Managed Care
Patient safety has become a priority in many hospitals globally. There has been general awareness among health care providers and policymakers, to strengthen the management of healthcare provision. Many hospitals have adopted appropriate centralized adverse event reporting systems, although most of them still differ. There is still evidence for weakness in the processes of managing healthcare activities such as reporting adverse events. Only a small percentage of hospitals score highly in the managed care performance index. Many hospitals need to enhance the technical integrity of systems that foster managed care (Wolper, 2011, p. 653). For instance, nurses should be trained on how to conduct proper reporting and maintain updated records. Through performance improvement interventions, detailed assessment can be carried out in hospitals to determine the most effective methods to implement. Physicians should take part in managed healthcare provision that needs expertise, than just using general nurses (Lucero, Lake, & Aiken, 2010, p. 2185).
A high level of nursing care is an essential variable in intermediate care units or the HDUs. There is the limited ability of intermediate staff to provide complex care required by high dependence unit patients (Wolper, 2011, p. 654). Nurses must act profusely according to the patient’s current changing conditions. When allowed out of the ICU, patients requiring advanced nursing care are at a higher risk of an adverse event. Nurses can prevent many serious errors in the ICU. They should be regarded as a safety mechanism and have a pivotal role to play in error recognition and recovery. Lucero, Lake, and Aiken (2010) argue that about 5.7% of patients discharged from the ICU in Australian hospitals face high chances of experiencing serious adverse events including death. The most preventive measure to implement is deploying a high level of nursing care. This will ensure the early realization of adverse events predictors. It is vital for patients in the HDU to be attended by high skilled staff, considering their complex conditions (CDER, 2005).
Organizational Downsizing
Globalization became a strategy that countries and healthcare firms were using to tap the unexploited resources and opportunities for wealth creation (Wolper, 2011, p.183). This led to an explosive growth of businesses internationally. At this time, the fashionable thing was to look beyond national borders and take the opportunities that present themselves at international markets, which became closer than ever before globalization. It is now clear that globalization creates business opportunities at a cost. This cost is a result of international rationalization, which is ravaging the labor market with dire consequences, mostly in some parts of Europe. Downsizing is a reality for many healthcare organizations around the world. The desire of many firms to become more effective and efficient made the firms in both public and private sectors adopt the strategies of downsizing (William, Blinder, & Wolff, 2003, p.195).
The workplace became dynamic and competitive, and the globalization trends made health institutions downsize. The competitive pressures around the world are forcing health institutions to reduce cost, reduce labor force and restructure. Downsizing reviewing can take place in three perspectives that include industry level, organization level, and individual level. Downsizing is the reduction of the workforce in a systematic way, through sets of activities that will help health care institutions to improve on their performance and efficiency. This affects the processes, costs and workforce of the institutions. Downsizing aims to improve the organization. Downsizing is not only for organizations that are experiencing problems, but also for organizations that are growing (William, Blinder, & Wolff, 2003, p.195).
References
CDER. (2005). Conducting a Clinical Safety Review of a New Product Application and Preparing a Report on the Review. Web.
Lucero, R., Lake, E., & Aiken, L. (2010). Nursing Care Quality and Adverse Events in US Hospitals. Journal of Clinical Nursing, 19 (15/16), 2185-2195.
William, B. J., Blinder, A. S., & Wolff, E.N. (2003). Downsizing in America: Reality, Causes, and Consequences. New York: Russell Sage Foundation.
Wolper, L.F. (2011). Healthcare Administration: Managing Organized Delivery Systems. Sudbury: Jones and Bartlett Publishers.