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Continuing Education

Volume 11
www.nhanow.com

Copyright 2012. National Healthcareer Association. All rights reserved.

Problem Solving in the Workplace


All health care personnel encounter problems with equipment, patients, resources, and other staff. Health care workers
continuously identify and resolve these problems. Problems may be simple and easily resolved, or extremely complex
and difficult to solve. In a fast-paced clinical environment, it is important for workers to identify and resolve problems
quickly and efficiently.
Problems encountered in health care
Problems in health care can be patient-related. Patients can be non-compliant with medications or prescribed therapies.
A patient can suddenly develop shortness of breath and the provider must take action. Problems may be encountered
when communicating with patients who speak a language other than English or who have cognitive disabilities. Patientrelated problems of varying urgency and complexity can occur in any clinical setting.
Problems with equipment, staff, policies, and processes can also arise in any clinical setting. For example, a hospital
unit could have inadequate staffing or budgetary constraints that compromise the quality of patient care. An equipment
problem can be a vitals monitor that is frequently out of service, or the implementation of a new insulin delivery device
that causes a doubling in the rate of needle stick injuries. These types of complex problems require a systematic approach
to identify solutions.
Steps to Problem Solving
Simple problems may have obvious solutions, but complex problems often require a systematic approach to solve.
Numerous problem-solving models exist. In general, these approaches involve the following steps:
1. Define the problem.
Although this step may seem simple, be sure to identify the actual problem and not the symptoms of the problem.
If the problem is complex, a root cause analysis is sometimes used. This systematic type of problem solving seeks
to determine the root cause of a problem and is used to define the true problem that is causing adverse effects. For
example, in a nursing home that has a high mortality rate of influenza infections, the root cause analysis may reveal
that the facility does not have a clear respiratory isolation policy. The problem to resolve would then be development
and implementation of respiratory isolation practices.
2. Analyze the problem and collect data.
Determine the factors that contribute to the problem, describe the current situation, and determine the complexity of
the problem. Identify a goal or outcome to achieve as a result of solving the problem or describe the ideal situation.
3. Generate a list of solutions.
Brainstorm to generate possible solutions. Do not discard any ideas at this stage, because a seemingly poor solution
may be the best option. Thoroughly evaluate each solution as described in the next step prior to discarding it. To
produce diverse solutions, view the problem from several different perspectives, and ask for input from others if
appropriate.
4. Analyze the solutions and decide which is best.
For each solution, write down the advantages and disadvantages. Assign an importance to each advantage and
disadvantage and prioritize. Evaluate the solutions with the most important advantages and least important
disadvantages. Determine if the solution actually solves the problem and evaluate the potential effects of
implementation.
5. Implement the solution.
Construct a plan of action for implementing the solution. Determine the resources needed and the personnel
involved. Divide the plan of action into steps and assign tasks as necessary. The plan of action may need to be
modified if resources are unavailable or if steps cannot be implemented.
6. Evaluate the effectiveness of the new solution.
After implementing the solution, evaluate its effectiveness. Recall the original problem and determine how well the
solution resolves the problem. Evaluate the extent to which the solution meets the goals or outcomes, or how well
it improves the situation. The solution may need to be modified. A new problem may be created, or an alternative
solution may need to be implemented entirely. If necessary, repeat the problem-solving process and redefine the
problem.

NHA Continuing Education Volume 11

Barriers to problem solving


Barriers to problem solving may be internal or external. Internal barriers involve the providers thought processes and
motivation, while external barriers are related to people, policies, or systems. These barriers sometimes prevent a person
from identifying a problem or implementing a solution. Be aware of potential barriers so that they do not impede the
problem-solving process.
Internal barriers include personal values, prejudices, and motivation. These affect problem-solving ability. For example,
staff may repeatedly use a piece of equipment that is known to be dysfunctional and choose not to resolve the problem
for lack of motivation. In addition, a person may feel that certain people do not deserve help in solving a problem or
that a problem is not worth solving. It is important to understand how personal values and prejudices can impede the
problem-solving process.
An external barrier is fixation, which is when previous experiences or familiarity with a subject prevent a person from
identifying a problem or solution. For example, a quality assurance representative identifies the cause of frequent
medication administration errors in a certain unit to be inadequate training. The same representative assumes that the
problem of frequent medication errors in another unit has the same cause and fails to identify a systems error as the root
of the problem. It is important to be aware of fixation and carefully examine each problem objectively.
External barriers may prevent a problem from being identified or resolved. For example, other staff members may be
resistant to change, preventing a solution from being implemented. The facilitys policies may need to be changed in
order to resolve a problem, the resources needed to solve the problem may not exist, or management may not be willing
to allocate the required resources. To overcome these barriers, understand why they exist and be creative in working
around them. If the problem is important, the situation may need to be escalated along the chain of command. Use the
problem-solving steps to design a proposal for implementing a solution.
Summary
In summary, a wide range of problems with varying complexities is encountered in the health care setting. Although
simple problems can be resolved quickly, others will require the use of a systematic problem-solving method. Internal
and external barriers can prevent a problem from being identified or resolved, requiring a creative approach in
developing a solution. Problems can be identified and resolved by staff working at any level, and with collaboration and
a systematic approach, effective solutions can be designed and implemented.

NHA Continuing Education Volume 11

References
Cherry, K. (n.d.). What is Problem-Solving? Retrieved from http://psychology.about.com/od/problemsolving/f/
problem-solving-steps.htm
Problem Solving Skills. (2010). Retrieved from http://www.athealth.com/consumer/disorders/problemsolving.html
Problem Solving Skills. (2011). Retrieved from http://www.mindtools.com/pages/article/newTMC_00.htm
Seven Steps to Problem Solving. (n.d.). Retrieved from http://www.pitt.edu/~groups/probsolv.html
Wikibooks Contributers. (2011). Cognitive Psychology and Cognitive Neuroscience. Retrieved from http://
en.wikibooks.org/wiki/Cognitive_Psychology_and_Cognitive_Neuroscience

NHA Continuing Education Volume 11