Analyzing Service Failure at Furness Hospital

Introduction

Service failure is referred to the care performance which has failed to meet the expectation of the service users. In healthcare, service failure has an intense negative impact on the health of the services users where one can even face death. The nurses or service providers and hospital responsible for service failure are seen to experience public protest, negative legal consequences and image in the society. In the given case study, it is seen that Furness Hospital has faced severe service failure due to which 10 death of newborn is reported along with the death of a mother. In this assignment, with the help of process map one aspects of service failure in Furness Hospital is to be identified and analysed. Later, recommendation to resolve the aspect of service failure is to be provided. Lastly, plan for the mentioned recommendations is to be discussed.

Task 1

Identifying and analysing an aspect of service failure in the mentioned case study through process mapping

According to the NMC Code of Practice, the nurses are informed to understand their clinical competence level so that effective care services can be provided to the patient. In addition, it is required so that safe and secured care can be delivered to the service users (NMC, 2015). However, the analysis of case study of Furness Hospital informs that lack of clinical competence in providing care services to the patients is one of the key aspects in service at the hospital that led to their failure to deliver satisfactory care and improved health condition to service users. As stated by Soroush et al. (2016), clinical competence in nursing services is referred to the mixture of knowledge, attitude, skills and abilities to be held by each nurse to perform proper care of the patients in any clinical settings. This is because clinically competent services are able to maintain, promote and restore effective health of the service users or patients in clinical settings.

The clinically competent services can be provided in a hospital setting if the service providers or nurses have proper skills and knowledge regarding the way to deliver specific nature of care and support services required by the service user according to their individual health condition (Bvumbwe, 2016). This is because skills and knowledge lead the nurses to have effective understanding of the way of delivering appropriate and safe care to the service users, in turn, achieving the outcome of clinically competent services. In the given case study, the Morecambe Bay investigation revealed that service failure at the Furness Hospital occurred at the maternity ward because the frontline staffs were not providing appropriate and safe care to the service users and new-born babies (https://www.theguardian.com/society/2015/mar/03/morecambe-bay-nhs-scandal-furness-hospital" target="_blank">theguardian.com, 2015). In healthcare, the front-line staffs are the nurses or service providers who are directly responsible to deliver proper care services to the patient at all condition (Sharp et al. 2016). Thus, this reveals that lack of competency of front-line staffs those are the key care providers of the patients lead to the service failure as their inappropriate knowledge, ability and skills of not providing safe and effective care services led to the death of the mother and babies.

The clinical competence aspect in care services indicates the nurses have education and skills about the way to teamwork and share information to ensure quality care for the patients (Soroush et al. 2016). However, in the case study, it is informed that there was lack of efficiency among the healthcare workers to respond to fatal incidences and to adopt proper decision to prevent them. Thus, this lack of competency to change services according to the health condition of the patients led the Furness General Hospital face failure in delivering quality care services (https://www.theguardian.com/society/2015/mar/03/morecambe-bay-nhs-scandal-furness-hospital" target="_blank">theguardian.com, 2015). As mentioned by Mirlashari et al. (2016), clinical competence aspect in healthcare services leads to building of effective nurse-patient relationship and person-centred care. This is because delivering clinically competent services needs the nurses to communicate with patients and health professionals to determine nature of care to be provided to each patient according to their condition. However, this has not been achieved in the Furness Hospital by the nurses and it is evident as the nurses focussed on leading the pregnant mother to deliver their child through normal birth irrespective of their health complications and ability (https://www.theguardian.com/society/2015/mar/03/morecambe-bay-nhs-scandal-furness-hospital" target="_blank">theguardian.com, 2015).

The abidance of clinical competence aspect in care service leads the nurses develop practice-based learning and ideas about improvement to be made in their care delivery ways (Elie et al. 2018). This is because clinical competency educates the nurses take decision by considering the current health condition of the patient to arrange care as well as change the ways of care as per the changes in the health of the patient’s overtime. In the mentioned case study, it is reported that there was lack of clinical competency as the nurses did not learned or improved their services even after their initial failure that led them to execute series of service failures creating intense threatening situation for the patients within the hospital settings (https://www.theguardian.com/society/2015/mar/03/morecambe-bay-nhs-scandal-furness-hospital" target="_blank">theguardian.com, 2015). As asserted by Kim et al. (2019), clinically competent services make the nurses use evidence-based practice to deliver care to the patients. This is because evidence-based practice leads the nurses to understand from existing information about the fruitfulness of the specific care being planned to be delivered to the patient making them able to properly judge and delivery right care. In the mentioned case study, no evidence-base practices are reported to be used by the nurses which inform that clinical competence aspect of care service was not followed that eventually lead to the failure of care services at the hospital settings.

In order to provide clinically competent care services, effective quality improvement opportunities are required to be made available in the settings by the management. This is because quality improvement helps nurses and midwives in the hospital settings update their skills, knowledge, attitude and actions according to changing health condition so that they can become clinically competent to deliver improved in care (Kim and Shin, 2016). However, in Furness Hospital it is reported that the management at all levels are dysfunctional and have not taken any effective actions to improve quality in the settings even after initial service failure which led to the downfall of care and death of service users in the hospital (theguardian.com, 2015).

The development of effective teamwork and collaboration is required to deliver clinically competent services. This is because teamwork helps the nurses and other service providers in health settings to discuss and share information related to care services to ensure competent care support is established (Brashers et al. 2016). However, in the case of Furness Hospital, it is seen that there was lack of collaboration and teamwork between staffs that lead them to deliver hindered care services which are not clinically competent. This is because without collaboration skill and knowledge gaps are established which created barriers to deliver effective care.

Task 2

Recommendations to improve service delivery

Life-long learning:

The nurses, midwives and health professionals at the hospital settings are suggested to involve in life-long learning to deliver clinically competent care services. This is because life-long learning leads the health professional, nurses and others learn from different sources about the improvement in their skills, knowledge, ability and attitude is required so that they are able to improve their competency level for delivering quality care services to the service users in all clinical condition (Rugen et al. 2018; Sevin et al. 2016). This is evident as life-long learning will lead the midwives at the Furness Hospital understand the advantage of caesarean over normal birth in certain condition making them change their attitude of forcefully pursuing normal childbirth for all.

Evidence-based practice:

The midwives and nurses at the Furness Hospital are required to involve in evidence-based practice. The evidence-based practice is referred to the integration of patient values, clinical expertise and best nature of research evidence for making care decision to deliver care successful care to the patient (Dang and Dearholt, 2017; Saunders and Vehviläinen-Julkunen, 2016). Thus, taking up of evidence-based practice initiative is going to help the midwives and nurses improve their skills and knowledge about the way to reach excellence in care delivery for the specific patients. This in turn also makes them better clinically competent to deliver care. Moreover, evidence will help to resolve raised problems in the settings making the nurses and midwives find an easy solution for the barriers experienced in delivering clinically competent care.

Benchmarking:

The Furness Hospital is required to mention benchmarking for care services within the settings. The benchmark is the reference point or standard that is considered for comparing activities (Lejonqvist et al. 2016). The implementation of benchmark within the setting will improve clinically competent services because it will help the nurses and midwives have ability to compare their present services with mentioned standards and be alert about the changes to be made in their skills and knowledge along with attitudes so that effectively competent care for the service users can be delivered. This is going to ensure safe and appropriate care be provided to the patients in the mentioned settings.

Training:

The nurses and health professional at the settings are required to be provided training by the hospital management to make them competent to provide effective clinical care in emergency as well as in normal condition. This is because in training the health professional, nurses and midwives are informed and educated about various updated skills and knowledge to be required by them in delivering improved care to the service user. In this training process, the midwives are able to be informed about the significance of caesarean birth and the reason behind normal childbirth is not preferred making them act clinically competent to provide appropriate care to patients accordingly to their health condition.

Proper Investigation:

The Furness Hospital requires improving the investigation ways within the settings so that faults and failure in care services can be identified at right times. This is essential as it is going to help the nurses and midwives within the settings become aware of the situation and patients for whom the clinical competence in their services are not met. It is going to make them take early actions to prevent service failure and prevent negative impact on the health of the service users.

Teamwork and Attend conferences and seminars:

The nurses and midwives in the Furness Hospital are required to attend conferences and seminars where different topics regarding nursing are discussed. This is essential as in these conferences various information about advanced nursing care as well as management of different health complications are provided. In addition, attending the conferences will lead the nurses and midwives have the opportunity to exchange ideas as well as stay updated about nursing practices through interaction with different speakers, professionals and experts. This is going to make them remain updates to provide efficient clinically competent care for the service users. The nurses and midwives at the settings are to be made to work as team and share information so that they can provide clinically competent services. This is because team working helps them to execute care in a competent way by sharing skills and knowledge from other to resolve barriers ion services that eventually lead them to fail in providing effective care to the service users.

Better management:

The management within the Furness Hospital is required to implement mechanisms and strict rules to positively promote skills, knowledge, personal attitude and beliefs of the nurses and midwives. It means the management of the hospital is needed to set punishment and rewards for clinically competent care service accomplishment and failure for the nurses and midwives so that they are made to work properly. This is because the rewards act to provide value to the nurses and midwives to work competently to deliver positive care to the service users whereas the punishment acts to make them fear of avoiding to carelessly supporting the patients as seen previously.

Task 3

Developing an implementation plan for the suggested recommendations

In order to implement the recommendation regarding benchmarking and evidence-based practice in Furness Hospital, the SMART goal is to be used to develop the plan regarding the implementation. The SMART goals help to clarify the ideas, develop focus on efforts, make effective use of time, use resources productively and accomplish the needs that are wanted. The SMART is an acronym which stands for specific, measurable, attainable, reliable and time period (Revello and Fields, 2015).

SMART goals for implementing Evidence-based practice:

Goal Aspect	Description
Specific	The goal is specific because the evidence-based practice helps to provide detailed theoretical information to the nurses and midwives regarding the way to deliver clinically competent services to avoid service failure in the settings.
Measurable	The goal is measurable because reviews and feedback from the management, service users and their family members along with peers of the nurses and midwives in the hospital setting are to be received after implementation of evidence-based practice. This is because the feedback and reviews are to be compared to identify if the evidence-based practice has been effectively applied to deliver clinically competent services to services users by the nurses and midwives or not. Moreover, the health condition and mortality rate of newborn babies as well as patients are to be evaluated because the numbers are less then it indicates that the evidence-based practice is successfully applied and clinically competent care is provided due to which better health of the patients is achieved and fewer patients are suffering negative care in the settings.
Attainable	The goal is attainable because within the hospital settings previous clinical reports and treatment consequences of the patients without revealing their names are to be informed to the nurses and midwives so that they can use it as evidence to plan care to achieve effective clinical competence in providing care services to patients.
Reliable	The goal is reliable because way to execute evidence-based practice for achieving clinical competence in delivering care is to be informed to the nurses and midwives by experienced health professionals and mentors.
Time Period	In order to meet the goal, a minimum of 1 month time is required.

SMART goals for implementing Benchmarking:

Aspect	Description
Specific	Implementing benchmarking to compare nurses' and midwives' services with clinical standards to ensure competent patient care.
Measurable	Weekly monitoring of services to compare with clinical standards; evaluation of patient health condition for improvement.
Attainable	Standards for comparison are established by the government.
Reliable	Benchmarking implemented in consultation with legal healthcare standards.
Time Period	Minimum of 2 months required for implementation.

Conclusion

The above discussion informs that in Furness General Hospital the clinical competence aspects of service is not followed by the nurses and midwives which led to death of babies and mother along with intense service failure. The clinical competence aspect of service can be improved by the hospital by implementing benchmarking, training of nurses and midwives, executing life-long learning, following evidence-based practice, maintain proper investigation, team working and attending conferences and seminars and better management. The way to achieve the recommendations of benchmarking and evidence-based practice for delivering clinically competent care services are planned through SMART goals.

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