The Case Study of Springfield General Hospital

This paper examines the case study relating to the welfare of the patients at Springfield General Hospital to investigate why technology led to more rather than fewer mistakes.  The essay also explores the theories of changes administrators at Springfield General Hospital could have employed to help the hospital find a solution to the problem of medical mistakes. Finally, the paper discusses what Springfield General Hospital can do to solve the problem and the extent to which the new technology has been useful to them.

Key words: welfare, hospital, patient, handwriting.

Case Study 3

Springfield General Hospital believed that the new technology would have solved their writing problem they were experiencing at the time. Reading some handwritings presents difficulties for most people and nurses and doctors too are not exempted from this challenge (Stuman, Régo, Dick, 2011).  Springfield too was having errors emanating from the difficulty of reading different handwritings, a problem that caused harm to many patients of the hospital (Spector, 2013). The hospital then resorted to solving this problem by implementing a new technology that would soon cause more harm than improve the situation (Spector, 2013).  This paper identifies the problems the hospital experienced and explores the possible remedial measures that could be implemented to solve these problems. 

Wrong

There emerged a few problems associated with the way Springfield General Hospital implemented the new technology. These problems included the implementation of the system, usage of the warehouse instead of the clinical guideline, grouping of the patients and the dependence on technology (Spector, 2013).   Starting with the problem of reliance on technology, the staff at Springfield General Hospital felt that t new technology would be relied on to do all their work (Bijker, Hughes, Pinch, & Douglas, 2012).  This implies that the nurses at the hospital failed to countercheck the dosage they administered to the patients. Instead, they relied entirely on the software-provided dosage information without further verification. 

One of the other problems is the abandoning of the clinical guideline data for warehousing data.  The new medical staff system was relying on the warehousing data and not the clinical data.  This implies that if a patient needed levothyroxine, they would input that into the system. The software would then show the dosage information based on what is available in the warehouse stock instead of the drug's clinical guideline. In some instances, the software-provided dose info may state 25 mcg and 12.5 mcg when 50 mcg is the actual dosage that the patient requires (Medscape, 2011). Therefore, the doctors relying entirely on the system would fail to prescribe a stronger dosage (Spector, 2013). In a more clinical guideline-reliant system, an initial dosage reading of 25-50 mcg would increase or decrease to 12.5-25 mcg after a period of six to eight weeks - this what is recommended dosage stated in the guidelines for an individual above the age of 50 years or a patient below the age of 50 with CV disease with mild hypothyroidism (Medscape, 2011). To sum up, the hospital would be better of relying on clinical guideline data than warehousing data.

Patient confusion because of the grouping of the patients is another problem that existed because of the technology (Spector, 2013).   The names of the patients do not appear on all of the screens in the software; leading to the mistaking of patients. With the screens being nearly the same color, more confusion emerged among the nurses leading the mistaking of one patient for another. Besides, the grouping of patients further aggravated confusion alphabetically since some patients had similar names. This problem could be worsened by the small fonts displayed in the screens, and with the busy and hectic hospital environment, doctors and nurses can easily confuse the patients leading to using the wrong patient files to diagnose a different patient (Spector, 2013).

The last problem that was caused by the technology, or related to the new technology, as the implementation of the software. It is not mentioned in the case study whether staff was trained on the use of the software or not.  If there was no proper training was conducted for the employees on the software, it could have led to many problems that could have been avoided.

Change Implementation

             For a proper change implementation, the hospital ought to have started the implementation process with a mutual change involving a shared problem diagnosis between the doctors and the staff (Miller & Rollnick, 2012; Spector, 2013).  After the Springfield General Hospital decided on a mutual change, it ought to have subsequently redesigned the process (Miller & Rollnick, 2012; Spector, 2013).  The hospital's administration should have, alongside with the redesigning process, aligned courier, and training process (Spector, 2013).  Another critical aspect of change implementation that the hospital should have considered is the evaluation of the benefits and disadvantages that the technology would bring to the hospital. While there is no doubt that the technology would benefit the hospital, it would have been important that the technology will be used to reinforce the existing problem awareness in the hospital (Spector, 2013).  It is also essential for the employees are prepared for the technology and not forced into using it if maximum benefits are to be reaped.

Solving the Problem

            Fixing the problem at Springfield General Hospital requires that the new technology is introduced as noted above. Some changes in the software would be needed including changing the color of all of the windows, changing the fonts, and having names in all pages. In addition, both the staff and the patients should be involved in the implementation process. In addition, the administrators must inform the staff and the patients of the need for the change. This would create patients and staff awareness of the technology and would make them support the change process since they would understand its need.

Since Springfield General Hospital has already tested the new technology, this should not be redone (Spector, 2013). However, the above-stated suggestions for the technology should be implemented. Implementing the technology correctly would help unravel its potential and help the Springfield General Hospital solve its problem.  Proper training should be conducted at the hospital to equip nurses and doctors with requisite knowledge of handling the technology.  This will help reduce the many problems relating to technology use that are associated with the hospital and its staff.

Unanswered Questions and Lack of Information

It was not stated whether the hospital staff was informed about the new technology and proper training conducted to familiarize them with the new system.  If no adequate training of the employees was conducted, errors were bound to happen that could only have been avoided by ensuring employees are properly trained.  For instance, the employees would not have relied on the technology in choosing the dosing for the patients and would have instead determined proper doing by themselves.  If the patients were informed of the new system, and possible problems with the system, they would know to look for possible problems.  For instance, if the doctor informed the patients of the doses prescribed to them (the patients), the patients could have checked to confirm that the doses given are those prescribed to them by the doctor. The patients would also be a positive thing with the errors in the old system.  It is not the patient's responsibility to check and make sure they received the proper dosage; however, it is always in the best interest of the patient to check and make sure that they are getting the correct treatment and to ask questions if they feel it is not the correct thing.

Biblical Integration

            This case study talks about people and understanding each other.  The bible states that, “And the Lord said, “Behold, they are one people, and they have all one language, and this is only the beginning of what they will do.  And nothing that they propose to do will now be impossible for them" (Genesis 11:6, English Standard Version).  This implies that when people strive to do the same thing, and understand that there is a problem, they can seek to find a resolution to find it.

References

Bijker, W. E., Hughes, T. P., Pinch, T., & Douglas, D. G. (2012). The social construction of technological systems: New directions in the sociology and history of technology. MIT press.

Medscape. (2011, April 29). Levothyroxine (Rx). Retrieved July 1, 2018, from http://reference.medscape.com/drug/synthroid-levoxyl-levothyroxine-342732

Spector, B. (2013). Implementing organizational change: Theory into practice.

(3rd ed.). Upper Saddle River, NJ: Prentice Hall

Sturman, N., Régo, P., & Dick, M. L. (2011). Rewards, costs, and challenges: the general practitioner's experience of teaching medical students. Medical education, 45(7), 722-730.