The History Of Computed Tomography

Published Date: 02 Nov 2017

This coursework will be presented in the form of Gibbs’s reflective model to reflect on an incident I witness during clinical attachment with the incorporation of knowledge, skills and attitudes acquire in this module to enable me to become an effective member of an inter-professional team in a healthcare system. However it should be understood that the common goal of a inter-professional team in a healthcare system is to ultimately creates a better healthcare system for patient with significant contribution by different professionals. Hence, this coursework will also illustrates how I could contribute to the inter-professional team in reaching the ultimate goal of creating a healthcare system with high quality patient centered care

To protect the confidentiality of the patient, hospital and healthcare professionals involved in the incident, the identifiers will not be disclosed and "Jenny" will be used to represent the patient involved in this incident in adherence to the privacy rule under the Health insurance portability and accountability act of 1996 (HIPAA) (U.S. Department of health & human services, n.d.).

Other than protecting confidentiality of the patient, other medical ethics principles that safeguard the well-being of the patient between the interaction of a healthcare professionals and patient comprises of autonomy, beneficence, non-maleficence and justice (Gillon, 1994). With recognition and application of the four principles of medical ethics when interacting with patient, a foreseeably improved in patient satisfaction and safety can result in lesser litigation against healthcare professionals or the hospital. Also building a mutually respectful relationship between the healthcare professionals and patient hence advancing closer towards a high quality healthcare system.

Although my future role as a diagnostic radiographer might not deal with all the principles of medical ethics, but non-maleficence will be more emphasize in the applicability for a diagnostic radiographer especially in the incident that will be presented later.

The Gibbs’s reflective model comprises of 6 stages, description, feelings/thoughts, evaluation, analysis, conclusion and action plan (Gibbs, 1988). Each of this stage will begin with the illustration of the incident follow by a summary of issues of concern and management conducted to achieve quality assurance.

Description

Jenny had undergone a computed tomography (CT) guided radiofrequency (RF) ablation for her lung tumours and was resting on a trolley outside the CT room at the trolley bay for observation as sedation and local anesthesia was provided to her with the accompany from her son. The doctors, nurses and radiographer who were involved in Jenny’s procedure were off for lunch. I was in the CT room observing another CT examination when I heard a commotion at the trolley bay where Jenny was. She was choked by the water her son gave her. It might be because Jenny was still in a sub-conscious state which results aspiration of water into her lungs due to the sedation she underwent shortly before.

The commotion had drawn the attention of patients and counter staff surrounding near Jenny bed and nothing was done until doctors came over. However, as the doctors who came was not the doctors in charge of Jenny in the CT procedure, the doctors spend some time reading the case notes before realizing it was not a big issue for worry. The issue was resolved with no harm to the patient.

However, Jenny’s son was unsatisfied and disappointed with the staff involved in the CT procedure for not notifying him issues to take note. Hence, a complaint was lodged against the team of staff whom were involved in Jenny’s CT procedure.

Feelings/ Thoughts

All the staff who were complained were displeased and enraged as they thought that the incident was not worth complaining as it was a issue not to be worried or concerned about. Whereas, I felt baffled and pity for Jenny and her son as I thought that the staff should at least show some acknowledgement and accountability to the incident rather than disregarding the effect of the incident on Jenny and her son. This goes to show that the inappropriate working attitude of the staff disfavor building a patient centered care which is observed from a general tabulation by General medical council (2013) showing an increased of complaint from the patients to the healthcare professionals of 23% from 2010 to 2011. Also, by acknowledging the mistakes, the staff would than learn from the mistakes not to commit that again hence encourages a high quality patient centered care.

In addition to preventing the incident from happening again, identification of the root cause is essential for risk management to implement new approaches or measures accordingly. With that, not only the patient satisfaction will improve, the job satisfaction in the healthcare professional would also increased as the complaints and litigation from patients are reduced hence increasing their moral in working with the other professionals in building a better healthcare system.

Evaluation

It was identified that the working attitude by the staff was inappropriate hence hinders the development and progress of being an effective member in a inter-professional team to create a better healthcare system.

According to Scally and Donaldson (1998), the application of clinical governance in the form of risk management and staff management could educate the entire team of inter-displinary professionals the benefits and importance in adopting correct working attitude that can contribute positively to creating a better healthcare system. In addition, based on the reason for the Jenny’s son complaint was the lack of notification to him on the issues to take note. Hence, it can be derived that the nature of the incident was actually due to the lack of effective communication between the staff and the patient/public. Clinical governance in application towards effective communication can also be achieved through a systematic implementation of new approach to ensure communication between staff and patient so that misunderstandings can be avoided especially in this incident, should the staff eduated Jenny’s son, the incident would not have occurred. In addition, to effective communication between staff and public, Leonard, Gramham and Bonacum (2004) highlighted that involvement of the public or patients could enable achievement of better healthcare system as they could play a role in maintenance of the efficacy of the work by healthcare professionals.

Taking this incident in consideration, if the public or jenny’s son was involved in managing patient care of this mom by educating him, the incident can be prevented. In this case, luckily no harm was inflicted. In serious adverse events, the actions of the public can discounts the effort of treating the patient because harm was caused hence resulting in the negligence of non-malficience as not informing issues to take note is also a form a harm. This is supported by Morse (2003) that the liability of the staff in causing harm not just involved a direct harm to patient as the lack of measures in preventing harm to occur also constitute harm inflicted by the staff. Hence, in this incident, the staffs were correctly held liable even though no harm was done.

Although in the incident, Jenny was not harm by the acts of the healthcare professional, there is a alarming amount of hospital inflicted harm resulting in increased mortality and morbidity with no relations to their initial medical conditions. National coalition on health care (2004) reported the rise in medical errors results in increased hospital stays as well as increased hospital costs and increased financing from insurance. However, as some financially limited patient who cannot afford healthcare insurance, their chances of accessing healthcare services are limited. Hence, it is very important to reduce the medical errors as much as possible so that accessibility of medical care to poorer patient is not aggravated financially. In addition to increase the accessibility of healthcare services even to poorer patients, new researches can be carried out to develop cost effective methods in diagnosis, treatment and management of the patient condition hence allowing healthcare to be affordable and easily accessible.

The negative experience I encounter would be the complacent working attitudes of the staff although it is predictable that some degree would exists. However, complacent in healthcare is unacceptable as it could result in poor quality of care and poor standard of care which will have a deterministic and influential effect on patient safety and recovery. This issue can be resolved by staff development as part of risk management so that complacenent do not exist which can result in medical errors.

As for the positive experience I have learned from this incident is to put myself in the shoes of the patient and consider from their point of view instead of ours as they are ultimately the reason why we existed. Hence, by having the right mindset of creating a patient-centered care, the decision and action that we made will move the healthcare system towards a safer and more efficient environment raising patient satisfaction and staff job satisfaction.

Analysis

Based on this incident, it is obvious that every professional when working on a similar case plays a indispensable role in ensuring quality medical services for the patient. Similarly, the effect of an incident could discounts the effort by the team of professionals, hence excellent team work and a fool proof approaches to eliminate ant incident to happen can be enforced to establish high standard of care for all patient in the hospital and not varies across different healthcare professionals or different examination they encounter.

A efficient inter-professional collaboration involves sharing their individual needs and discuss objectively the approach to implement to achieve the common goal. Hence, a holistic approach would be beneficial in deriving a win-win situation so that the common goal of serving the patient well is establish without compromising own well-being. According to Bridges, Davidson and Odegard (2011), effective collaboration involving a team for different professionals requires every member to contributes to the discussion by providing their stand even though there will be conflict when different standpoints are raised. But it is important to keep a open mind so as to create a collaborative culture that is transparent and goal oriented to aid inter-professional collaboration. to welcome different standpoint and addressed everyone of it.

Also with a effective team work through effective communication and mutual respect for one another, the solutions synthesized would produce a more diverse and well considered field rather than individual professionals working in isolation. Hence, with effective team work between interprofessional collaboration, high quality work produce can create a more effective problem solving method with reduced time and resources. Furthermore, through interprofessional collaboration, interprofessional learning can be achieved. From in this case, I figure that takeing up training course as a continual professional education to reinforce my understanding on procedure after care so that I can advise patients and their relatives when the doctors and nurses are too busy to do so. However, it is important that the radiographer should not cross the boundaries of the information that can be disclosed to the patient which is only permit to the doctors.

In addition, Belbin (1981) highlight that a successful team should comprise of 9 key roles that display different advantages that would allow a team to be productive, efficient and successful. After going through Belbin test, I am a monitor evaluator and a co-ordinator hence I can see myself contributing to making accurate judgement when too much idea are presented on board and setting realistic goals that could contributes to faster achievement of target. However, I need to work on my leadership qualities to inspire other team member to contribute equally to the discussion as some member might give up their autonomy to reduce conflict. In a team where different perception and point of views can easily cause conflict, however conflict may not always be a negative issues as long as effective and a collaborative approach is taken to mange conflict. The needs of all the members in the team will be able to fulfil. After taking a test to determine my conflict mode using the Thomas-Kilmann conflict mode instrument, I belong to the collaborative conflict mode hence I see myself to be able to achieve a balance between cooperative and assertiveness when managing conflict (Consulting psychologists press, n.d.). However I should also be aware that my conflict mode might not be appropriate at when the issues are too time–consuming and needed a fast solution.

Conclusion

Judging from the incident, it can be derive that a efficient inter-professional collaboration is the determining factor in building a better patient centred healthcare system. Hence, it is important to have a leader who can guide the inter-professional team to greater heights.

Action plan

Based on the new approached that a inter-professional team with the guidance of a capable leader, implementation of the new approach requires a error reporting system that track the error, frequency, seriousness of the error with the help from root cause analysis (Sale, 2005). These measures taken are needed to serve as a clinical audit to determine the efficacy of the new implementation. This allow the team of professional to accurately identify the factors that causes issues and can improvise new protocol hence achieving the target.

Furthermore, with the records of the implementation, a evidence based practice approach is used that allow high quality assurance leading to a better healthcare system for both the patient and the healthcare professionals. Most importantly, such working protocol and styles allow the building of a better healthcare system by inter displinary professional soon to be anticipated.

Conclusion

This coursework had enable to understand that reflection is not just only a process of documenting, it is a process that learning to further learning known as reflective learning. With the benefits and importance of reflective learning, I can apply reflection to analyse the situation and will be able to resolve the issue with a greater perspective. Lastly, the characteristic identified in this coursework have guide me towards the requirements to improve so that in future I can be a effective member that contributes to interprofessional team creating a high quality patient centered care together.