A hospital proposes to introduce a policy that any member of clinical staff (doctors or nurses) who takes or authorises actions that leads to a patient being injured will be subject to criminal charges. Explain why this is a bad idea, which is unlikely to improve patient safety and why it is likely to adversely effect the resilience of the organization.
What will be an ideal response?
Treating mistakes as criminal actions is a bad idea for several reasons:
1. It is likely to increase costs significantly as staff become over-cautious and
order unnecessary tests on patients to ensure that they cannot be accused of
having misdiagnosed a condition.
2. It is likely to reduce patient safety as it will make it difficult for people to
learn from other’s mistakes. If people make a mistake, they are likely to try
and cover this up rather than admit the mistake and discuss why it happens.
When incidents occur (i.e. things go wrong but the problems are found
before a patient is injured), there will be a reluctance to discuss these. The
reason for this is that if the incident re-occurs and a patient is injured, then
those involved may be accused to failing to take account what happened in
the previous incident.
3. It is reduce the resilience of the organization because it will demotivate staff
and will hinder actions to resolve situations that are in some way,
workarounds of the ‘proper process’. Instead of using their professional
judgments to deal with problems, staff will follow the rules even if this
leads to a higher likelihood of patient harm.
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