The objectives of this paper include identifying the reasons why patients in America suffer in the hands of health professionals, the impact of such factors to quality of healthcare and strategies to be used in dealing with the challenges. It is evident that lack of patient care, high costs of accessing quality healthcare and medical errors are the main reasons why patients do not receive quality healthcare. Some of the strategies to be used include recruitment of more health professionals to reduce workloads on these professionals hence reducing medical errors and designing frameworks to be used in enhancing communication between patients and health workers. The conclusion is that these challenges can be eliminated if the stakeholders in the health sector take a responsibility and participate in enhancing quality healthcare.
Key words: medical errors, quality healthcare, medical professionals, disease management programs, care coordination of care.
Over many years patients in America have at one point or another suffered in the hands of health professionals due to lack of patient care, high costs and medical errors. This has affected quality of healthcare services as patients are not provided with satisfactory services despite them spending a lot of resources to access quality healthcare. Research shows that health professional shortages are in the rise leading to lack of patient care and an increase in instances of medical errors.
This paper focuses on the causes of lack of patient care, high costs and medical errors in the health sector, strategies for improving the three challenges and the overall steps to be taken by the stakeholders in the health sector to improve quality of health services.
Lack of patient care is caused by factors such as poor communication between health professionals and patients, heavy workloads for medical professionals and lack of approaches to be used in dealing with different category of patients. Strategies for improving patient care include development of the framework for communication.
High costs are in terms of costs of accessing quality health services, costs in recruiting more health professionals and costs incurred in controlling specific diseases. These costs can be reduced by designing larger programs which benefit from economies of scale.
Health professionals are prone to making errors due to fatigue, complex medical procedures and breakdown of equipment. Such errors can be prevented by recruiting more health professionals and training these professionals on how to operate medical equipment.
Quality healthcare is essential for the growth of an economy. It enhances productivity of citizens which in turn helps in the growth of the economy (Ayanian, 2009).
Reasons why patients may suffer in the hands of healthcare professionals
Lack of patient care, high costs and medical errors are the reasons why patients suffer in the hands of health professionals. Some of the factors are contributed by the patients themselves: (poor patient health worker relationships, poor communication) whereas others are contributed by health professionals and accidents: (medical errors, lack of patient care). These challenges can be reduced or eliminated hence improving quality of healthcare (Ayanian, 2009).
Lack of Patient Care
Patients require care during diagnosis, treatment, and disease control. Different patients require different patient care depending on the diseases they are suffering from. Lack of patient care is caused by:
Poor communication between medical professionals and their patients. Poor communication paralyses exchange of information between patient and medical professionals hence paralyzing diagnosis and treatment process. Doctors may misdiagnose a patient due to insufficient information provided by the patient and patient may overdose or under dose as they misunderstand the instructions given by the medical worker. Poor communication hinders creation of good interpersonal relationship between patients and medical professionals paralyzing diagnosis and treatment process. Making treatment related decisions also becomes hard due to poor (Ong, deHaes, Hoos, & Lammes, 1995).
Heavy workloads on medical professionals due to shortages. Health professionals’ shortages results to heavy workloads which leads to fatigue hence hindering health professionals from delivering quality services. Spending mush time with their patients also becomes a challenge. Due to high patient to doctor/ nurse ratios, the health workers feel overburdened and dissatisfied hence they provide poor services. The shortage of Registered Nurses (RNs) is projected to increase due to an increase in health care needs. Research by World Bank shows between 2008 and 2014, the ratio of physicians per 1,000 people is 2.5 whereas ratio of nurses and midwives per 1,000 people is 9.8. The Association of American Medical Colleges predicts that by 2020, the shortage might be more than 90,000 doctors including 45,000 patient care physicians. States such as Georgia, Oklahoma, Nevada and Alabama have the least number of doctors with doctors per 100,000 people ratios being 179.9, 178.7, 178.1 and 178.0 respectively (Berry & Curry, 2012).
Lack of care coordination modes to be used in dealing with different category of patients. There are several programs such as Medicare for patients suffering from chronic diseases. These programs have failed due to poor care coordination, complexity and size hence patients spend more to receive healthcare services. It is projected that by 2019, Hospital Insurance Trust Fund will be exhausted (Ayanian, 2009).
Inefficient disease management programs. According to Brandat, Hartmann and Hehner, the programs used currently are small, complicated, do not focus on patient needs, are not IT transparent. These programs do not benefit from economies of scale, have complex paths and there are no incentives provided to patients for compliance (Brandt, Hartmann, & Hehner, 2010).
Strategies for improving patient care
Development of the frameworks that bring together the background, proceedings and outcome of the communication lines between patients and medical personnel. The framework will enhance communication between patients and health workers hence building a good interpersonal relationships and a result making diagnosis and treatment faster (Ong, deHaes, Hoos & Lammes, 1995)
Reduction of workloads on health personnel by reducing personnel to patient ratios. To a great extent, the staffing of nurses has an effect on the quality of health care. Health facilities need to recruit more health professionals in order to reduce the patient personnel ratio. Reduction of these ratios results to reduction of workload, increase satisfaction and better delivery of services (Berry & Curry, 2012).
Enhancing care coordination by using trained nurses who interact with patients suffering from chronic diseases as care coordinators. This strategy will strengthen interpersonal relationships and communication. These nurses will also provide medical education and outreach (Ayanian, 2009).
Designing diseases management programs that are larger, simple, focus on patient needs, are IT transparent and offer incentives to be used in reducing the costs incurred in managing diseases. Such programs will benefit from economies of scale, focus mainly on patients’ needs and possess single provider care coordination (Brandt, Hartmann, & Hehner, 2010).
Costs are incurred by patients in accessing health services, by health facilities in recruiting health professionals, buying equipment and providing health services. Costs are also incurred in designing disease management programs. Reasons, why high costs are incurred, include:
Inefficient disease management programs. The programs being used currently are small, complicated, do not focus on patient needs, are not IT transparent. These programs do not benefit from economies of scale, have complex paths and there are no incentives provided to patients for compliance (Brandt, Hartmann, & Hehner, 2010).
Inefficient approaches used in dealing with different category of patients. Patients suffering from chronic diseases need more care. With the existing approaches, focus is not on patient needs therefore patients do not benefit from the large amounts they spend in accessing healthcare as a result patients suffering from serious diseases spend lots of money in accessing healthcare services (Ayanian, 2009).
High expenditures by health facilities. Hospitals spend a lot of money in recruiting new health professionals, buying new equipment and managing the facilities. Research has shown that total expenditures for health facilities reflect the cost of services they offer. Many facilities use cost to charge ratio therefore the higher the expenditures the higher the cost of accessing healthcare services (Ayanian, 2009).
Inadequacy of funds may force patients to seek medical health from facilities that do not offer quality services. Better services are offered at a higher cost since better equipment and technologies are used. Patients may suffer in the hands of health professional due to inadequate funds to access quality healthcare (Ayanian, 2009).
Strategies to be adopted to reduce costs
Designing disease management programs that focus on patient needs to ensure the amount used by the patient is optimized. This can help reduce health care costs by reducing the number of health professionals to care for one patient. As a result quality health services will be provided (Needleman, Buerhaus, Mattke, Stewart & Zelevinsky, 2002).
Designing practical and effective approaches to be used in dealing with different category of patients in order to minimize health costs incurred by patients and keeping a report on the overall cost savings for both the patients and the health care systems. A cost saving report is required to track the effectiveness of the cost saving programs to ensure both the patients and the health facilities are indeed benefiting from the programs (Brandt, Hartmann, & Hehner, 2010).
Reduction of health facilities’ expenditures. The amount spent by health facilities in operating facilities reflect the cost of services they offer. Many facilities use cost to charge ratio therefore the higher the expenditures the higher the cost of accessing healthcare services. Hospitals should be compelled to restructure their budgeted expenditures so that they offer quality health services at a lower cost. This will enable patients to access quality services without spending much. The costs incurred by health facilities can also be reduced by the government providing incentives for provision of services (Ayanian, 2009).
Expanding affordable insurance covers. Insurance covers will enable citizens to pay for their healthcare services comfortably without having to worry about how hospital bills will be paid (Ayanian, 2009).
Medical errors have become a great concern in the health sector in the United States since such errors are in the increase. Research by Johns Hopkins patient safety experts shows that 10 percent of all deaths in the United States are caused by medical errors. It is the third highest cause of death after heart diseases and cancer in the United States even though these errors are an under recognized as causes of death. More than 250,000 deaths per year are caused by medical errors. Cases resulting in courts due to deaths caused by medical are around 170,000 to 251,000 (Truog, 2011). Medical errors are caused by:
Fatigue due to heavy workload on medical professionals. The health sector is faced with shortage of medical professionals hence nurse/ doctor to patient ratios are high. With higher ratios, workloads on these professionals become heavier as a result they suffer from fatigue hence they are unable to perform effectively and efficiently. Also due to dissatisfaction they become prone to making errors e.g. during surgeries (Berry & Curry, 2012).
Lack of effective disease management programs, diagnostic and treatment technologies. Ineffective diagnostic technologies may lead to misdiagnosis and treatment of the wrong disease. Different diseases can be controlled using different management programs e.g. Medicare which is specifically for chronic diseases. Ineffective programs and technologies may lead to errors occurring during diagnosis, control or treatment of a disease (Brandt, Hartmann & Hehner, 2010).
Poor communication and relationships between patients and the health professionals. Good relationships between patients and the health professionals are very critical since it enables the patients to provide all the required information for the treatment process and the medical workers to provide quality services. Due to poor communication, patients might not provide all the information about the disease they are suffering from and as a result the health professional might misdiagnose the patient (Ong, deHaes, Hoos, & Lammes, 1995).
Recruitment of inexperienced and incompetent health professionals. Medical practice require through training in order for the health professionals to gain skills on how to provide quality health care. Inadequate experience especially on how to a handle specific equipment and diseases may lead to errors (Needleman, Buerhaus, Mattke, Stewart & Zelevinsky, 2002).
Healthcare complexity due to complicated technologies and new procedures. The use of complicated technology that a health professional does not understand well might lead to medical errors. Equipment might be used for the wrong purpose or wrong equipment might be used for the right purpose (Truog, 2011).
Equipment failure during diagnosis or treatment. There are chances of an equipment break down during a medical process leading to wrong results or medical errors. These breakdowns might be noticed or not. The equipment should also be replaced whenever they are outdated for new technology to be adopted. This will help in ensuring the process of diagnosing and treating diseases is efficient and up to date (Truog, 2011).
Human error. Human beings are prone to making errors. This can be accidental or due to other factors such as incompetence and fatigue resulting from heavy workloads. These errors are costly since they lead to deaths of Americans. Such errors may also result from misjudgments, inability to differentiate things. These can be avoided by full concentration and keenness from both the health practitioner and the patient. A high percentage of medical errors are due to human errors which can be prevented in order to reduce mortality caused by these errors (Truog, 2011).
Strategies for improvement
Challenges resulting to shortage of health professionals should be addressed. This can be done by improving the working environment for these professionals to ensure the job becomes more attractive to more people, the health sector should implement workforce to ensure models are developed for health workers to plan their strategies and the methods they will use in delivering their services and more effective recruitment methods should be used to recruit more health workers and more advanced education should be adopted to train health workers to ensure more qualified workers are available for recruitment (Berry & Curry, 2012).
Designing efficient and effective disease management programs and technologies that can help medical personnel in managing different diseases. The disease management programs should focus on patient needs to ensure the amount used by the patient is optimized. This can help reduce health care costs as quality health services will be provided hence the few health professionals will be required (Brandt, Hartmann & Hehner, 2010).
Development of the framework that enhances communication between patients and the health professionals. The framework should bring together the background, proceedings and the outcome of the communication lines between patients and medical personnel. This will ensure that good relationships are created between the two parties hence making communication easier (Ong, deHaes, Hoos, & Lammes, 1995).
Recruitment of highly skilled and competent health professionals and continuously training them on the dynamics in the field and the new technologies adopted to control different diseases. This will equip them with knowledge and skills hence they will provide quality health services (Needleman, Buerhaus, Mattke, Stewart & Zelevinsky, 2002).
Continuously training health professionals how to operate equipment especially if anew equipment has been acquired. This will enable them to get used to operating the equipment hence reducing chances of medical errors occurring. Health sector just like any other sector has several dynamics which take place from time to time e.g. innovation of new methods for diagnosing and treating diseases. For health professionals to provide quality services they must have knowledge concerning such dynamics (Truog, 2011).
Continuously servicing the equipment to reduce instances of them breaking down during use. Health facilities should also procure high quality equipment and outsource contractors to continuously service the equipment. Errors that might occur due to equipment breakdown will be reduced hence there will be smooth operation of diagnosis, treatment and surgery (Truog, 2011).
Healthcare is facing different challenges such as lack of patient care, high costs and medical errors. These challenges have affected the quality of healthcare services. There are several strategies that can be used in eliminating these challenges. These include development of frameworks, approaches and programs that will help in improving the healthcare. Different stakeholders in the health sector are required to play their roles in ensuring quality health services are provided to citizens. Quality health services are very important for the growth of the economy. The productivity of a nation can only be improved by delivering quality services to citizens. The strategies identified are practical and effective therefore when adopted; an improvement in provision of health services will be noticed (Truog, 2011).
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