Inefficiency and Reduced Quality of Care: Case Analysis

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Introduction

The pivotal aim of the healthcare sector is to provide high-quality care to patients and preserve their well-being. At the same time, it is expected that it would be able to consider different clients’ demands and conditions and ensure that adequate and necessary treatment is offered. However, today there is a critical increase in the diversity of cases and patients’ demands. It means that the healthcare sector faces the challenge of preserving its effectiveness and assisting individuals in their recovery. The continuity of care, collaboration, and data exchange is viewed as the main aspects critical for achieving the existing goals. Thus, there are still some issues emerging when dealing with complex cases. The sources of inefficiency and reduced quality of care might differ. For this reason, it is vital to analyze such accidents to create the basis for future improvement.

Background

Margaret’s case can be investigated to determine the main issues preventing specialists from making a correct diagnosis and prescribing the necessary treatment. The patient, a 58-year-old woman, suffered from tremors and problems keeping her head and hands from shaking. It caused her physical and mental suffering because of the fear of future more significant issues. Her primary care physician failed to diagnose her correctly and improve her condition. Later, hematologists, an endocrinologist, and a neurologist could not manage the problem. Finally, a psychiatrist diagnosed Margaret with generalized anxiety disorder and prescribed treatment to improve her condition. The case shows several critical flaws in the existing system, mainly linked to the inability to evaluate the patient’s condition and diagnose her correctly. It results in reduced quality of care and growing patient dissatisfaction and level of anxiety.

Sources of Inefficiency and Reduced Quality of Care

Analyzing the case, several sources of inefficiency should be outlined. First of all, it is vital to admit the ineffective use of the existing health system (Chandra & Staiger, 2020). The comprehensive investigation of a patient is one of the major principles regulating the work of medical units and specialists (Askin et al., 2014). It implies that every client’s condition should be examined by using available methods to determine the source of the problem and eliminate it (Askin et al., 2014). The case shows that the primary care physician made standard tests that were ineffective regarding the problem. However, he did not insist on additional investigation and consultations with other specialists. It means that all opportunities of the system were not used to diagnose Margaret and provide appropriate care. The absence of progress was the factor that made the physician continue the investigation and recommend other specialists. It indicates the disregard for the principle of comprehensive care and the inability to use available options.

The ineffective collaboration is another critical problem in the case. The statistics show that the lack of cooperation between specialists impedes clinical work (Steihaug et al., 2016). It is expected that complex cases or cases with unclear diagnoses might require cooperation between the medical staff and different specialists (Steihaug et al., 2016). It will ensure that all symptoms and necessary tests will be done and the patient’s condition will be evaluated effectively. Otherwise, there is a high risk of the wrong diagnosis, which is evidenced by the case. Moreover, the lack of knowledge and information sharing can be another source of reduced quality of care. The lack of discussions between specialists might negatively impact the choice of treatment and its effectiveness (Chandra & Staiger, 2020). Finally, the physician’s lack of competence and understanding of guidelines for assessing patients’ states can be considered the source of inefficiency (Askin et al., 2014). In such a way, it is critical to address these factors to improve the system’s work.

Possible Changes to the Health Care System

Collaboration

The case shows that the healthcare system requires continuous improvement to ensure increased quality of care and patient satisfaction. A major change should be made in diagnosing patients and managing their symptoms. Using individuals’ claims as the only factor for investigating the case might be an ineffective method of diagnosing. Clients might fail to recognize their conditions and do not have the knowledge and skills to provide a clear and correct report (Askin et al., 2014). It means that if the reason for the emergence of specific symptoms remains unclear, it is vital to ensure the case is examined by other specialists (Stewart, 2018). It will guarantee the proper investigation of every case and improve outcomes. However, it requires enhanced collaboration between specialists and aligned mechanisms for their interactions. The inability to discover a possible cause for the deterioration in the client’s state should be viewed as a signal to discuss it with colleagues and recommend visiting another specialist. In Margaret’s case, it will help to minimize the risk of poor diagnosis and ineffective treatment.

Information Sharing

However, the change discussed above requires enhanced information sharing. Health workers should have an opportunity to share tests and investigation results with their colleagues to ensure they possess the correct understanding of the case and diagnoses that are already excluded (Steihaug et al., 2016). It will help to focus on analyzing other aspects of the body’s work to discover the possible reasons for the emergence of an undesired condition. Moreover, this approach guarantees that the patient will not have to remake some tests as their results are already available to physicians or other specialists. From another hand, collaborative work on a particular case helps to analyze it from various angles, consider all possible options, and make a final decision about the possible condition and treatment. It reduces the probability of mistakes and helps to avoid situations such as those described in Margaret’s case.

Continuity of Care

Another possible change that can be made regarding the discovered sources of inefficiency is to align the continuity of care. The approach implies that patient-centered care is provided by a highly cooperative team engaged in the continuous management of a discovered condition to attain the desired outcome and provide high-quality medical care (Biringer et al., 2017). Margaret’s case shows that the physician’s lack of involvement and understanding of her current needs might be one of the reasons for the inability to notice changes in her mental status and behavior. It impacts the quality of care and patient satisfaction levels. For this reason, it is necessary to use the patient-centered care model and plan all interventions regarding ongoing healthcare management and existing issues. It would ensure that Margaret’s and other clients’ diverse needs are considered and examined by a team possessing enhanced knowledge of their current statuses.

Mental Health

The lack of attention to patients’ mental health can be another possible cause of reduced care. The case shows that the psychiatrist was the last option that emerged when all other specialists failed to diagnose Margaret and improve her condition. It evidences the lack of cooperation between physicians and psychiatrists and the lack of attention to this aspect of health. However, following the official statistics, about 21% of adults in the USA experience mental illness (National Alliance on Mental Illness, 2022). It demonstrates the scope of the problem and the necessity to consider some neurological symptoms while examining patients. Physicians should possess higher awareness of possible signs of mental disorders and recommend visiting a mental health specialist to acquire a better understanding of the current case and possible treatment. It might be beneficial for clients to include psychiatrists in the team, providing patient-centered care and investigating the case (Askin et al., 2014). It would help mental disorders at the first stages and use an effective treatment.

Conclusion

Altogether, the discussed case shows some serious sources of the reduced quality of care and ineffectiveness impacting outcomes and patients’ satisfaction. Margaret’s physician could not diagnose her because of the lack of competence and skills required to work with mental disorders. It indicates the lack of collaboration, data exchange, and communication between health workers. The system was used ineffectively as Margaret had to visit other specialists before a psychiatrist offered the correct treatment. The possible changes to improve the situation might require using the patient-centered approach, aligning better collaboration between health workers when dealing with patients’ cases, and increasing attention to mental health issues. It might reduce the number of unnecessary tests made by specialists to evaluate the condition and improve patient satisfaction. In such a way, the case helps to outline problematic issues and consider possible methods to address them.

References

Askin, E., Moore, N., & Shankar, V. (2014). The health care handbook: A clear & concise guide to the United States health care system (2nd ed.). Washington University in St Louis.

Biringer, E., Hartveit, M., Sundfør, B., Ruud, T., & Borg, M. (2017). Continuity of care as experienced by mental health service users – a qualitative study. BMC Health Services Research, 17(1), 763.

Chandra, A., & Staiger, D. (2020). Identifying sources of inefficiency in healthcare, The Quarterly Journal of Economics, 135(2), 785–843,

National Alliance on Mental Illness. (2022). Web.

Steihaug, S., Johannessen, A. K., Ådnanes, M., Paulsen, B., & Mannion, R. (2016). Challenges in achieving collaboration in clinical practice: The case of Norwegian health care. International Journal of Integrated Care, 16(3), 3.

Stewart, M. (2018). Stuck in the middle: the impact of collaborative interprofessional communication on patient expectations. Shoulder & Elbow, 10(1), 66–72.

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