Setting Standards in Health Care

Setting Standards always has motivated me to work harder. There are areas where standards will improve with time alone as developments creep in as there will be exposure to everyone. however one should not wait for these and have to be actively engaged in these activities.

It is not just important for setting standards by yourself as the long term goal maintaining the standards largely revolve around the fact that everyone follows them. I have found this as the hard way as setting standards being easier, only to find out in dismay later that these are not followed.

It is possible for us to set standards and see them maintained only if the stakeholders are taken into confidence and even be involved in setting the standards themselves by discussion. On the otherheand,forcing them enforces the changes only if two conditions are met.. 1. If you are the paymaster or the employer and the people will do with fear. 2. they will do when you are around and will not necessarily follow them when you are not there.

This is a new learning experience for myself as the culture, ethics and the society is different to my exposure in the last few years. However people's needs and the necessities are the same! Hence we trod along and find ways to set standards and maintain them.

It is also important that standards have to be constantly reviewed as the present standards are not necessarily acceptable in the future and in fact they often are not. Hence persisting the standards one learns during their earlier experience will be detrimental by not bringing new standards.

This appears to be a complex post even to me after writing this but i will elaborate by a simmple illustration.

Pain after surgery or after major trauma is perceived to be normal or acceptable to most health care workers, but from the patient point of view it is not acceptable. Hence the standards for assessing and acting on the pain of the patient by the health care worker had to be changed when i started my practice two and half years ago in India.

We brought our own version of Pain assessment and management in colloboration with the nurse leadership. I found setting the standard was not the most difficult part as the hospital management were very receptive. however the maintainance of this simple standard as we set out is difficult even after two years.

This may be the fact that i did not involve all the stakeholders when designing the standard in the first place. I am still learning.

I hasten to add that our standard of assessing and managing pain is much much better than two years ago with the awareness and the attitude to be significantly in the right direction. Hence i am happy with what we are doing and we have implemented so many other standards in the past two years.

I will elaborate on these in the future blogs

Regards

Chockalingam