The Patients Perspective

Explain why or why not the perspective of the patient is the most important determinant as to whether an adverse event has occurred.

Even with precise calculations, effective protocol, methodology and practice, adverse or undesirable events are unavoidable. With the fluidity and ever-changing scene in health care, casualties spring up from time to time within health care and usually many factors and individuals are involved. It is important to weigh carefully and determine the precise misstep, or area in which the event took place in order to avoid future mishaps. Patient perspective is undeniably an important part of this process and something to be considered as the patient is usually at the center of the setting; however, it is in the opinion of this student that the patient perspective, although very important, is not the best determinant as to whether an adverse event has occurred.

For example, outcomes may not always meet the expectations of patients even though they may be considered positive from a clinical perspective. The patient experience is subjective and therefore not always the best determinant of a medical error. Patients, in general, may lack the ability to decipher an event as a positive one if the results are not significant in their production of change, or positive change; albeit positive from a clinical aspect. Procedures may be followed precisely to quality standards; however, a patient generally lacks the knowledge or understanding of hospital or facility protocol, for this reason, an undesirable event or outcome may be perceived when in fact there is none.

Likewise, there are always risks with any medical procedure. Potential risks are always discussed with patients prior to treatment in preparation for a best and worse case scenario. Some risks are minimal, while others are adverse. Patients can be sensitive and emotional when it comes to their health and may view the occurrence of a small risk as much more adverse than it truly is. With this being said, I personally feel the voice of the patient is not something to be taken lightly or ignored. The patient voice is an important part to maintaining and improving quality standards for the overall benefit of the community, but not always the best resource for determining an adverse event.

When determining if a medical error has occurred it is important to rely on facts and empirical evidence in culmination with the patients voice. It is important to investigate all avenues leading up to the event in question to identify if and where an error has occurred. Adverse events are usually a combination of latent failure (less apparent errors) in areas such as organization, training, or poor design, and active errors (errors which are immediately apparent leading up to the event). The comparison and intensive investigation of evidence will ensure the efficacy and efficiency of all medical protocol and procedures. 

Electronic Health Records and Health Care Quality

Electronic Health Records, or EHR, is revolutionizing the coordination, standardization, sharing, and analysis of health information like never before. It is helping to create and facilitate interdisciplinary teamwork amongst physicians, as well as transfer medical records in a matter of seconds. Lack of communication or coordination has always been a prominent problem within the healthcare field and EHR is beginning to have a significant impact on a facilities infrastructure; and most importantly, patient outcomes.

EHR can be a powerful source for quality improvement and performance measures. It can store demographic data, aid in managing appointments and schedules, streamline billing, as well as, facilitate communication between doctors and patients. Information now has the ability to be shared within a community or across country through a single integrated application. This type of access, data collection and comparison allows a patient’s entire medical history to be at a physician’s fingertips. A physician is able to direct a more sound course of treatment more effectively and efficiently than ever before, thus delivering a higher standard in the quality of care directly into the hands of the patients. EHR not only improves quality and delivery of care, but safety as well.

EHR will ultimately, in my opinion, reduce health care costs; increase safety and quality not only for the patient, but health care facilities too. Better coordination and organization of care will have effects on things such as reduction of patient readmission rates for recurring or chronic conditions, increase desirable outcomes, increase efficiency and productivity of medical facilities, and increase the overall health of patients by having the ability to more easily direct, or redirect a course of treatment.  Meaningful implementation of EHR ultimately has the ability to improve health not only of the individual, but a community as a whole.