Occurrence Of Flaws In Hospital Management

By Author: Henry Ford
Total Articles: 189
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The art of hospital management is unique due to the nature of its clients who in most cases rely on the hospitals to avert critical diseases and even possibility of death. The management has to critically balance between prudential management practices and providence of needed treatment in the most ethical manner. The hospital is set in a social environment where it tackles issues that have direct influence on the society. The patients who are the primary concern for the hospital forms belong to an extensive network of relatives and hence are a societal concern. As such, all activities within a hospital have direct bearing on the immediate community which generates a lot of scrutiny on the nature of medical practice. The people behind the running of the hospital are the management and a good deal of decisions threat are made in a hospital are discussed and adopted by this management. The medical personnel such as nurses and doctors who contact the patients physically act on the basis of decisions made by the top management. A good deal of hospital activities results to what is commonly referred as medical dilemmas as the hospital ...
... is always on an ethical test in its actualization of duties. Like in all managements, the hospital teams are faced by numerous challenges in different decision areas which place them in a position of possible conflict with the stakeholders of the hospital. All the scenarios which present possible conflict to the hospital management are considered to be flaws within the management (AHA, 2009). The stakeholders who have interest within the hospital are numerous, starting with the patients, the staff, the community and other crucial stakeholders such as insurance companies and the government. This implies that any decision made by the management has far reaching ramifications affecting a wide range of people. There has been cases of mismanagement where the management literary engages in vices such as siphoning institutional resources and employing underhand dealings. These are generally criminal activities that are dealt as per the criminal code of a given country.

This study is concerned with those decisions that the management takes rationally and after thoughtful considerations yet they end up becoming crisis decisions. The hospital set up is sensitive because of the nature of work that goes on. There is a great deal of ethical considerations that are associated with hospitals and this presents the management every time with ethical considerations when making decisions. A decision made by the management may be okay to one stakeholder and be adverse to the other. For instance, the management, guided by evidence based medicine may adopt an expensive operation to be performed on a patient (AHA, 2009). This decision may be at the best interest of the patient but on the other hand will be burdensome and unwelcome to the immediate family considering the cost implications. The management has to make decisions that may require some departments to be allocated more funds by the others out of need, yet this brings interdepartmental conflict as every department considers its position crucial to the hospital running. In cases where insurance companies are supposed to cater for Medicare, very expensive operations have adverse effect on their profitability and this presents a conflict with the hospitals running the operations.
In some instances, the management is required to make decisions that pertain to life and death, where some patients may voluntarily request for mercy death or when families can no longer afford their patient being supported on life support machines. The decision made by the management in such cases has ethical considerations and presents the management with dilemmas in their efforts to fulfill their duty. There are also situations where management has to make decisions that are unethical but crucial, like when they have to divulge crucial information to family members against the wishes of patients. In such a case, the management treads the thin line between divulging private information which is considered unethical yet it is important for the care givers such as families who provide the financial resources required for treatment.

According to the Hospital Management Net (2009), NHS in Britain may pay up to £ 713 m as claims against clinical negligence between 2009 and 2010(Net Resources International, 2009). The area of negligence in recent years has also presented different hospital managements with potential conflicts between major stakeholders. When clinical negligence causes harm to a patient, sometimes the hospitals are sued leading to losses to the hospitals when the patients are awarded against damages. The management thus has to balance many factors in its efforts to protect its staff in their line of duty (Net Resources International, 2009).

The management is also daily challenge by the occurrence of flaws that occurs as a result of adoption of technology. In a report released by these findings appear in the (JAMIA, 2009), there is sufficient evidence that the bar coding technology used by hospital pharmacy departments are in some cases faulty resulting to wrong prescriptions and possible likelihoods of overdoses and under doses. The study showed that there are increasing instances when technology fails or is misread leading to the production f wrong results. Such a flaw is likely to be attributed to the management which warrants the implementation of such technology (JAMIA, 2009).

In this study, an attempt will be made to assess what are considerably the most common flaws among hospital management and an analysis will be done for selected case studies with an aim of giving necessary recommendations. The hospital management in this study is treated as the overall decision influencer implying that most hospital activities can be traced back to the management.

1.2 Background of the Study
The management in the hospital is the overall overseer of the activities that goes on around the hospital. As such, any consequences occurring within the hospital precincts are bound to be associated with the management. In actual sense, it is a fact that the top management has much contact with patients as compared to doctors, nurses and other specialized technicians. However, the simple or gross mistakes performed by these members are seen as the management mistakes because the staff is simply seen as subordinates. The number of cases that records mistakes or flaws by such members of staff is staggering if they are anything to go buy. The American chiropractic publishes statistics pertaining to cases that are deemed to have reported a possible flaw from the hospital attendants. In an article in their website titled, medical events, ignored bomb, the article asserts that roughly 100, 000 US citizens die every year as a result of Medicare adverse effects most of which are related to drug use. It also asserts that over 2 million are hospitalized every year out of medical care adverse effects.
In 1999, the FDA received more than 258,000 cases of adverse drug reactions which was four times the figure recorded a decade earlier of 68,000 incidents. This implies that cases of flaws that can be attributed to management are actually very many and can be very diverse covering al aspects of hospital administration (American Chiropractic, 2009). A survey in 2000 revealed that on average, 18% patients registered a drug related case. It also claimed that many cases of flaw sin medical practice may occur much later after treatment and hence patients have no ground for going back to make claims. According to American chiropractic, the numbers of drug complications are in the range of 36 million per year in the US alone. Most of these complications arise as a result of poor prescription or cases of under and overdose. There are also possibilities that some cases are not documented because doctors do not like admitting flaws in their practice and would rather ascribe it to other causes.

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