delivery are interconnected. Approaches that a health care administrator can apply to foster collaboration among clinicians are discussed. Collaboration is depicted as an important way to minimize human error in order to promote patient safety while also reducing organizational risks. The paper also discusses how physician leadership can encourage initiatives to promote reduction of organizational risks and patient safety.
Delivery of health care services in the current world is shifting towards a more integrated process. Different personnel, with different levels of education and experience, take part in this system. It is nearly usual that every patient admitted into inpatient care is managed by different health practitioners: nurse, doctor, physician, nutritionist, and other health care personnel. A health care delivery process comprises of steps, each of which consists of various tasks performed by different personnel. These steps are interconnected and geared towards a common ultimate goal: achieving intended patient outcome.
Achieving intended patient outcome may not be possible at times. This is mainly attributed to occurrence of human error anywhere along the chain of service delivery. In an effort to avert these errors or reduce the gravity of their effects on potential victims, two approaches are commonly used: person approach and system approach (Reason, 2000). Whereas person approach focuses on unsafe acts of people at the sharp ends, system approach mainly emphasizes on reducing possibilities of systems failures. Consequently, system approach is more suitable in medicine fraternity. The approach is linked to Swiss cheese theory of systems accidents.
Swiss cheese theory is a model proposed by James Reason to explain how system failures occur. According to Reason, an ideal system can be compared to a stack of slices of Swiss cheese (Reason, 2000). Each slice represents a barrier or defense against potential error. On each slice, there are holes that represent opportunities for system failure. If some holes on the layers overlap such that a straight line can be drawn through them, then the system is prone to failure since a potential hazard can pass through the holes all the way to a potential victim. In order to reduce occurrence of human error, these holes should be sealed and more barriers added to the system. This is the main aim of all approaches aimed at reducing human errors.
We have seen that delivery of health care services is a process that involves different players who take part in different interconnected roles. The roles represent steps of health care delivery system. We have also seen that an error can occur at any step. Therefore, the players in the system should collaborate and communicate effectively to minimize human error and enhance desirable patient outcome and safety. In other words, collaboration amongst clinical professionals is imperative to promoting patient safety and reducing organizational risks. The role of fostering this inter-professional collaboration is largely played by an administrator. Even though many challenges are involved, there are many approaches an administrator can apply to foster an environment that promotes collaboration.
First, lack of trust and preference of autonomy among clinical professionals hinder collaboration to a great extent. It is crucial to promote awareness of interdependence among clinicians. This would promote a sense of belonging, trust, and knowledge of each other’s qualifications and values. To accomplish this, strategies such as conducting joint training of the clinicians and formation of working committees whose members belong to different departments should be considered. A health care administrator can make slight changes on organization policies to cater for these initiatives. According to D'Amou et al’s dimensions of analyzing level of collaboration, these strategies fall under the dimension of internalization (D'Amou et al, 2008).
Another initiative crucial in promoting inter-professional collaboration is effective governance. In order for clinicians drawn from different departments to collaborate effectively, it is important to establish a central authority responsible for coordinating their activities. This can be done by creating a committee of clinicians and charging it with the responsibility of planning implementation of activities aimed at promoting collaboration.
It is also important to synchronize goals of different clinicians to come up with a common goal. This can be accomplished by developing a joint project (D'Amou et al, 2008). Through a common goal, clinicians can develop culture of consultation and can become more mindful to the need for collaboration. It is the work of an administrator to coordinate discussions among the clinicians hence creating an environment for formulating a common goal.
Finally, another approach for enhancing collaboration is formalization of how clinicians should operate in association with one another. In this case, a health care administrator can facilitate drawing of a joint agreement on procedures and responsibilities of all partners. This provides a framework for collaborative approach in patient management. The approach also provides procedures to be followed by all partners in case of a conflict.
Apart from facilitating collaboration among clinicians, other initiatives can also help prevent organizational risks and promote patient safety. First, it is important to encourage physician leadership to conduct assessment of current systems in place for patient safety and risk reduction. Consequently, the leadership would be able to identify personnel responsible for functions aimed at promoting quality and patient safety and the perception of these functions among people in the organization, and identify areas in need of improvement (ECRI, 2009).
Secondly, data collected from each function along the chain of health care service delivery should be identified. This data can serve as a tool for identifying how information flow enhances risk reduction and patient safety (ECRI, 2009).
Another encouraged initiative would be creating an organizational culture that makes it easy for staff to report any flaw detected in the system, or mistake made by any personnel. This can be partly achieved through promoting confidentiality, and removing unnecessary bureaucracy and punitive measures. Physician leadership is most suited to implement this initiative. This is mainly due to the fact that leadership makes important decisions on setting procedures for service delivery and supervision.
Collaboration among clinicians and physician leadership involvement are indispensable to quality delivery in health care system. While collaboration facilitates flow of information, and thus smooth transition of tasks from one step to another, leadership implements policies that provide environment for undertaking these tasks. The two elements help minimize chances of contact between a potential hazard and potential victim in a health care system in a sustainable manner. In conclusion, collaboration among professional clinicians and encouragement of physician leadership are imperative to reducing organizational risks and enhancing patient safety.
References
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D'Amour, D., Goulet, L., Labadie, J. F., Martín-Rodriguez, L. S., & Pineault, R. (January 01, 2008). A model and typology of collaboration between professionals in healthcare organizations. Bmc Health Services Research, 8.
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Reason, J. (March 18, 2000). Human Error: Models and Management. Bmj: British Medical Journal, 320, 7237, 768-770.
Royeen, C. B., Jensen, G. M., & Harvan, R. A. (2009). Leadership in interprofessional health education and practice. Sudbury, Mass: Jones and Bartlett Publishers.
