Root Cause Analysis In Healthcare

1597 Words 6 Pages
Falls in the hospital settings are considered to be the most common negative event after medication error, and many of hospi-tal’s falls cause serious injury that many times results in prolonged and complicated hospital stay, increase costs for the hospitals, and poor quality of life for the patient, and I do believe that one of the most causes which I also mention in my root cause analysis dia-gram has to do with the policies and protocols that are not reviewed and updated at the right time. The gap in updating and imple-menting serious policies and protocols led to an increase rate up to 40% that was announced during a staff meeting in august 2009 in the company I used to work. Along with other cases that occur I want to present the case …show more content…
- Screening all patients age 65 and older for future risk falls during admission because this screening will make aware not only the hospital personnel but also the patient and family member in regards the risk and will give the opportunity to get some education in regards how to prevent falls. This measure was welcome not only by the staff but also by the family because the family was feeling that they are part in the treatment process of their loved one.
- Assessment of all patients age 65 and older with history of falls during admission and during each shift will provide an up to date health evaluation that will help the patient to make environmental, behavioral life adjustments to prevent falls not only in the hospital setting but also those falls that occurs at home and helped the doctors, occupational therapy and physical therapy to reevaluate and readjust the needs of the patient based on the present
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The following are some of the main causes of patients ' falls, poor teamwork between hospital staffs, and lack of a safe environ-ment for the personnel who will be monitoring the safety standards to ensure no patient is at risk of falling. The aim of im-proving is to ensure that all patients are safe from anything that can make them fall hence reducing the risks associated with this accident. There are many causes that lead to falls in hospitals, to improve this situation these causes should be eliminat-ed. The causes can be categorized as environmental, staff related, patient related and policy related. The choice of action that will be taken to ensure that there will be no falls is improving employees’ effectiveness and having new safety policies and procedures. On improving employees’ effectiveness, various issues will be considered. The hospital lacks adequate skilled employees hence this affect patients when they need help no one is there to help them, or an employee serves many patients at a time. When there are adequate numbers of employees, it will be easy to help patients hence avoiding falls. Em-ployees should occasionally be trained on how to improve safety in hospitals (Oliver et al. 625). The safety policies and procedures should be changed because they seem not to be effective, and this change also comes with a change in safety measures

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