Selection of a Patient Safety Strategy
Synopsis
Langley Manson Health (LMH) is situated in North Reno County in the state of Nevada. In order to cater for the growing population of North Reno County and to meet the state mandated seismic requirements for 2013, LMH developed a facilities master plan (FMP) that incorporates plans to build a modern replacement hospital for its Langley Medical Center campus and build satellite clinics in four of its communities. The estimated cost for implementing the FMP is $1 billon. Due to limited funds, LMH has only $10 million to spend yearly on routine maintenance, equipment and technology for all its facilities. LMH is committed to patient safety but the limited capital available to spend poses a challenge to this commitment. In 2005, LMH implemented phase one of the information system (an enterprise wide system) at a cost of $20 million. The second phase of the project is to implement a computerized provider order entry (CPOE). This phase has been delayed since phase one is yet to be stabilized and optimized. LMH pharmacy and nursing staff have submitted a proposal to purchase smart IV pumps to replace the old pumps. This expenditure for this project would use up to half of the available capital funds for the fiscal year beginning July 2009.The chief information officer believes that the implementation of the smart pumps should be seen as one component of an overall medication management capital purchase and patient safety strategic plan. On the other hand, the director of pharmacy feels that smart IV pumps are vital to patient safety and are much simpler to implement. Still, others are of the view that no new projects should be considered until CPOE is fully implemented.
Question 1
One of the major issues is limited funds to fund the information system. With only $10 million to spend yearly on routine maintenance, equipment and technology for all its facilities, LMH does not have much to spend on information system. Consequently, LMH cannot fully deliver on its commitment of patient safety.
Secondly, phase one of the information system has not been fully stabilized and optimized, and there has been delayed implementation of the second phase of a computerized provider order entry (CPOE).
Thirdly, the difference in priorities of the various stakeholders is also a major issue. While the chief information officer is of the view that the smart IV pumps should not be implemented in isolation. She believes that smart IV pumps are just one component of an overall medication management capital purchase and patient safety strategic plan. On the other hand, the director of pharmacy feels that smart IV pumps are crucial to patient safety and that LMH does not have time to go through the long and demanding planning process. Other stakeholders are of the view that all new proposals should be placed on hold until CPOE is fully functional.
Question 2
The advantage of Marilyn’s approach is that the final system is likely to deliver more functionalities and medication safety on more levels. Although her approach will have an initially high implementation cost, it is likely to be less costly in the long run. The disadvantage of implementing an overall management system is that it will be time consuming and the process of approval may also be tasking. This approach will also be extremely costly and given the current limitation of funds at LMH, the implementation of an overall system is likely to have many hiccups and drain the organization of the already limited resources.
Paul’s approach will be easy t implement as it will require very little time and effort to plan, develop and execute. Implementing smart IV pumps in isolation will also be less costly. This will be an advantage given the limited resources that LMH currently has. Consequently, LMH’s resources will not be over-stretched. Additionally, the pharmacy and nursing staff will be able to quickly realize the benefits of the smart IV pumps such as reduced medication administration errors. Patients will also benefit from the implantation of this technology as they will be less likely to suffer the consequences of wrongly administered medication. Although this approach will be less costly to implement, it will be more expensive for LMH in the long run. Additionally, the benefits of implementing smart IV pumps will not be as far reaching as those of implementing an overall system.
In my opinion, none of the above approaches is feasible. As rightly observed by others, LMH has many pressing issues at hand. Hence, these proposals should be put on hold first, as LMH attempts to solve the current problems. Until phase one of the information system is fully stabilized and optimized, and phase two is successfully implemented, it is not feasible to implement a new system. Otherwise, LMH will have a bunch of half-baked solutions which do not fully deliver the required functionalities. Additionally, the organization has limited resources which should be carefully utilized. In this regard, LMH should use the available resources to complete phase one and two of the information system. After completion of these two phases, expected benefits, such as strong operational performance, is likely to result in additional revenue for LMH. Consequently, the new proposals can be successfully implemented in future. Basically, LMH should focus on one project at a time and be committed to bringing every project to completion before moving on to another.
Question 3
If I were to mediate a discussion, I would first ask each participant give his or her perspective of the issue at hand. I would then facilitate an open and honest discussion and let the participants discuss the advantages and disadvantages of each proposal while bearing in mind the current situation at LMH. I would ask the participants to critically analyze short term as well as long term benefits of each proposed solution, keeping in mind that patient safety is one of LMH’s main objectives. I would then ask the participants to agree on the best way to proceed basing their choice on the strengths of the proposed solutions.
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Pardy, W., & Andrews, T. (2009). Integrated Management Systems: Leading Strategies and Solutions. Maryland, USA: Government Institutes.
Rees, P. (2010). Focus and Importance. Retrieved May 12, 2012, from Project Management guide: www.projectmanagementguide.org/project-management/focus-and-importance
Wager, K. A., Lee, F. W., & Glaser, J. P. (2009). Health Care Information Systems: A Practical Approach for Health Care Management (2 ed.). London, USA: John Wiley & Sons.
