With the current attention being paid on the healthcare industry, healthcare practices and concerns have taken center stage – particularly on matters such as accessibility, cost, and quality. Unquestionably, quality is one of the concerns that has constantly generated discussion all due to the fact that at the current cost of American health care – and despite its access to the best technologies – the system is defined by its lack of quality services.
This lack of quality has generated tremendous liabilities in terms of patient safety, and thus has become a pressing concern. The Agency for Healthcare Research and Quality [AHRQ] (2001) define patient safety practice as “a type of process or structure whose application reduces the probability of adverse events resulting from exposure to the health care system across a range of diseases and procedures.
” From this definition, it can be interpolated that patient safety can then be defined as the absence of adverse events in relation to or as a result of exposure to medical/clinical exposure secondary to a disease or procedure. In the current environment, patient safety is compromised in various ways but is commonly achieved primarily through medical errors. “Medical errors can be defined as the failure of a planned action to be completed as intended or the use of a wrong plan to achieve an aim” (Institute of Medicine, 1999, p.
1). There are many reasons found to cause medical errors. One is that the healthcare system encourages over-consumption and this unregulated practice openly brings patients in harms way by increasing the amount of exposure to the system and thus the likelihood of an anomaly happening or availing unnecessary procedure increases also and thus endangers the patient. A second reason is the problem of fragmented and decentralized system which is a problem on essential information dissemination.
A third reason is “most third-party purchasers of health care pro-vide little financial incentive for health care organizations and providers to improve safety and quality. ” However, it was also found that medical errors are not a “bad apple problem” but are actually rooted in “faulty systems, processes, and conditions that lead people to make mistakes or fail to prevent them” (Institute of Medicine, 1999, p. 2). In addressing the patient safety issue, researchers and policy makers have identified barriers that limit the current healthcare system from achieving safety in the practice and delivery of medicine.
Five barriers are primarily named and these are: 1) Acceptance of limitations on maximum performance which calls for a limitation of the risk levels allowed since “[w]hen limits do not exist…the system in question is very unsafe” 2) Heeding the call for an abandonment of professional autonomy where health care professionals have a more limited autonomy but compensated by higher teamwork capabilities and benefits; 3) Moving towards the “Equivalent Actor” mindset over the Craftsman mindset which is essentially “adopting a position that values equivalence among their ranks”; 4) A need for system-level arbitration to optimize safety strategies due to the increased pressure from medical malpractice liability and media scrutiny and; 5) The need to simplify professional rules and regulations which calls for simplifying the system, eliminating nonproductive regulations and giving clinicians more latitude in terms of decision making (Amalberti, Auroy, Berwick, and Barach, 2005, p. 758-760).