You are in charge of human relations at a large teaching hospital. The head of p

Question

You are in charge of human relations at a large teaching hospital. The head of pharmacy comes to you and describes continuing conflicts with the physician managing residents in anesthesiology. The physician continually badgers your staff with incomplete requests and sketchy notes that he claims are clear prescriptions, as well as demands for immediate handling of routine scripts. He does this while making rounds with residents and is often heard instructing them, “It’s necessary to keep the troops in order and tell ‘em who’s boss.” His residents are starting to follow these instructions to the consternation of your pharmacists; friends in nursing say the same behavior is taking place there. How do you, as a non-physician manager, deal with this growing problem?

1.       Would you file a complaint with the dean/physician in charge of the teaching program?

2.       What are the advantages and disadvantages of filing such a complaint?

3.       Is there a way to develop a program that would motivate the offending physician to change his behavior without creating an escalating conflict that is not winnable?

4.       What part might financial incentives play in creating such motivation?

Explanation / Answer

Safe prescription is very important to treat the patient's with no harm. A doctor plays a vital role in medication management because he or she is an authorized representative to prescribe medication for managing the clinical characteristics. And working as a team, where everyone has their responsibility to deliver quality and effective health services to patients. Any misguidance among the team shall be avoided for better functioning of he team. In the above mentioned situation, policies are not followed well by the head of the team,the doctor.

1) Making a complaint is very easy but not on the first attempt of any work related issue. The problem can be discussed one to one with the individual or else an open group discussion between the leaders of the team might be initiated. Followed, by this the recurrent events can be documented with the proof of illegible prescription and any related medication errors shall be reported immediately. If nothing works on the ground level with persistent efforts, it can be lodged as a complaint to the Dean or the physician in charge of the training program.

2) Advantages- It helps to change the attitude of the individual by undertaking strict actions. The work force will be driven by policy rather than behaviour.

Disadvantages- It can remain as a black mark in one's career and people may not have good understanding. There can be emotional turmoil and may not have a good mind set to work.

3) A program which includes the complete details of medication safety. This program can include real time examples of medication errors and the causes related to the errors.

Policy on medication management shall be inculcated during this program. Live presentation on medication error related to illegible handwriting. To make stringent rules to use capital letters for prescribing medicines, that can be shown effectively during presentation. Case studies related to consequences of illegible handwriting must be a part of the program.

4) Not only financial incentives, anything which can be given as reward for the better performance or lesser reports of medication errors. Remuneration can help in a smaller way and may not bring in huge differences but appreciation and felicitation can definitely motivates a person to change their behaviour and attitude.

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