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The Case Study of the Medical Plato Hospital

Introduction

The radiology department subjects patients to an unsafe environment due to the potential risk of excessive radiation exposure, which is why the procedures and hospital policies have to be tailored to address this potential risk. There was an incident at the Medical City Plato hospital involving a radiology technician who injected a patient with a dose of radiation fifty times higher than that required by the procedure standards. This technician was fired, but the error is a result of systemic problems that exist in this radiology department. Hence, patient safety is compromised since radiology specialists must possess the knowledge and understanding of processes that will allow them to avoid such mistakes. Moreover, the radiologist specialists complain about the poor image quality and the exposure to high rates of radiation both for patients and personnel. This paper will use the root cause analysis technique to analyze the issues at the Medical City Plato radiology department and propose recommendations to resolve them.

Problem Statement

The Medical City Plato Hospital’s radiology unit is unsafe for patients due to exposure to high rates of radiation.

Evaluation Criteria

Although the goal of any medical facility is to provide care to patients, the Medical Plato Hospital is a for-profit organization, which means that the financial costs and benefits of each recommendation are a significant consideration. The practices ensuring patients’ safety in the radiology department must be both effective in terms of safety criteria and adequate when considering the cost of their implementation. With this, however, this report recommends increasing the budget of the radiology department as the current funds provide limited resources for the training and development of the employees. The second criteria are the ease of implementation; since the facility cannot stop its operations while implementing new practices, the radiology department must continue working as it is an integral part of the hospital’s trauma care. Hence, the solutions should be integrated into the current operations of the hospital and not restrict them.

Problem Identification

A radiology department is a unit in a hospital where patients are subjected to procedures using radioactive elements. The latter is potentially dangerous, and exposure to high doses of radiation may lead to adverse effects on a patient’s health. At the Medical City Plato hospital, there has been an incident where a nuclear medicine technologist inserted a high dose of material during a procedure. However, prior to this incident, the radiologists in this unit constantly complained about the quality of images and the exposure to dangerous rates of radiation, which points to the issue with the way the technicians perform their duties.

Analysis

There are three healthcare management issues in this scenario. Firstly, there is a problem in the area of personnel training and development since the issue in question was a human error. Next, the human resources practices in this hospital have to be reviewed as well, since it is vital to hire technologists with adequate knowledge and training background who would not allow for such error to happen. The final issue that will be a part of the discussion in this case study is the financial resources and the need to increase the budget to enhance patient safety in the facility.

To analyze the problem, the root cause analysis technique will be employed. ASQ (n.d.) defines this technique as “the root cause is the core issue—the highest-level cause—that sets in motion the entire cause-and-effect reaction that ultimately leads to the problem(s)” (para. 1). The patient safety issue is linked to exposure to high rates of radiation. Mainly, the responsibility of radiology technicians is to use the minimal dose needed to complete the procedure to make sure that the least amount of harm is caused to the patient’s health (ESR & EFRS, 2019). However, in this hospital, the personnel routinely complains about patients and themselves being exposed to higher rates of radiation than necessary.

The general training of radiologists has several flaws that do not allow medical students to fully understand the scope of their future work. According to Hartman et al. (2018), “in the traditional model, students typically only gain a superficial appreciation of radiologists’ role in patient care and their interactions with clinical services, multidisciplinary teams, and patients” (p. 1646). The authors argue that these students have to learn noninterpretative skills and focus on understanding patient needs and employing a team-based approach in their work, which will help improve patient safety. Hence, the root cause of the problem is that the training that the technicians of the radiology department receive does not prepare them for the work in a real-life hospital setting, which results in them being unable to address the patient safety needs. While the hospital cannot directly influence the training of these professionals, there are several managerial actions, which will be recommended in the following paragraphs, that can reduce the risk and address the gaps in the training of these professionals.

Recommended Action: Alternatives

This part of the paper is a discussion and evaluation of three potential alternatives to the patient safety problem at the Medical Plato Hospital’s radiology department: training and development, HR policies, and budget. Each option will be evaluated based on the effectiveness of the solution in terms of improving patient safety, its cost, and disruption to the hospital’s workflow, as these are the main criteria.

Training and Development

Since the issue happened due to the radiologist specialist injecting a high dose of radioactive material during a procedure, since this is a human error, this hospital should invest more effort and money into personnel training to ensure that this does not happen again. Although it is the responsibility of each radiology technician not to cause harm to the patients, it is important for the management to ensure that these workers undergo routine training to improve their skills and refresh their knowledge.

Evaluation

The advantages of improved training are evident-the specialists participating in the training sessions will update their knowledge and familiarize themselves with new research, evidence, and technology that can aid in improving safety. Medical professionals, in general, should engage in lifelong learning, which means that they have to continuously update their knowledge by reading new studies and participating in training workshops. However, in reality, the most specialist is already overburdened by the need to work on many patient cases, especially as the population ages while the demand for medical professionals increases (ESR & EFRS, 2019). Hence, there is an advantage in integrating training and development into the hospital’s policy for mandatory activities because it will mandate the radiology employees to take time and update their knowledge. The second advantage is that by addressing the training and development issue, this hospital will address the root cause of the issue, a human error, that calls for improved HR hiring practices. Arguably, hiring high-quality specialists is problematic since many hospitals compete for the best graduates or experienced technicians, striving to provide the best quality to their patients. However, a tight labor market means that these technicians can choose places of work that offer the highest salaries and best benefits. With the improved training and development practices, this hospital will be able to improve the qualifications of their existing personnel without having to hire many new specialists.

HR Policies: Hiring A Quality Control Specialist

A change to the existing policies may include hiring radiology technicians with more experience when compared to previous hires and those who have more qualifications. For example, the hospital can hire a radiology quality control technician who will be responsible for monitoring the procedures and checking the image quality before they are sent to the radiologists. This approach should limit the potential error as this professional’s sole responsibility will be to check the work of radiology technicians.

Evaluation

In terms of cost, this alternative has a disadvantage since the hospital would have to pay more in salaries and benefits to people with greater experience and better credentials. Additionally, hiring a quality control specialist will require additional expenditure to account for the salary and benefits. From the viewpoint of not interrupting the hospital’s work process, this decision also has a disadvantage since the management will have to develop a new process map to include the evaluation by the quality specialist, outline different scenarios of work, and introduce these new procedures to the personnel. The benefits, however, are a reduced risk of exposure to high rates of radiation since this specialist will monitor the radiology technician’s work and improved image quality, both of which will help the hospital save money.

Budget Increase

The increased budget would allow the radiology department to hire front desk personnel and purchase equipment that would improve the processing of patients and enable better safety. Mainly, the hospital can hire front desk personnel and purchase additional equipment that would allow them to process patients faster, eliminating delays and disruptions of the workflow. Additionally, by buying new X-Rays, C-arm machines, and CT scanners, the hospital will improve the quality of the images.

Evaluation

This alternative has an evident disadvantage from the viewpoint of cost since it will require the hospital to spend more money, both as salary expenditures and to purchase the new equipment. Additionally, it will disrupt the radiology department’s workflow because the new personnel will have to be trained to familiarize themselves with their responsibilities. Moreover, the installation of new equipment will cause a disruption of work because some elements of the unit will have to stop working to allow the contractors to take put the old equipment and install the new one. The advantages, however, are improved patient safety and quality of services, both of which will affect the costs indirectly. Both safety and quality will allow the hospital to process patients more efficiently and avoid potential lawsuits due to radiation exposure.

Solution

Out of the three alternatives discussed above, the recommended course of action is to address training and development changes. This alternative is selected because its advantages outweigh disadvantages, and it will allow addressing some factors outlines in the other two alternatives. For example, training should improve the knowledge and skills of technicians. Hence the quality of their work should improve, eliminating the need for hiring a quality control specialist. Additionally, training should help address the issue of image quality, which will result in lesser delays with processing patient cases, meaning that the hospital will no longer need to hire more front desk personnel. Finally, this alternative addresses the problem identified by Hartman et al. (2018), which is the unpreparedness of radiology specialists to work in a real-life hospital setting. Thus, this training and development will be integrated into the workflow of the hospital; the implementation of this alternative should not disrupt the workflow and should be more efficient financially when compared to the other two.

Implementation Plan

To implement the training and development option, the management will have to assess the training needs of their personnel. The best solution is to either ask HR to distribute the questionnaire to the technicians or to hire a contractor that specializes in medical training and development programs. This is a long-term project since this alternative implies that the technicians will undergo training and development constantly, for example, once a year. The first training session should be implemented within three months from the evaluation because the hospital’s problems with radiation exposure are evident and pressing; hence, the reduction of radiation exposure risks will be the first topic on the agenda. The success of the training should be measured by gathering radiologists’ feedback regarding exposure to radiation. If the patient safety and image quality do not improve with the implementation of this training session, HR should consider hiring new personnel, firing the technicians who do not adhere to the standards of practice, and creating a position of quality control technician.

Feedback

To reevaluate, this paper offers three alternative solutions to the issue of quality control and patient safety at the radiology department of the Medical Plato Hospital. Out of the three options, this case study recommends employing training and development. This approach should help address the gaps in the radiology technicians’ knowledge and should contribute to them using the lowest doses of radiation needed to create images. To monitor the situation, the management should assess the feedback from the radiologists regarding the exposure to radiation and image quality. Additionally, they can review the records of procedures to determine if the technicians use the low doses as was recommended during the training. Future recurrence of the problem may be avoided by ensuring that these training sessions are held regularly and by tracking the technicians’ attendance.

Conclusion

Overall, this paper addresses the case study of the Medical Plato Hospital and, more specifically, its radiology department. The scenario focuses on the error of the radiology technician, who injected a high dosage of radioactive material. The radiology department, in particular, is a dangerous area for patients because they are exposed to radiation that can have a highly damaging effect on their health. Hence, the management of this hospital has to address three areas of healthcare management to ensure that this mistake does not happen and that the patients are safe. In this paper, three recommendations for improvement are included, such as enhancing the training and development, increasing the radiology unit budget, and addressing the hiring practices to ensure that people with the best qualifications are hired.

References

ASQ. (n.d.). What is root cause analysis? Web.

European Society of Radiology (ESR) & European Federation of Radiographer Societies (EFRS). (2019). Patient safety in medical imaging: A joint paper of the European Society of Radiology (ESR) and the European Federation of Radiographer Societies (EFRS). Insights Imaging 10, 45. Web.

Hartman, M., Thomas, S., & Ayoob, A. (2018). Radiology field trips—A list of “must sees” in the radiology department for medical students. Academic Radiology, 25(12), 1646-1652. Web.

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