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    Hospital Patient Focused Functions and Hospital Organization

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    Part 1:

    Certain functions are not limited or contained within one department. For example - Drug administration.

    Doctor checks patient; Doctor decides on medication; Ward nurse orders it from pharmacy; pharmacy orders it from supplier; pharmacy delivers to nurse on ward; nurse gives to patient; patient swallows pill; as you can see, we have various people in the loop. Hopefully, patient will get the RIGHT medication at the RIGHT time!
    1. How do we deal with an inter-departmental function, so that "nothing falls between the cracks"? Your insight on this, please.
    2. Describe the components of effective administrative, intra- and inter-departmental communication, including both verbal and written.

    Part 2:
    1. I would like to focus on Organization Performance.
    Please provide your insight as to:
    a. the Concept;
    b. The need for; and
    c. The implementation of; organization performance.
    2. In your Case Assignment you discussed some of the issues in an emergency department. Please comment on each of the following:
    a. Discuss issues of crowding.
    b. List common ED operation metrics.
    c. Identify ED technologies that can help improve patient flow.

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    Please find below a guide to address Hospital Patient Focused Functions and Hospital Organization Functions parts 1 and 2.
    The solution is arranged under the questions as asked for ease of reference.
    Feel free to raise any questions you may have.

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    Hospital Patient Focused Functions and Hospital Organization Functions

    How do we deal with an inter-departmental function, so that "nothing falls between the cracks"?

    My insight on this.
    Inter-departmental communication and collaboration are very important in ensuring that nothing falls between the cracks.
    I would propose to the student a three part solution to deal with this problem and make sure that continuity of quality and safe patient care is achieved and these are:
    • Establish a daily forum where members of the different departments discuss patient care as a matter of routine
    • Put a system in place that is understood by all where information can be documented for continuous effective communication about patient care
    • Develop a system for infusion of training on teamwork and communication skills in curricula for health worker training institutions as well as in new staff orientation programmes
    The following evidence based facts are used to justify these insights
    1. The provision of patient care in a health care setting is a multidisciplinary function as it involves input from various departments and professionals with different backgrounds that includes physicians, nurses, pharmacists, laboratory staff, physiotherapists, occupational therapists, medical records staff, porters, just to name a few.
    2. The fact that different cultures, departmental silos, disciplines, personalities must work together and focus on this one individual who is the patient, proper coordination, effective communication, shared responsibilities for planning and problem solving, shared decision making are prerequisites for provision of quality and safe patient care.
    3. This diversity is also a fertile ground for friction, conflict, competition, professional jealousies that can negatively impact on patient safety for instance affecting the guaranteeing of provision of the 5 rights of drug administration i.e. the right patient getting the right medicine at the right dose given at the time using the right route.

    4. What is interprofessional collaboration?

    5. The Canadian Interprofessional Health Collaborative, defines collaboration as a 'partnership between a team of health providers and a client in a participatory collaborative and coordinated approach to shared decision making around health and social issues.( Canadian Interprofessional Health Collaborative 2010)
    6. In 2001, The Institute of Medicine Committee on Quality of Health Care in America made a recommendation which suggested that healthcare professionals working in interprofessional teams can best communicate and address the complex and challenging patient health care needs.(Bridges et.al 2011)
    7. Poor coordination among providers at various levels of the organization appears to affect the quality and safety of patient care
    8. The following research studies have reported on examples of health care interdepartmental and interprofessional conflicts and their effects on patient care and safety:
    8.1. Ineffective communication among health care professionals is one of the leading causes of medical errors and patient harm(Dingley et.al 2008)
    8.2. A review of reports from the Joint Commission reveals that communication failures were implicated at the root of over 70 percent of sentinel events
    8.3. In the acute care setting, it has been found that communication failures lead to the following:(Dingley et.al 2008)
    8.3.1. increases in patient harm,
    8.3.2. length of stay, Resource use,
    8.3.3. More intense caregiver dissatisfaction
    8.3.4. More rapid turnover
    8.4. According to the National Council of State Boards of Nursing reports, When nurses were asked to select contributing factors to patient care errors, ...

    Solution Summary

    Inter-departmental communication and collaborations are very crucial to patient safety and quality care in a health care organization.
    This solution presents the definition of collaboration, effects of poor collaboration and how this can be improved for the benefit of patients and to some extent health care workers themselves.
    Examples from research studies have been cited for further illustration.
    The guide also gives further insights on organizational performance with references provided for the student's further research.