The world is currently faced by a financial crisis of unprecedented levels, this may come as a surprising event in consideration of the fact that the earlier years of this century were marked by considerable economic developmental. The US is headed for a recession, at least that is what financial analysts predict, unless quick measures are instituted to control the situation. The management of the current situation is a short term remedy however a long term solution requires proper analysis of the causes of failure and development of strategies and measures that will effectively address the causes.
The US healthcare system has not been exempted from the current crisis and if the economy is to recess the social amenities and provision of basic social services will be affected a great deal (O’Neill, 2002). The failure of the capital markets and financial systems have been blamed on the internal workings of such systems, this paper seeks to establish the nature of the health care system and determine if medicine errors has nay effect on the financial status of the healthcare system.
The healthcare system is a very important social system thus its proper functioning is a key concern to not only the federal government but all in the social system. Budgetary allocation to the healthcare systems are derived from the taxpayers thus in one way or the other all individuals are involved in either financing the healthcare systems, using its services or both (Katsoris, 2001). A proper understanding of the factors that affect the finances of the healthcare system is desirable to all stakeholders.
This paper seeks to determine the nature of the effects of medicine errors on the financial status of healthcare system with the aim of coming up with recommendations that will minimize negative financial impacts of such errors by minimizing the rate of occurrence of such errors. This will be accomplished by thorough research that implements a content analysis approach. Findings from the research form the basis for findings and recommendations made thereafter.
Healthcare management is a field of study that is concerned with the management of medical resources and the development and implementation of medical policies with the aim of ensuring improvements on the healthcare system (Demaine ; Fellmeth, 2002). Ensuring proper management of healthcare system for ease of access to quality health services is therefore the motto in this field of management (O’Neill, 2002).
The research is relevant to HCM as a field of management in that it aims at making recommendations that are for the betterment of the healthcare systems, this is in line with the mission of healthcare management. The research relates to HCM as a field of study in this two ways: ? A goal in the education systems is to ensure graduands have the required skills and experience to apply theories learned in class to real life situations (O’Neill, 2002). The applicability of theories and principles is a foundation stone to the education system. This paper seeks to analyze financial effects of medical errors on the US.
healthcare system, analysis is a theoretical approach and involves the application of principles learned in class, the healthcare system is a real life system and the recommendations are therefore applicable to the society. The research is thus a perfect example of the benefits a society can reap from the education system. ? Retention is a key objective in transmission of knowledge. The ability to retain theories determine the likelihood of their use at a latter time. It has been noted that application of principles to real life situations and their use in a variety of complex situations are all important in ensuring retention.
This research provides a platform for analysis of literature from different aspects of HCM and their practical application in recommending corrective actions and is therefore relevant to meeting the retention objective in transmission. Problem Statement Medical errors are a part of the medical practice. Though it may be possible to minimize the occurrence of medical errors, it is nearly impossible to eliminate their occurrence they should therefore be considered an aspects of medical practice. Errors invariably have effects be it at the individual level or at the systems levels; these effects tend to take on a negative dimension.
The management of the ramification of these errors often involve intense resource use; a proper understanding of these errors and their financial implications on the healthcare systems is therefore desirable not only to the management of finances but also in ensuring errors are solved in a timely manner. Purpose The purpose of this study is: ? To determine the cause of medicinal errors in a healthcare system. ? To determine the financial implication of the errors in a healthcare system. ? To make recommendations on what should be done to ensure the proper financial management of the healthcare system in light of medicinal errors.
Research Questions This research is guided by the following questions: ? What are the causes of medicinal errors in the US. healthcare systems? ? Are their ways that the causes can be dealt with to eliminate or minimize medicinal errors in the US. healthcare systems? ? How do medicinal errors affect the US. healthcare system’s finances? ? What should be dome to ensure the proper functioning of the US. healthcare system with regards to medicinal errors? Methodology Content analysis is the approach employed in this research.
There are a lot of cases of medicinal errors in record and their financial impacts have been well assessed. The area of healthcare system is one of the most well researched on area of study and getting access to literature sources regarding the research questions should be easy. Cost especially time considerations are deterministic in choosing this approach. The first step in this approach is the determination of key research areas that are to be dealt with. Healthcare is such a diverse area and determination of the exact areas of study that will be focussed on is important in ensuring objectivity and cost minimization.
The key areas of study in this research include medicinal errors and their management, financial implications of medicinal errors and proper management of patient-physician communication in healthcare systems. The next phase involves choosing literature resources that will be used. Not all sources that are well presented have credible data or information. The accuracy of the literature resources that will be used in these research is of utmost importance since it forms the basis for the findings. To ensure accuracy the following guidelines are used in choosing literature resources:
? The research resources must either be books or journals. The use of internet resource is prohibited due to the inaccuracies associated with information from certain internet sites. ? All literary resource must be peer reviewed. This is a measure put in place to further guarantee the accuracy of the information that will be retrieved. ? At least ten literature resource will be referenced in the research. Ten is reached on in consideration of time and the variety of sources required to ensure accuracy. ? Literature resource should not be of more than ten years to guarantee their relevance to current issues and practices.
? All resource must be schemed through to ensure their relevance to the research objectives thus minimizing the risk of content irrelevance. ? Sources that display clear sign of bias are disqualified immediately. Bias and subjective opinions dent the integrity of information. ? Any sign of physical damage leads to automatic disqualification as integrity of such data cannot be guaranteed. ? All resources should have proper bibliographic details to ensure proper referencing and ensure originality by avoiding plagiarism. Failure to meet bibliographic specifications as per APA specifications lead to automatic disqualifications.
After choosing literature resources the next phase involves analyzing content. A key concern in analysis of the literature is ensuring relevance to the objectives and diversity of opinions. The analysis should therefore involve a summary of the content retrieve from literature analysis. Analysis encompasses a critical review of the literature with relevance to the themes brought out in the research questions. Findings are made from the critical review and recommendations constructed with respect to information got from the literature. Population
The research will center around FDA’s report on medicinal errors whose data is retrieved from voluntary reporting from all over the US. The population is therefore a portion of US. population who have reported medicinal errors to FDA voluntarily. Advantages These are the advantages of the research approach: ? Primary research is not required by this qualitative approach to research. Quantitative approaches to research are often associated with experimental errors which may be difficult to control if the researcher has little experience.
The criteria used in the selection of information ensures that data is of high integrity thus guarantee accuracy in analysis and recommendations derived from such data. ? Qualitative approaches are generally cost effective, the time taken in undertaking this research is small compared to the time that would have been taken had a quantitative approach been used. ? The approach is quite simple due to the elimination of mathematical and statistical complexities associated with quantitative research. Furthermore, the researcher is given more control of the research process which if well used could ensure research is carried out effectively.
Disadvantages These are the disadvantages of the research approach: ? The researcher is in control of the entire research process thus increasing the risk of bias. ? The use of a qualitative approach makes it impossible to provide an error bound and significance level for the results thus the statistical accuracy of the results cannot be ascertained. Limitations These are some of the limitation to this approach to research: ? Though the use of a large number of resource may be desirable, cost considerations makes it unrealistic.
This creates a bound on the number of resource one can use and thus the comprehensiveness of the findings. ? The research approach is not readily applicable in specific research areas for example if the research involves a specific hospital or a clearly set hypothesis, the application of a more quantitative approach would be desirable. Assumptions These are some of the assumption made in applying this approach methodology: ? The selection process ensures the elimination of bias and use of resources that are of high integrity and accuracy.
? The data contained in the selected materials is representative of the conditions in the US. healthcare system. Literature Review Medication Errors The Food and Drug Agency (FDA) is the body responsible for receipt of error reports on human and non-vaccinal products (O’Neill, 2002). The FDA is responsible for the management of drugs and foods and is tasked with ensuring management of issues relating to the quality of both services and products relating to food and health. Medication errors are defined as preventable causes that may lead to inappropriate prescription of medication or harm the patient (Puglise, 1998).
It is therefore quite clear that medication errors revolve around healthcare products, communication, packaging, naming, distribution and monitor (O’Neill, 2002). Medication errors are quite wide and involve almost all aspects in healthcare management since failure in any area of operations invariably has ramifications that either affect patients, consumers or healthcare professionals. Though the definition may involve a number of stakeholders the central issue is the harm the patient is exposed to as a result of erroneous medication.
Over 95000 cases of medication errors have been reported ever since 2000 (Orentlicher, 2005). The figures are based on voluntary reports thus there is a high likelihood that a number of cases are not reported to FDA. Furthermore, some cases are never reported thus the exact medication errors prevalence level is not clear. The American Hospital association states the following as the most common medication errors causes: ? To effectively prescribe a course of treatment the physician should have a thorough grasp of the patient’s condition.
Prescription being an important part to the determination of the nature of health complication and its subsequent management is central to healthcare. Errors in retrieving patient information may be due to incomplete interview or analysis of the patient which leads to failure in noting allergies, underlying conditions, medication that they may be in, previous diagnosis and lab results (O’Neill, 2002). ? Lack of Drug information: Though physicians are specialists in human anatomy and physiology, the drug industry is a fully commercialized industry and drugs are a commercial products (O’Neill, 2002).
It is almost impossible for a physician to master information pertaining to all drugs they are therefore dependent on additional information provided by either medical journals or manufactures on the action and side effects of drug. Further developments and research on a drug may make recommendations that were not present in the original development of the drug. Lack of information on the effects of a drug may lead to prescription of drugs that may either be ineffective in managing the condition in question or lead to other medical complications.
? Poor communication of Drug Orders: This is one of the most common cause of medicinal errors. Ordinary people may consider the handwriting of physicians poor; there are cases where even their fellow practitioners fail to decipher meaning from their scribbles. Poor communication of orders may result from confusion of drug names especially drugs with similar names due to misuse of numerical symbols for instance wrong placement of zeros and decimals, confusing metric and dosing units and inappropriate abbreviation that may create a meaning different from what is intended (Maynard, 2000).
? Poor Labeling: Labeling is a key factor in ensuring organization and reducing the risk of mix ups. A number of drugs are prepared in large units and then repackaged into smaller units. Poor packaging due to improper management of repackaging and labeling process may lead to the administration of completely different drugs to a patient. Administration of a drug not relevant to a patient’s condition leads to drug abuse and the patients conditions worsens since it is not being addressed.
? Environmental Factors: The physician’s task in prescription requires observing a patient, interviewing the patient, analyzing symptoms and signs, coming up with a conclusion and drafting a recommendation (Orentlicher, 2005). These are activities that require well developed skills and proper use of individual mental faculties. Environmental factors like excessive heat, noise, continued interruption may interrupt the diagnosis process and lead to failure by the physician to take note of some symptoms or information. These leads to wrong recommendations which places the patient in danger of their condition not being addressed effectively.
Studies into the nature of medicinal errors show that such errors occurs as result of a complex interaction of a number of factors and cannot be blamed on one cause. According to research, all areas of the US. healthcare systems are to blame for the occurrence of errors (Orentlicher, 2005). Though the physicians often bear the blame, most of the cases can be blamed on the physician, healthcare systems and patients. Financial Implication One of the most common effect of medicinal errors is misuse of medication. This is blamed on the patient, customer and to some extent the physician.
The physicians may fail to give proper prescription due to the factors that have already been outlined, however a large numbers of these cases trace their origin to patients and the caregivers. One of the most commonly misused drug among adults and children is prescription cough medication. Patients fail to notice that Hydrocodone (an active ingredient in a number of cough medicine) has life threatening implication if taken in large quantities (Orentlicher, 2005). A number of fatal breathing disorders have roots in misuse of prescription medicine (Orentlicher, 2005).
Management of fatal respiratory conditions is often complex and requires the use of lots of healthcare system resources even though the patient has to contribute to the management of his condition. Such extensive use of the limited US. healthcare system resources is uncalled for since the causes could have been avoided (Orentlicher, 2005). Parents who label cough syrups as ‘candy’ have themselves to blame if their young ones develop breathing complications in future. It is estimated that over 10000 children are treated for complications arising from overdosing over the counter drugs (Orentlicher, 2005).
Records from emergency rooms show that cases in young children center around overdose of over the counter cough medication where the patient administers the medication without the knowledge of the caregivers (mostly parents). Deaths and fatal injuries have arisen from poor administration of such medication. The financial losses that the social system incurs due to deaths and fatal injuries is immeasurable and the costs associated with management of emergency cases which may involve specialized transportation and management are above average (Orentlicher, 2005).
Emergency operations require the best personnel and collaboration by a number of teams. The resources involved in such practices are considerable and the taxpayers are forced to pay more in order to support such avoidable costs. Physician-patient relationship is governed by the principles of beneficence and patient autonomy (Mcmillin, 2000). In situations where the internal system of the healthcare system is guilty of implementing poor systems that allow for medicinal errors the law requires the aggrieved to be compensated. This may go in line with justice system principles which are aimed at ensuring wrongdoings are punished.
Errors may occurs and in most cases they are never premeditated. If the offended party is to be compensated, the finances are drawn not from the physicians account but from the taxpayers funds allocated to the healthcare system. In a nutshell, such costs are considered operational costs that the taxpayer has to put up with if he is to benefits from healthcare services (Orentlicher, 2005). Review When discussing the US. healthcare system it should be looked at from two perspectives: As a service industry and a social system. The healthcare system just like any other social system is supported by the taxpayers who also use its services.
The healthcare system is therefore a platform through which the society channels its resources to ensure health issues are addressed amicably (Post, 2006). Under these consideration, it is quite clear that an increase in the cost of provision of medical care will invariably be transmitted to the society in one way or the other. The management of the US. healthcare system by the central government ensures that all taxpayers contribute to the development of this important social system. One problem with basic social systems is that an increases in expenditure must be met by an increase in budgetary allocation.
The healthcare system is a basic social system and cuts can only be made on administrative costs while the operational costs are largely inflexible. It is thus quite clear that any conditions that may lead to an increase in the resource usage of the healthcare system will affect its finances and thus service delivery. As a social system the healthcare system is charged with ensuring the wellbeing of the members of the society at all cost. Medicinal errors jeopardize this objective in that the errors puts the health of its members in jeopardy (Post, 2006).
Errors that expose the ability of a system to meet its objectives should be taken seriously and it is upon the society to ensure that corrections are instituted. Errors result from multiple complex factor thus medicinal errors should not always be blamed on an individual entity. The management of the problems should not be a one entity affair thus the involvement of the healthcare systems in the management of chronic conditions and emergency that result from medicinal errors even if the blame cannot be directly placed on its internal workings is more of a social responsibility.
Findings These are some of the findings from the research: ? Medicinal errors are caused by errors in retrieving patient information, lack of drug information, poor labeling, poor communication of drug orders and an environment that hinders the patient-physician interaction. ? From the definition of medicinal errors it is quite clear that they are avoidable. Their manifestation is based on carelessness and improper implementation of processes, though they cannot be eliminated measures can be developed to minimize their occurrence.
? Since the healthcare system is a basic social system increase in costs due to management of emergencies and chronic conditions results in increased resource allocations thus the taxpayers are forced to pay more to meet costs that would have otherwise been avoided. ? Though the increase in budgetary allocations to healthcare systems should be welcomed, in situations where increased allocations do not directly translate to better quality in service delivery but rather increased taxation, it is unwelcome.
Since the occurrence of medicinal errors cannot be avoided there is need to implement measures that will minimize the occurrence of such errors. Recommendation To minimize the risk of medicinal errors there is need for consultative effort (Buck, 2000). The nature of the problem is such that it involves a complex interplay of a number of factors; no simple solution can be instituted for such complex systems (Buck, 2000). Consultative efforts should ensure changes at the industrial, patient-physician interaction and administration levels (Buck, 2000).
Drug production industry display the same characteristics as other areas of operations. Globalization, commercialization and technological developments are factors that determine the dynamics of this industry. There are a number of players in this industry and if statistics are to go by the industry is developing in terms of size and dynamism. The FDA has been reviewing the names of drugs that companies propose as drug names (Scott, 2003). This is a positive step towards reducing name confusion; there is need to channel the efforts to the drugs in the market.
If professionals can confuse the names of some of the drugs in the market, what is expected of ordinary people seeking over the counter drugs. Drug fact labels are required of all drugs that can be bought over the counter. The same should apply for prescription drugs and those that are repackaged into smaller packages. Design of drug packaging and the manufacturing environment of the drugs have to be analyzed. The current FDA mandate is more product based and the processes and risks are left for bodies that are less concerned with health issues (Aruguete & Roberts, 2000).
This should be revised to ensure it effectively assesses the entire product production process thus reducing the risk of improper labeling due to internal production blunders. The 2004 FDA rules make it mandatory for certain drugs and biologics to have bar codes that ensure right dosage at all times (Post, 2006). Information technology is developing, it is clear that administration of drugs is in need of this technology. This bar code technology should be extended to other area of drug administration as the threat in overdosing or underdosing is considerable in almost all areas of drug administration.
Other areas of FDA operations should be improved on for instance, the collection of medicinal error reports should be mandatory for all healthcare institutions, this would ensure accurate data that can be used in guiding the industry and public on medication error awareness (Post, 2006). At the physician-patient interaction level, responsibility should be encouraged. Educating both physicians and patients on the financial implication of medicinal errors and how to avoid such errors may help in reducing their occurrence. The environment in which the physician interacts with the patient should be made as conducive as possible.
This is the responsibility of the patient, physician and the management of healthcare facilities. Reference List Aruguete, M. S. & Roberts, A. C. (2000). Gender, Affiliation, and Control in Physician-Patient Encounters. Sex Roles. A Journal of Research, 34, 11-23. Buck, R. A. (2000). Women and Language in the Anglo-Saxon Leechbooks. Women and Language, Vol. 23, 45-48. Demaine, L. J. & Fellmeth, A. X. (2002). Reinventing the Double Helix: A Novel and Nonobvious Reconceptualization of the Biotechnology Patent. Stanford Law Review, 55, 32 Katsoris, C. N. (2001).
The Fordham Urban Law Journal: A New Millenium. Fordham Urban Law Journal, 30, 34. Maynard, W. B. (2000). Thoreau’s House at Walden. The Art Bulletin, 81, 55-60. Mcmillin, T. S. (2000). Consuming Text: Transubstantiation and Ingestion in the Interpretation of Emerson. Criticism, 38, 23. O’Neill, M. (2002). Ohio’s Patient-Physician Privilege: Whether Planned Parenthood Is a Protected Party. Journal of Law and Health, 17, 31. Orentlicher, D. (2005). Making Research a Requirement of Treatment: Why We Should Sometimes Let Doctors Pressure Patients to Participate in Research.
The Hastings Center Report, 35, 17 Post, R. (2006). Federalism, Positive Law, and the Emergence of the American Administrative State: Prohibition in the Taft Court Era. William and Mary Law Review, 48, 43-55. Puglise, M. S. (1998). “Calling Dr. Love”: The Physician-Patient Sexual Relationship as Grounds for Medical Malpractice – Society Pays While the Doctor and Patient Play. Journal of Law and Health, 14, 24-34. Scott, G. F. (2003). Writing Keats’s Last Days: Severn, Sharp, and Romantic Biography. Studies in Romanticism, 42, 23.