Health Care Systems- Surgical Unit

 Introduction
The Sentara health care is an integrated health care delivery system that operates and serves the residents of North Carolina. The hospital has developed a methodical program that fosters an atmosphere of safety throughout it affiliate hospitals. The aim of the hospital is to reduce the potential for patient harm. The purpose of the program is to encourage employees to be mindful of signs of inadequate services and act on those signals. The program facilitates the superiors role in
ensuring employees behavior in a way that guarantees patient safety, institute a ruling from mistakes program that safety guards against repeating the same errors, and rewards employees who attain the highest standards of performance. The initiative has reduced the frequency of occurrence of serious errors in the hospital by 80%.
Health care systems- surgical unit
It has been a decade since the institute of medicine (IOM) released their report err is human. The report brought to light a number of common errors and possible fixes that could help fix the problem. Since the report of released over a decade ago, there has been joint efforts to try to increase patient safety in the country, however, the nation is far from achieving an ideal. A research conducted by the commonwealth fund five years after the release of the report identify organization that have taken steps towards achieving one of the recommendation of the IOM report, which is an organization culture of safety. This case study documents the progress that has been achieved through sustained effort by the Sentara healthcare. The healthcare center initiated an initiative aimed at reducing the occurrence of accidents that result in harm to the staff and patients and hospital ultimately building a culture of safety.
To understand the working of the hospital it important to know that the hospital is a non-profit organization that serves close to 2 million people in the Virginia and Carolina area. The hospital operates in more than 100 acres and has eight acute care hospitals. Other care centers in the hospital include nursing homes, assisted living centers, and outpatient and diagnostic imaging centers. The hospital uses a system wide electronic health record keeping system that helps integrate and improve the safety of care. The medical information stored in the hospital services is accessible through a portal. The hospital was the first hospital in the country to enable a remote an Electronic Intensive Care unit (e-ICU) system that enables healthcare providers to monitor patient wellbeing from a remote location.
The Open System Theory (OST) provide the theoretical foundation for the Nursing service delivery Theory (NSDT). According to the OST, institutions like the Sentara health care center constitute an energic input-output system. The inputs into the organizations system depends on the organizations environment. The output depends on the patterned activities and interaction of individuals to yield outputs. According to the OST, an organization and its subsystems strive to achieve equilibrium, such that disturbances in the system prompt the system to adapt. The energy flow through the system preserves the organizations character. According to the OST, an organization transforms input energy through the division of labor to the various subsystems that accomplish tasks. This optimizes the performance of the system through technical proficiency. The underlying secret is the division of labor using coordinating devices that integrate work processes across subunits.
The multiplicity in function of an organization subsystem increases the demand in coordination within the organization. Working in the Sentara health care surgical unit is an experience like no other. The large number of population dependent on the hospital means the workflow in the surgical unit is higher than in other health care system. As in any other human operated system, errors occur from time to time. The important thing is not to deny the error, but to accept and learn from the error. Unlike other departments within the hospital, the surgical department is performance critical operations that have dire consequences when errors occur. Because the organizations operation follows the OST, the organization can always adapt and evolve depending on feedback from the external environment while still maintaining its character.
Part of the surgerical operations performed at the hospital is acute care surgery. This encompasses general surgery and surgical critical care. There is a growing demand of access to emergency surgical services of a critical nature unfortunately, this is accompanies by a declining number of surgeons willing to take emergency calls. While the field of acute care surgery is evolving in response to this need, sometimes the demand is all too overwhelming for the existing personnel. On the major factors that turn away surgeons to the acute care unit is multiple organ failure, which is a common occurrence. The application of the OST to the Nursing Service Delivery Theory (NSDT) reveals six concepts. Inputs are the first concept in the open system and include the flow of information. The application to the NSDT is the people, materials, resources, and information at the healthcare center. Inputs could be perhaps a source of problem in the care of patients because the number of patients willing to serve critical patients is not enough to meet the demand for their services. Throughput includes the energies within the system, such as the provision of services by the nurses. Output includes the products exported to the external environment, such as the patients. Output is another part of the system that needs addressing because the number of patients visiting the hospital exceeds the number of personnel available at the hospital ready to offer the care required by the patients, especially patients requiring care of a critical nature.
System as cycle of events in the other concept in the OST that is applied to the NSDT. The system through accreditation and the revenues gained from its operations aspire to achieve the highest standards of service possible. The organization considers negative feedback as a performance indicator and uses it to keep the organization on target. Some of the policies that the organization can institute to tackle the current challenge is to train more surgeons and nurses to perform surgical critical care. The healthcare center could provide incentives to personnel to encourage them. Satellite care centers could also be constructed with rapid response systems that ensure the fast transportation of patients requiring critical care. Other patients not requiring critical care could receive care at the satellite facilities. The e-ICU could aid in the joint operation of the facilities. This would ensure that surgeons at the main surgical facility are only consulted when the situation becomes critical. With the availability of well-trained surgeons across the satellite facilities, the expert surgeon could aid the operation from a remote location using the e-ICU.
Conclusion
Established safety standards reinforce expectations and ensure accountability. For a healthcare center such as the Sentara to provide top-notch services, it must strive purposefully to achieve highly reliable operations. The system must make it easy by providing the necessary resources and material for every personnel in the facility to perform their duty. The system and machines in the facility are designed with an understanding that humans can perform an error at some times. The machines and system therefore have prompts and provide advice based on the information available on the patient in question. The progress made so far is a result of the perseverance, focus, and willingness of the Sentara community in their engagement in safety.