A discussion of the problem of sentinel events, such as accidents, suicides or medical misadventures, at healthcare facilities.
Written in 2009; 781 words; 5 sources; APA; $ 27.95
Paper Summary:
This paper explains what are meant by sentinel events, as detailed by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), and describes how they are used to determine the weaknesses in existing procedures and systems. The writer explains that by quantifying the number of such adverse events and trending this information, problem categories can be identified and effective responses to them formulated. However, this can only work to the extent that healthcare facilities actually report such sentinel events.
Outline:
The Basics of Sentinel Event Reporting
The Legal Implications of Sentinel Events
Developing an Effective Risk Management Program
From the Paper:
"The standards established by the JCAHO for patient and employee safety are integrated through the organization's standards book and include reporting procedures, the leader's role in safety, failure mode analysis, patient disclosure information, data collection requirements and root cause analysis techniques (Bernsten, 2004). The JCAHO reports that, "Sentinel Event Alert identifies specific sentinel events, describes their common underlying causes, and suggests steps to prevent occurrences in the future. Accredited organizations should consider information in an Alert when designing or redesigning relevant processes and consider implementing relevant suggestions or reasonable alternatives" (Sentinel event alert, 2008, p. 1)."
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