Running head: HEALTHCARE INDUSTRY RESEARCH

Healthcare Industry Research

Ivan Jesus Gonzalez
Nevada State College

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Introduction
In the healthcare industry, patient safety is as big of an issue as worker safety, although
miscommunication is much too common. Since the release of the landmark institute of medicine
study in 1999, reducing the amount of medical errors has been top priority (Kohn & Korrigan,
2000, p.2). The Committee on Quality of Health Care in America founded a study in 2000 stating
that preventable medical errors account for as many as 98,000 patient deaths per year
medication errors alone caused up to 7000 of those fatalities (Kohn & Korrigan, 2000, p. 27).
One could agree that the numbers alone are shocking, but this continues to be an ongoing
problem. This large number of fatalities raises the question: How do healthcare professionals
writing skills impact patient care?
Literature Review
The literature review contains two different themes on the impact that healthcare writing
can have on patient care. One of these themes is the communication and miscommunication
among doctors, nurses and medical assistants. Miscommunication among health care
professionals can provoke adverse advents such as medication errors or even technical
malfunctions. The other theme is the differential between the training that a physician must
undergo compared to a nurse practitioner and its effect on both of their writing skills.
The communication on diagnoses of patients among doctors, nurses, and medical
assistants should be clear and concise. All of these healthcare professionals have a vital role to
play when performing their duties. Writing skills should be just as important as communication
among peers. The documentation within medical records is very important because it contain
the patients history, clinical findings, diagnostic test results, preoperative care, operation notes,
post-operative care, and daily notes of a patients progress and medications (Thomas, 2009,
p.4). These are just a few examples of why communication is key when having to carry out these
procedures patient by patient. However, miscommunication can occur due to physicians

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assuming that entry into the computer system replaces their previous means of initiating and
communicating their plans, and that orders will be carried out without further action on their
part (Gorman, 2003). As a result of this miscommunication, orders are missed, medication is not
given, and diagnostic tests are delayed. A medical professional should make sure that he or she
communicates clearly with whoever takes over handling the patient. In this case, it could be
between a nurse and a physician in the transfer phase. If this is not preformed successfully, then
errors are bound to occur.
Medication errors are not only dangerous but are also very costly. Medication errors in
Australia resulted in 80,000 hospital admissions in a year costing the country 350 million dollars
(Ash et. al, 2004). Although adverse events are not completely caused by miscommunication, at
times physicians do not focus on errors that were caused by technical dysfunctions or even faulty
programming. Unfortunately, these hardware problems are much more common than they should
be, and this is critical especially in a field like medicine. However, these problems can be
avoided through testing before implementation, and often errors that occur due to individual
dysfunction are not discussed (Gorman, 2003). An example of this could be a physician refusing
to check for a technical problem because it is simply not his task.
Although the healthcare industry contains a complex variety of medical professionals,
there could be a differential between a nurse practitioners skills in writing compared to a
physicians. Both of them have a similar goal in mind and that is to improve patient outcomes,
but barriers that do not allow for successful collaboration exist. Physician dominant
organizations as well as the American Medical Organization believe that physicians' longer,
more intensive training means that nurse practitioners cannot deliver primary care services that
are as high-quality or safe as those of physicians (Fairman et. al, 2011, p. #). Many times, the
records that physicians must use are written by nurses or medical assistants, but this can be

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difficult due to the fact that some physicians believe that nurse practitioners are lacking
competence to provide quality healthcare to begin with (Fairman et. al, 2011).
The ability to compare physicians with medical degrees and nurse practitioners was not
possible in the past but now nurses can obtain higher level degrees. The roles between the two
used to be easily distinguished due to one wearing a white coat and the other one wearing a white
uniform cap, and this is not the case anymore. Even patients cannot tell whether or not they are
being looked after by a physician or a nurse practitioner and the reason behind this is the
development of advanced degrees for nurses (Jecker et. al, 1991, p. 292). Their educational level
was also a reliable indicator, but now a doctor will have an undergraduate and an MD while a
nurse might have a masters degree or even a research degree if they wish (Source). They used to
be well separated, and this simply does not exist anymore because physicians can prescribe you
medicine to patients, but now so can nurse practitioners (Hain et. al, 2014). Both have equal
education, but they undergo different types of education since a doctor will be trained to think
more analytically while a nurse will be well rounded and specialize in clinical thinking (Hain et.
al, 2014). Author Julia Clarke on Perspectives on Learning says pity the poor nursing student,
who is required to write at times like a sociologist, at others like a philosopher, yet again like a
scientist and finally as a reflective practitioner given that the nurse would be more wellrounded due to variety in training (Clarke et. al, 2002, p. 10). Seeing as they are both very
educated and long for the high risk field of medicine, this needs to be proven to see if there really
is a difference in the way they think. In the research survey both nurses and doctors answered
most of the questions but both of them answered in a different way. When it comes down to it,
both of these professionals were asked if they always make sure to follow up with other
healthcare partners on the tasks they performed and were given the possible answers yes, no, and
sometimes. 71% of the respondents answered sometimes including the professional with the

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medical degree so this research showed that medical professionals are much more likely to
assume that orders will be carried out without further initiative then to provide reassurance.
Many people including healthcare professionals will wonder how they impact a certain
individual or what skills allow them to do so. In this case how would a medical professionals
writing skills impact patient care, specifically doctors, nurses and medical assistants?. As an
interested researcher I wanted to examine what these people think but without taking too much
time out of their busy schedules like an hour interview would. So I began to think about
incorporating surveys due to the fact that they arere very simple and require nothing more than
10 minutes of their time. A survey seemed to be the most optimal solution concluding that this
research would be more so quantitative than qualitative.
Methods
In order to examine how healthcare professionals writing skills impacts patient care, a
survey will be put in placewas administered so that we canto examine if they exhibit their prior
knowledge and if they follow specific guidelines that were set. This will be concluded on
physicians and nurses and the results of this observation will inform fellow researchers and the
hospital itself if these medical professionals communicate efficiently and also follow up on each
task they must perform.
The survey contained a mixture of ten multiple choice and free response questions that
had to do with how many years the person has been in the healthcare industry, how they would
rate their own writing skills and if writing skills should be just as important as communication.
Since attempting to make this questionnaire as appealing as possible and posting the link on
healthcare forums such as Allnurses.com and various groups on Facebook I should have
known the responses I was going to receive. A total of 17 healthcare professionals decided to
take the survey and add to my researchresponded. Over 41% of the respondents had been in the
industry for over 10 years, and one participantof them had 43 years under their scrubsof

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experience which is very remarkable. Since I was notnt able to handpick all of the participants, I
instead had a batch of multiple degrees:, 37% of the respondents had an associates degree in
nursing; while the another 37% had a bachelors in nursing; and even one doctor of medicine
answered the questions listedparticipated.
I was very interested in knowing their backgrounds as med. professionals and some
decided to answer while others skipped the questions or gave responses like no.. What really
caught my attention was that for the people who did respond, they had many other professions as
their life went on. For example the nurse who has a masters in nursing, thesis program has been
through many other careers such as a critical care nurse, nursing Ed, nurse editor, and even
consulting. Everyone had the question On a scale of 1 to 3 which do you think is most
important: communicating effectively among patients, incorporating proper writing skills when
completing daily logs and patient history charts, and following up tasks performed with other
healthcare professionals and 50% of the respondents had placed communicating effectively
among patients as their first choice while the other 50% placed incorporating proper writing
skills into their daily routines. While the nurse who has the masters degree in nursing labeled the
answer incorporating proper writing skills as her first choice, this could mean that with more and
more experience comes more responsibility for their actions done on a routine basis. Fortunately
this person answered many other questions as well unlike other respondents who decided to skip
many of the more important questions. The same person rated their own writing skills a 1 from a
scale of 1-5 and after being asked if he/she believed that they have used the skills and
information learned in prior English classes, the participant responded with clear
communication is vital in all aspects of care. I have always tried to write clearly, succinctly, and
accurately.. This answer coming from someone who has a vast amount of experience in the

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healthcare industry could mean that after so many years they still incorporate the information
learned in their daily lives.
Along with the most important questions in the survey one of them is writing skills
should be just as important as communication and thankfully everyone agreed. Disregarding the
pediatric nurses opinion to one of the free response questions stating that this survey is poorly
written a majority of people wrote that the most common error regarding communication
among healthcare professionals was medication errors for example missed or late doses and
generally, the most common errors are wrong drug, wrong dose, wrong patient, and wrong time
as well.. Due to the research covered by the survey it allowed us to detect the reason why
adverse events were occurring following the medication errors.
Overall the people who had the most experience for example multiple professions in the
past and higher education levels had the most in depth opinions on the questions. They provided
more of a specific and detailed answer rather than just skipping questions. It was interesting to
see who would skip certain questions and out of all the people who saw this survey, only a small
portion decided to fill it out. Every single person had a different opinion on things but questions
that are taught in school, the respondents answered them correctly as they were once taught. So
the writing skill of a healthcare professional can and will affect the way a patient is treated
whether it be a wrong drug due to poor writing or the wrong time the drug is given. The
information recorded allows us to believe that they all exhibit their prior knowledge on their
daily routines while at work giving patients the satisfaction needed.
References
Aiken, L. (2003, January 10). Educational levels of hospital nurses and surgical patient mortality.
Retrieved from http://jama.jamanetwork.com/article.aspx?articleid=197345
Ash, J. (2003). Perceptions of physician order entry: Results of a cross-site
qualitative study. Journal, volume, issue, p. # Retrieved from
http://www.ncbi.nlm.nih.gov/pubmed/14534628
Fairman, J., Rowe, J., Hassmiller, S., & Shalala, D. (2010). Broadening the

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scope of nursing practice. Journal, Volume, Issue, p. #. Retrieved, from

http://www.nejm.org/doi/full/10.1056/NEJMp1012121
Hain, D., & Fleck, L. (2014). Barriers to nurse practitioner practice that impact
healthcare redesign. Journal, volume, issue, p. # Retrieved from
http://nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/T
ableofContents/Vol-19-2014/No2-May-2014/Barriers-to-NP-Practice.html
Harrison, R., & Clarke, L. (2002). Academic writing in new and emergent discipline areas. In
Supporting Lifelong Learning: Perspectives on Learning (Vol. 1). (Eds) London:
Routledge Falmer p. 10
Kohn, L., & Corrigan, J. (2000). To Err is human: Building a safer health system. Journal of
Vascular and Interventional Radiology, (Vol. 6). p.112-113.
Jecker, N., & Self, D. (1991). Separating care and cure: An analysis of historical and
contemporary images of nursing and medicine. The Journal of Medicine and Philosophy, 16,
285-306. Retrieved from file://fs01/profiles_students$/5002399904/Downloads/SeparatingCareAndCure.pdf
Reflection
This being the last paper I tried to incorporate as much information as possible with all of
research being done by me. In my opinion I really enjoyed this paper because of the fact that I
had to go ahead and record data on my own. At first I thought that I would make my way to one
of the local hospitals and do my research their but that failed when I wasnt even allowed to go
into the more important rooms because medical professionals are so busy most of the time. I then
found out about a website called survey monkey and made my own survey that fit well with my
paper. Since there wasnt much time to conduct research I took everybodys answers on the
questionnaire and incorporated them into the methods section instead of going to the hospital and
having a whole team of med professionals fill out the survey. In order to make this paper work I
kept the introduction and the literature review but I made some changes to it in order to fit the
whole paper. The methods section was completely re done and made to fit the responses of the

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participants. I kept the same references because they were used for the literature review and I
saw no point in leaving them out.