Question

Have you witnessed a workaround be more effective than what is currently in place? Please share an example and how the workaround could have been implemented into the safety culture in the clinical setting. What potential follow-ups can and should be done when a workaround is implemented?

Answer 1

Safety culture in clinical setting :

Health care has often faced the pressure to design, or redesign, its workflows to be more efficient and effective. In many cases, the trigger for examining workflow is in response to changes in how things are done. Today, the need to think about workflow design is more pressing due to several factors, including:

• The introduction of new technologies and treatment methodologies into clinical care

• The challenge of coordinating care for the chronically ill

• The participation of a growing array of professionals in a patient’s care team, and new definitions in their roles

• Cost and efficiency pressures to improve patient flow

• Initiatives to ensure patient safety

• Implementation of changes to make the care team more patient-focused

For example:

in a study of implementation of a nursing documentation information technology system, the investigators found that adoption was influenced by a number of attributes of the nurses, including commitment to nursing care planning and written documentation, acceptance of computers in nursing, computer and typing skills, professional experience, level of motivation, and climate of trust and support within the nursing team.

Potential work around implementations:

A workaround is a bypass of a recognized problem in a system. A workaround is typically a temporary fix that implies that a genuine solution to the problem is needed. But workarounds are frequently as creative as true solutions, involving outside the box thinking in their creation.

Typically they are considered brittle in that they will not respond well to further pressure from a system beyond the original design. In implementing a workaround it is important to flag the change so as to later implement a proper solution.

For example, in computer programming workarounds are often used to address a problem or anti-pattern in a library, such as an incorrect return value. When the library is changed, the workaround may break the overall program functionality, effectively becoming an anti-pattern, since it may expect the older, wrong behaviour from the library.

Answer 2

Safety culture in clinical setting :

Health care has often faced the pressure to design, or redesign, its workflows to be more efficient and effective. In many cases, the trigger for examining workflow is in response to changes in how things are done. Today, the need to think about workflow design is more pressing due to several factors, including:

• The introduction of new technologies and treatment methodologies into clinical care
• The challenge of coordinating care for the chronically ill
• The participation of a growing array of professionals in a patient’s care team, and new definitions in their roles
• Cost and efficiency pressures to improve patient flow
• Initiatives to ensure patient safety
• Implementation of changes to make the care team more patient-focused

For example:

in a study of implementation of a nursing documentation information technology system, the investigators found that adoption was influenced by a number of attributes of the nurses, including commitment to nursing care planning and written documentation, acceptance of computers in nursing, computer and typing skills, professional experience, level of motivation, and climate of trust and support within the nursing team.

Potential work around implementations:

A workaround is a bypass of a recognized problem in a system. A workaround is typically a temporary fix that implies that a genuine solution to the problem is needed. But workarounds are frequently as creative as true solutions, involving outside the box thinking in their creation.

Typically they are considered brittle in that they will not respond well to further pressure from a system beyond the original design. In implementing a workaround it is important to flag the change so as to later implement a proper solution.

For example, in computer programming workarounds are often used to address a problem or anti-pattern in a library, such as an incorrect return value. When the library is changed, the workaround may break the overall program functionality, effectively becoming an anti-pattern, since it may expect the older, wrong behaviour from the library.