Sunday, 4 May 2014

Triadic tension: Who does what in a hospital

THERE are three major groups in any hospital set-up: the medical team, the nursing team and administration or management, says neurosurgeon and law degree holder Dr Richard Veerapan.

Speaking on the Challenges to Compliance with Quality Improvement and Patient Safety Strategies during the recent “Overcoming Challenges to Quality Improvement and Patient Safety Strategies” workshop held in Kuala Lumpur, he notes that “so much goes back to the quality of the relationship you have with one another”.

The current law and society Doctor of Philosophy (PhD) candidate at the University of Victoria, Canada, calls the inter-professional relationships and conflict among these three groups the “triadic tension”.

“It is very important to understand the identity, authority and power balance between these three key groups.

“There’s a difference in how power flows in public and private hospitals; and also, for private hospitals, whether it is doctor-owned or corporate-owned,” he says.

One of the examples where this comes into play is when convincing hospital staff there is a problem in the first place, and that it needs to be tackled.

“For example, doctors have a different assumption about what a problem is, and their main focus is their patients,” says Dr Richard.

Then, there needs to be internal monitoring and data collection, which comes with its own set of problems.

“Who is driving this? Is it the administration, the nursing team managers or the doctors?” asks Dr Richard, adding that legal obligations are a “good ‘stick’” to encourage such activities.

He notes that when it comes to the human aspect, one problem is “getting people to step up and take responsibility – owning it”.

“Doctors need to do more than just treat their patients; they should also step up into leadership roles,” he opines. – Tan Shiow Chin

Tags / Keywords: Health , Patient safety , quality assurance , hospitals


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