Medical Errors Report #19
A Four-Year Solution Implementation Study
Territorial defenses and inter-departmental hostility create a severe blow to the progress of solving problems between two departments. There is ongoing hostility between the nursing and the laboratory department, pharmacy and nursing department, nursing and the medical staff. These problems are creating great deterrence to the progress of solving medical errors. Instead of working together as a team, workers from different departments resort to the blame game scenario making it difficult to have an objective evaluation of the problems. Lab workers should understand that nurses are not their enemies. Nurses should understand that they need to work with the lab to solve problems since both departments are dependent on each other to function. Physicians need to understand that they need to be more polite when dealing with nurses and to treat them as partners in delivering care instead of treating them as housemaids. Nursing staff members deserve the same respect and sometimes much more than the respect physicians share with their peers. Many times a nursing secretary or nurses are afraid to ask physicians for clarification of orders. In some situations, wrong tests are ordered because workers are afraid to ask physicians questions.
Building good relationships with workers from other departments is a very effective way to solve problems between two departments. There are problems which affect both departments because many hospital departments do not work alone. The old process is for one department to target and accuse another department of causing problems leading to errors. Nursing departments often accuse labs for delaying test results leading to delay in treatments. Labs often blame the nursing staff for ordering tests late, causing the delay in reporting tests. Continuous accusations between two departments have raised the level of hostility to a point of shame. When a committee is designed to discuss issues of concern between the two departments, it tends to reduce lack of trust. Building positive relationships between employees from other departments helps to bridge gaps of agreements and to reduce hostility.
Hospitals like any other businesses teach health-care workers to treat patients with kindness because they are customers. In continuous quality improvement (CQI) it is clearly defined that patients are customers to hospital employees. For many years, there has been emphasis on better patient care so the patients can come back. But, there was a very little emphasis on employee treating other employee better to achieve quality work. Sometimes interpersonal conflicts have been responsible for sabotaging good intentions of fixing a problem because employees are unable to resolve disagreements. More emphasis should be placed on conflict resolution if any health-care institution is to achieve continuous improvement by fixing medical errors and systemic failures. When employees are unable to resolve conflicts, such interpersonal conflicts lead to decrease in the quality of patient care.