I’m Dr Alanoud Alobaidly a Specialist Nurse at Jaber Alahmed Armed Forces Hospital, a lecturer at the College of Nursing, and an active researcher. I have a PhD in Nursing from Flinders University in South Australia. I’ve recently joined the Healthy Cities Office in Kuwait who aim to transform the State of Kuwait into a recognised healthy city by the WHO. My research is mostly on T2DM and obesity management. Although my background is in qualitative research, I’ve also conducted several quantitative research in public and community health. I’m also interested in innovative approaches in knowledge translation and education.
Swiss Cheese Model: Innovation in the management of T2DM and Bariatric Surgery
Abstract
Patients in Kuwait experience inefficient diabetes education, absence of patient education for bariatric surgery, and inconsistencies in service delivery. Despite the recommendations of the International Diabetes Federation of having a multidisciplinary team approach to manage people with T2DM for bariatric surgery, Kuwait has yet to include bariatric surgery as a treatment option for T2DM while implementing a multidisciplinary team approach. Discrepancies in the perceptions between patients and healthcare professionals might increase the risk harm to patients while decreasing service delivery for care of these patients. Therefore, understanding the views of healthcare professionals towards T2DM and bariatric surgery management might shed light on the type of service delivery provided, which then can contribute to the improvement on quality of care and patient safety.
Methods: Semi-structured interviews and observation of healthcare professionals during their consultation sessions working in a government hospital in Kuwait were invited to participate in this study. These professionals included nurses, physicians, surgeons, diabetologists, bariatricians, dietitians, pharmacists, physiotherapists, and psychologists involved in T2DM and bariatric management. The Swiss cheese model is a concept used in risk analysis and management in various industries including healthcare.
Results: A total of 18 healthcare professionals from various disciplines in the medical and surgical outpatient clinics participated in semi-structured interviews and observation during consultations. Using the Swiss Cheese Model highlighted the perceptions of healthcare professionals in a healthcare setting which reported the barriers imposed by the organisation and other healthcare disciplines as a potential risk to patients’ safety and the quality-of-service delivery. Barriers at an organisational level include absence of guideline and protocols, shortage of staff, limited resources, and lack of facilities. On the other hand, barriers at an individual level (healthcare professionals) included role confusion, line of hierarchy, lack of communication, and lack of a formal multidisciplinary team.
Conclusion: The findings illustrate the potential risks to patient safety for patients seeking T2DM and bariatric surgery management. These findings can be used to improve and develop hospital policy or guidelines to ensure best practice for service delivery in hospitals in Kuwait.
