For optimization of health outcomes, the home has been viewed as the most favorable setting for health care provision. Apart from being comparatively cheaper, studies point out that home care offers a platform for quality care and leads to a reduction in hospitalizations in cases of chronic conditions. Furthermore, many professional nurses have been proponents of home care as opposed to other institutions. The Chief Executive Officer of Visiting Nurses Association in Western Pennsylvania Kristy Wright argued that home care leads to a reduction in patient incidents and improves patient safety. In her very own words, “This has a lot to do with the patient being in control” (Jencks, Williams & Coleman, 2009).
Unlike years ago when home care involved simply talking to patients, taking their blood pressure, and bathing them, contemporary home care entails high-tech care offered by skilled professionals given to all patients including those in critical conditions. The importance of home care is further stressed in research that pointed out that 20% (approximately two point three million) of all patients who were discharged from hospital were later readmitted just after thirty days within one year. Thanks to poor follow-up, these returns to the hospital consumed a total of $17.4 billion from the Federal Reserve (Coleman & Williams, 2007).
Given the importance of home care both to the government and the citizens, there is a clear need for the promotion of the same. However, home care has been noted to have a share of its disadvantages. Medical errors are among the most prominent of these disadvantages. Hence, this paper seeks to point out how medical errors can be prevented in-home care and hence lead to improved health outcomes in-home care for diabetic patients.
The issue of medication errors in health care carries great weight given its heavy negative implications on the social and economic lives of Americans. A report by the Institute of Medicine written in 1999 showed that medication errors led to an annual economic burden of $17 billion in addition to 100,000 deaths and approximately a million injuries. In addition, 1.7 million infections were associated with health care providers each year.
This was coupled up with 99,000 deaths. Finally, the report pointed out that unintended drug overdose and mix-ups in drugs accounted for one point five million drug events each year. Given the shocking statistics above, there is a need for intervention. The social and economic burden associated with medication errors is inarguably gigantic (Jencks, Williams & Coleman, 2009).
To avoid the mentioned occurrences of medication errors in-home care for diabetic patients, one has to ask himself the very important question, what is the best way of tackling the issue of medication errors in-home care? If well answered, the above consequences associated with medication errors in patients will be a thing of the past. As a leader, one has the heaviest responsibility in fostering a home-based health care system with minimal medication errors.
As a senior, it is vital to ensure that your organization is founded on principles of safety in medical care provision. This can be fostered through active participation and engagement by the leader. The culture of safety should define the organization offering home-based care for diabetic patients. In addition, other elements of patient safety must be adhered to. As a leader, one must ensure that his staff members stick to the following principles (Watson, 2002).
General communication should form the basis of effective home-based health care for diabetic patients. General communication refers to both the communication between the patient and the care provider and the communication between the different members of the team that is offering the care. While every member can be good in his area of specialty, a lack of coordination between the health care providers can have detrimental effects. Studies point out that a well-designed transition between care providers can be vital in ensuring the safety of the patient. For instance, a study by Coleman and Williams (2007) showed that there were medical error occurrences in about 64% of older people who were receiving home-based care.
The errors were attributed to a lack of communication during the transition as most of them occurred within the first few weeks of discharge. This is a clear indication that the health care providers at the hospitals fail to communicate with those who are to take over at home after the discharge of the patient. There is, therefore, a need for teamwork and communication. Furthermore, the environment must be friendly and free from threats. There should also be the absence of intimidation and threats of retaliation. With this, the standard of performance will improve greatly.
The most important aspect of communication in avoidance of medication errors in home-based health care for diabetics is patient-centered care. As home service, health care providers, the patient, and his family members must be regarded highly. It should be noted that they are the main reason for the existence of the organization in the first place. Without them, the organization would be non-existent. As a result, a culture of compassionate health care must be designed and adhered to. Handling of patients must be done in a caring and understanding manner. Standardized values and norms must be designed to address the behavior and behavioral choices in given circumstances (Griffith, 2010).
Research and more research is another building stone towards safe home-based health care for diabetic patients. Care delivery that is focused on performance improvement and readiness to learn from previous mistakes offers another vital stepping stone towards a medical error-free home-based care provision for diabetic patients. Through prospective root cause analyses done on previous errors and instances of near misses, an organization can push for changes in certain approaches which tend to incline towards similar situations that led to a certain medical error or near miss. In addition, a research-based organization can easily identify errors and determine sustainable and most appropriate strategies to prevent the same.
Using research, a collaborative system of approach can be designed and assimilated within the organization to ensure safety for diabetic patients in home care services. To be precise, the whole responsibility of designing safety-oriented nursing processes and ensuring the sustainability of that culture is solely the responsibility of research (Watson, 2002).
As mentioned earlier, research leads to an improved process in care delivery. Coleman and Williams (2007) argue that the role of developing an improved process of care delivery is purely on the service providers. Through research, the providers have the responsibility of identifying the loopholes and areas of vulnerability and hence redefining and redesigning the processes through experience. To achieve the mentioned target, the providers have the requirement of redesigning the microsystem level before moving on other regions. This is to say, there is need to work with external regulations, accreditors, and legislations in advancing towards the ultimate goal of safety for diabetic patients within home care.
For the micro system approach, the organization will base its analyses on performance measurement. Using this, most departments and individuals will be held accountable for their actions. This can be achieved through provision and exposing of performance results to all stakeholders including patients and regulators. This will allow accountability on the side of regulating bodies while at the same time offering choices for payers and patients who will be free to choose the service that they prefer to buy by referring to the given unit’s performance level. Furthermore, the performance measurement is a vital tool for process redesign and improvement. Through performance measure, a leader will identify areas that need to be improved and those that need to be motivated to work even better (Griffith, 2010).
In conclusion, home based health care is one of the best forms of health care provision and hence needs to be promoted more and more. However, there are chances of medication errors associated with it. These errors consequently increase the weight of economic and social burden associated with health care service provision. However, it is evident that if well designed, home based health care can experience minimal medical errors.
This will be achieved through proper communication between the patient and the nurses, proper communication between the different departments providing health care, through research on the root cause analyses and how to avoid them and through improvement of process delivery. If all these are properly put into practice, there will be a drastic reduction in medication errors in diabetic patients undergoing home based care and hence reduction of deaths and economic burdens associated with the same.
Coleman, E.A., & Williams, M.V. (2007) Executing high-quality care transitions: a call to do it right. Journal of Hospital Medicine, 2(5), 287–290.
Griffith, S. (2010). Error Prevention in a Just Culture: System Design or Human Behavior. The Joint Commission Perspectives on Patient Safety, 10 (6).
Jencks, S.F., Williams, M.V., & Coleman, E.A. (2009) Rehospitalizations among patients in the Medicare fee-for-service program. New England Journal of Medicine,360, 1418-28.
Watson, D. (2002). First, do no harm. AORN Journal, 76, 752-755.