Main Body
How Leadership Dynamics in Health Care Can Contribute to Medical Errors
Rana Roberts
Introduction
Leadership dynamics and hierarchies inherently exist in organizations. While these dynamics can be beneficial to an organization, some leadership dynamics can be harmful. Leadership dynamics in the health care setting can be especially dangerous as these dynamics can contribute to medical errors. Medical errors are the third leading cause of death in the United States following heart disease and cancer (DeAngelis, 2016). Furthermore, research from Johns Hopkins reveals that nearly 250,000 Americans lose their lives each year due to a medical error. This number is a rough estimate due to the broad range of medical errors that can occur. A variety of factors may cause a medical error, such as a breakdown in communication among a treating team to issues with technology design (Deangelis, 2016).
While it is difficult to count the number of deaths that have been caused by a medical error, factors that lead to medical errors can be explored in order to determine the best practice in prevention. Tucker and Edmonson point out that the reported number of hospital errors tend to focus on errors that result in the death of a patient, but there are also more subtle errors that occur on a daily basis in the health care setting that deserve attention as well. (Tucker & Edmonson, 2003). Medical errors are of public health concern because any patient in a health care setting is vulnerable to having a medical error. Evidence suggests that medical errors also impose a high economic burden on our society; it is estimated that nearly 15% of hospital expenditures are attributed to medical errors. Among the most burdensome adverse events that occur in the United States are healthcare-associated infections (HAI), venous thromboembolism (VTE), pressure ulcers, and medication errors (Slawomirski, 2017). Leadership dynamics and hierarchies that exist in the health care setting are contributing factors to these medical errors.
This chapter explores psychological safety along with how leadership, hierarchy, and teamwork may create less or more safe environments. A systems science perspective is introduced along with examining the nurse-physician relationship and personal experiences with psychological safety.
Teamwork
Leadership in the health care setting serves an essential role in ensuring that quality care is being delivered. Cross-disciplinary teams work together to share responsibility of caring for a patient, which can create challenges. A recent study by Nembhard shows 70-80% of medical errors are related to interactions among healthcare team members (Nembhard, 2009). These interactions within cross-disciplinary teams are essential in delivering the most efficient and quality care. Due to the increase in specializations of the health care field, patients are typically treated by several individuals rather than just one primary care physician. These individuals