Medical errors cause many injuries and deaths each year. According to the Agency for Healthcare Research and Quality, nearly 1 in 25 hospital patients are subjected to injuries caused by medical errors each year (AHRQ, 2000). The agency also estimates that 48,000-98,000 die annually from medical errors. This topic is an important one in terms of health care quality. This is true because if medical professionals are making errors that increase the infection rate in health care facilities and these errors are causing deaths, this is definitely not an example of health care quality. These deaths are preventable and health care workers have to take additional measures to ensure the health of the patient is not jeopardized due to their error. Medical errors reduce the quality of care given to patients.
The safety of the patient is essential in health care facilities. Patients are trusting health care professionals to improve their health. It makes some health care workers appear untrustworthy and incompetent when patients are becoming sicker while in the care of medical staff due to error. Both clinical and administrative have the responsibility of ensuring patients are safe and to reduce medical error. According to the AHRQ, there are steps that health care organizations can to improve the quality of care given to patients.
Some of the steps that can assist with reducing errors include investing in computer systems like Electronic Medical Records, which helps to catch errors faster than the human eye1(AHRQ, 2000). AHRQ also suggests that sending reminders for follow up tests helps with quality and reduces error. Health care organization should also establish some type of protocol to reduce errors.
This topic is really important to me because these deaths and injuries are preventable. Health care organizations have to make more attempts to reduce medical errors in an effort to increase quality. If facilities can reduce the number of injuries and deaths associated with medical errors, they are able to improve care given to patients. It is saddening when patients are subjected to injuries in a facility that is supposed to improve their health. As a future health care administrator, it is important that I take the initiative to reduce medical errors and improve quality. This is an issue that I have realized is important to me.
Reference:
Reducing Errors in Health Care: Translating Research Into Practice. AHRQ Publication No. 00-PO58, April 2000. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/qual/errors.htm
Monday, June 7, 2010
Saturday, June 5, 2010
Racial Discrimination in Washington's Physician Offices
Ethical dilemmas are plentiful in the health care industry. We are in an industry where decision making is critical because decisions can determine the outcome of someone’s health and life. Therefore, it is important to acknowledge the significance of ethical decisions in health care. Racial discrimination still occurs in every aspect of our society and in all industries. In terms of discrimination, it occurs in the health care industry as well. After reading an article about research conducted in the state of Washington about African American patients being discriminated against, I felt this would be an appropriate ethical topic for this blog.
In health care there have been allegations of racial discrimination against patients as well as staff. For instance in research conducted in Washington, many patients felt they were not receiving the same care as other patients and were treated differently because of their ethnicity. The study was based mostly on African American patients.
Discrimination is an ethical issue that health care administrators have to address, regardless of their own prejudice. Racial discrimination can easily become a legal issue depending on the case. Therefore it is important for staff and administration to understand the ethics behind discrimination. In the study conducted by the state of Washington many patients decided to keep quiet about the discrimination they were facing in fear of not receiving treatment from that physician's office.
Patients should not be discriminated against because of their race. Minority patients should feel that they are really fair and quality services like everyone else. They should not feel afraid to speak up about the discrimination they faced. The administrators in these health care facilities should teach their staff about the importance of equality and treating every patient with dignity and respect. As stated previously an administrator needs to be able to set aside their own prejudices to provide care to the patients.
If they are not able to convey this message properly, they can consult with an outside agency that can educate the staff on ethics and discrimination to improve the care given to these patients. Although ethics is a subject that can become debatable because not everyone considers the same principles as being ethical, one should be able to determine that discrimination is not an ethical practice. Justice is an ethical principle that has been greatly disregarded in this case because they are not treating all patients similarly. There are also moral values that have been compromised in which they are limiting their compassion, conscientiousness, fidelity, and fairness due to the race of the patient.
Overall, the employees who were involved in discriminating should be reintroduced to the facility’s ethics policy and ensure quality is given to each patient.
In health care there have been allegations of racial discrimination against patients as well as staff. For instance in research conducted in Washington, many patients felt they were not receiving the same care as other patients and were treated differently because of their ethnicity. The study was based mostly on African American patients.
Discrimination is an ethical issue that health care administrators have to address, regardless of their own prejudice. Racial discrimination can easily become a legal issue depending on the case. Therefore it is important for staff and administration to understand the ethics behind discrimination. In the study conducted by the state of Washington many patients decided to keep quiet about the discrimination they were facing in fear of not receiving treatment from that physician's office.
Patients should not be discriminated against because of their race. Minority patients should feel that they are really fair and quality services like everyone else. They should not feel afraid to speak up about the discrimination they faced. The administrators in these health care facilities should teach their staff about the importance of equality and treating every patient with dignity and respect. As stated previously an administrator needs to be able to set aside their own prejudices to provide care to the patients.
If they are not able to convey this message properly, they can consult with an outside agency that can educate the staff on ethics and discrimination to improve the care given to these patients. Although ethics is a subject that can become debatable because not everyone considers the same principles as being ethical, one should be able to determine that discrimination is not an ethical practice. Justice is an ethical principle that has been greatly disregarded in this case because they are not treating all patients similarly. There are also moral values that have been compromised in which they are limiting their compassion, conscientiousness, fidelity, and fairness due to the race of the patient.
Overall, the employees who were involved in discriminating should be reintroduced to the facility’s ethics policy and ensure quality is given to each patient.
Tuskegee Syphilis Study
The Tuskegee Syphilis Study is an ethical dilemma that happened decades ago, but it is still an issue that I find very disturbing. Over the span of 40 years, men in Tuskegee who had syphilis were told they would be given treatment by a group medical staff. The medical staff put them through a lot of painful and unnecessary treatments. They were never told that these were placebos and that these treatments would not help their syphilis. Many of the men died as their illness got progressively worse.
This practice was occurring amongst African American men who had syphilis. The researchers wanted to study the effects of this illness if it goes untreated. The patients were not told that there was currently a cure for syphilis. Yet the researchers put them through several harmful acts. One can assume they chose these men because they lived in rural areas and the chances of them finding out there was a cure for syphilis were lessened.
These acts and this study took place for 40 years before it was ended. It is hard to understand how this was allowed to happen for so long. Many of the patients died when their deaths could have been prevented with a simple procedure of receiving penicillin. It is unbelievable and unethical that this happened to these men. Most of the patients were African American and impoverished men in a rural community. As a result of this study, many African Americans have been afraid to participate in studies believing it will become a repeat of the Tuskegee Syphilis Study. Health care morass took place in the African American community in which they lost trust in the health care system.
There were several ethical principles that were not taken into account during this study. These principles include beneficence, nonmaleficence, and justice. The leaders in this study did not display any moral values as well. They did not have any compassion for the patients or conscientiousness. They were not fair or honest either. These are just a few of the ethical issues that occurred during this study and do not include any legal issues. It saddens me to know that health care leaders and researchers did not stop this and many men lost their lives for no reason.
This practice was occurring amongst African American men who had syphilis. The researchers wanted to study the effects of this illness if it goes untreated. The patients were not told that there was currently a cure for syphilis. Yet the researchers put them through several harmful acts. One can assume they chose these men because they lived in rural areas and the chances of them finding out there was a cure for syphilis were lessened.
These acts and this study took place for 40 years before it was ended. It is hard to understand how this was allowed to happen for so long. Many of the patients died when their deaths could have been prevented with a simple procedure of receiving penicillin. It is unbelievable and unethical that this happened to these men. Most of the patients were African American and impoverished men in a rural community. As a result of this study, many African Americans have been afraid to participate in studies believing it will become a repeat of the Tuskegee Syphilis Study. Health care morass took place in the African American community in which they lost trust in the health care system.
There were several ethical principles that were not taken into account during this study. These principles include beneficence, nonmaleficence, and justice. The leaders in this study did not display any moral values as well. They did not have any compassion for the patients or conscientiousness. They were not fair or honest either. These are just a few of the ethical issues that occurred during this study and do not include any legal issues. It saddens me to know that health care leaders and researchers did not stop this and many men lost their lives for no reason.
South Florida Nurse Cause Harm to Hundreds of Patients
Last year there was a nurse in South Florida who was accused of reusing IV bags on multiple patients. There were nearly 2,000 she exposed to several infectious diseases such as TB, HIV, hepatitis and other diseases. The nurse had been a nurse for multiple years, and it is unknown if she had done this in previous years. This case shows many ethical dilemmas because she put the health of the patients at risk. Health care providers are taught to give the best care to patients and in this case she did not.
If she was worried about the lack of supplies, this should have been an issue she could have addressed with her manager. She should not have taken into her own hands to manage the supplies. This jeopardized the health of her patients and her actions made it seem as if the hospital was not producing quality care.
In health care ethics, one of the principles is nonmaleficence which is to avoid causing harm to patients. Nonmaleficence is a standard in the health care industry. In this case, the caregiver caused harm to many patients and exposed them to many deadly infections. She did not “avoid” causing harm to patients. This principle is important is all aspects of the health care industry. The health care system is used by patients to help with the improvement of their health. Patients should not leave a facility feeling as if they have been harm in some kind of way. The patients were not informed of the nurse’s actions until several months later, because that’s when the hospital were informed of it.
Another ethical principle that was questioned is beneficence requires doing good and helping others. In this matter, the nurse did not help others and her behavior is not labeled as doing good. If there was an issue with supplies, this should have been noted and expressed to her superiors. She did not help the patients, coworkers and other hospital staff by not mentioning to them what she was doing.
The health care administrators ensured that the patients were exposed were informed and requested they return for testing of infectious diseases that they could have been exposed to. Administrators could also review the ethics policy with the employees to ensure that they are aware of what is expected of them. This case cost the hospital a lot and reviewing the principles and standards of the hospital could reduce the risk of this happening again.
If she was worried about the lack of supplies, this should have been an issue she could have addressed with her manager. She should not have taken into her own hands to manage the supplies. This jeopardized the health of her patients and her actions made it seem as if the hospital was not producing quality care.
In health care ethics, one of the principles is nonmaleficence which is to avoid causing harm to patients. Nonmaleficence is a standard in the health care industry. In this case, the caregiver caused harm to many patients and exposed them to many deadly infections. She did not “avoid” causing harm to patients. This principle is important is all aspects of the health care industry. The health care system is used by patients to help with the improvement of their health. Patients should not leave a facility feeling as if they have been harm in some kind of way. The patients were not informed of the nurse’s actions until several months later, because that’s when the hospital were informed of it.
Another ethical principle that was questioned is beneficence requires doing good and helping others. In this matter, the nurse did not help others and her behavior is not labeled as doing good. If there was an issue with supplies, this should have been noted and expressed to her superiors. She did not help the patients, coworkers and other hospital staff by not mentioning to them what she was doing.
The health care administrators ensured that the patients were exposed were informed and requested they return for testing of infectious diseases that they could have been exposed to. Administrators could also review the ethics policy with the employees to ensure that they are aware of what is expected of them. This case cost the hospital a lot and reviewing the principles and standards of the hospital could reduce the risk of this happening again.
Wednesday, May 26, 2010
What quality means to me?
Quality is a very important aspect of our health care system. When patients enter a facility they want to know that they are receiving the best care and they will receive care that is in their best interest. Quality is not only expected in health care, but it is an expectation people request in all aspects of life. People want quality homes, care, food, and clothing. For example, people would rather purchase a home that was built with quality material versus paying the same price for the home and the house is poorly made. This example also displays how increasing quality can affect costs. Although people expect quality services in their everyday lives, this expectation only increases when it comes to health care.
Quality health care means that health care professionals are not only meeting the standards, but they are exceeding them. Those organizations that are considered to have quality health care always exceed the expectations of the patients and others. How can a health care facility distinguish themselves from the competition if they are providing standard services?
Health care quality should be analyzed and shown throughout all areas of health care, clinical to administration. Those working in health care have to understand that quality must begin with team work. A patient may experience superb customer service from an employee assisting them in concierge and receive horrible care from one of the nurses caring for them. If the experience with the concierge staff does not correlate with the services received from the nurse, this could lead to the patient believing they did not receive quality care.
For example, a patient could go for a doctor’s visit where the customer service is very minimal. They are welcomed by the registration staff that appears very bland and uninviting. The registration staff successfully checks the patient in, but does not engage the patient, smile or may any direct eye contact. The patient goes to see the nurse and a similar experience occurs. When the patient sees the doctor, the patient feels as if the visit satisfies the IOM’s aims for improvement and quality[1]. The physician focused on the patient providing them with efficient, effective and timely services. Although the physician may have provided quality care, they patient did not receive quality service from other members of the staff. Therefore management must stress the importance of teamwork in order for patients to experience quality care and services when visiting their facility. Even though this is just an example, the scenario could be the total opposite in which the physician does not provide quality care but the nursing and registration staff does. This is an example of why teamwork is important in health care quality.
Quality standards can vary from person to person. This may be one of the reasons quality is a big topic in health care because not everyone can agree on what is considered quality care. In my opinion providing quality care means providing care that heals the patient in a safe manner. Quality care also means giving patients the care they need with compassion. If more health care professionals were more compassionate about the care given to patients it would increase the quality of care given to patients. Patients want to know that they are in good hands. Although the health care provider may be a stranger to the patient, treating each patient like care as you would care for a family member. Also, patients like to know that the provider is listening to them and trying to find a solution to whatever problem they are having. When patients feel mistreated and disrespected by a health care provider, this does not represent quality care. Gaining the patient’s trust and being honest are other key elements in providing quality care. If a provider is demonstrating dishonest and untrustworthy behaviors, this raises suspicion and could jeopardize the patient’s care.
Overall, quality care means providing patients with the best care possible from all aspects of health care.
[1] Ransom, E. R., Joshi, M. S., Nash, D. B., & Ransom, S. B. (2008). The Healthcare Quality Book (2nd Ed.). Washington, DC: Health Administration Press.
Quality health care means that health care professionals are not only meeting the standards, but they are exceeding them. Those organizations that are considered to have quality health care always exceed the expectations of the patients and others. How can a health care facility distinguish themselves from the competition if they are providing standard services?
Health care quality should be analyzed and shown throughout all areas of health care, clinical to administration. Those working in health care have to understand that quality must begin with team work. A patient may experience superb customer service from an employee assisting them in concierge and receive horrible care from one of the nurses caring for them. If the experience with the concierge staff does not correlate with the services received from the nurse, this could lead to the patient believing they did not receive quality care.
For example, a patient could go for a doctor’s visit where the customer service is very minimal. They are welcomed by the registration staff that appears very bland and uninviting. The registration staff successfully checks the patient in, but does not engage the patient, smile or may any direct eye contact. The patient goes to see the nurse and a similar experience occurs. When the patient sees the doctor, the patient feels as if the visit satisfies the IOM’s aims for improvement and quality[1]. The physician focused on the patient providing them with efficient, effective and timely services. Although the physician may have provided quality care, they patient did not receive quality service from other members of the staff. Therefore management must stress the importance of teamwork in order for patients to experience quality care and services when visiting their facility. Even though this is just an example, the scenario could be the total opposite in which the physician does not provide quality care but the nursing and registration staff does. This is an example of why teamwork is important in health care quality.
Quality standards can vary from person to person. This may be one of the reasons quality is a big topic in health care because not everyone can agree on what is considered quality care. In my opinion providing quality care means providing care that heals the patient in a safe manner. Quality care also means giving patients the care they need with compassion. If more health care professionals were more compassionate about the care given to patients it would increase the quality of care given to patients. Patients want to know that they are in good hands. Although the health care provider may be a stranger to the patient, treating each patient like care as you would care for a family member. Also, patients like to know that the provider is listening to them and trying to find a solution to whatever problem they are having. When patients feel mistreated and disrespected by a health care provider, this does not represent quality care. Gaining the patient’s trust and being honest are other key elements in providing quality care. If a provider is demonstrating dishonest and untrustworthy behaviors, this raises suspicion and could jeopardize the patient’s care.
Overall, quality care means providing patients with the best care possible from all aspects of health care.
[1] Ransom, E. R., Joshi, M. S., Nash, D. B., & Ransom, S. B. (2008). The Healthcare Quality Book (2nd Ed.). Washington, DC: Health Administration Press.
Monday, December 8, 2008
Managed Care Organizations
Managed care organizations provide health care to millions of people in the United States. Two private MCOs are Health Maintenance Organizations (HMOs) and Preferred Provider Organizations (PPOs). These organizations have been around for decades and the HMO Act of 1973 allowed managed care to become more popular. Over the years more people have become dependent on managed care for health care needs. Although managed care has been helpful in some aspects, these organizations have been the topic of many debates.
MCOs have been stereotyped as having lower quality of care and focusing more on costs than the health care of patients. The accusation of lower quality of care could come from the idea that sometimes caregivers do not spend enough time with patients. This helps a facility see more patients throughout the day or not have enough staff to extend the amount of time with patients. Another accusation is that managed care organizations focus more on costs than helping patients. For example, there have been statements made that physicians who work in managed care organizations receive incentives for not performing certain procedures for patients. MCOs have also been known to deny claims for medically necessary treatments that could eventually lead to the further health complications or death. These are ways for MCOs to manage costs but this could cause concern for ethical issues.
It is important for MCOs to focus on the patient because these patients depend on them for health care. They want to feel that when they visit a facility they will receive good care, especially since they spend money to ensure they receive care. For those who have been treated unfairly by a MCO, these organizations have to remember their ethical practices. Patients have rights and the MCOs have keep their health the main focus. They should not put the patient's health in harm and give them the compassionate care they deserve. MCOs will be around in the future and there will be ethical issues in the future. Hopefully, they will be able to have a new approach to these issues and address them more appropriately.
MCOs have been stereotyped as having lower quality of care and focusing more on costs than the health care of patients. The accusation of lower quality of care could come from the idea that sometimes caregivers do not spend enough time with patients. This helps a facility see more patients throughout the day or not have enough staff to extend the amount of time with patients. Another accusation is that managed care organizations focus more on costs than helping patients. For example, there have been statements made that physicians who work in managed care organizations receive incentives for not performing certain procedures for patients. MCOs have also been known to deny claims for medically necessary treatments that could eventually lead to the further health complications or death. These are ways for MCOs to manage costs but this could cause concern for ethical issues.
It is important for MCOs to focus on the patient because these patients depend on them for health care. They want to feel that when they visit a facility they will receive good care, especially since they spend money to ensure they receive care. For those who have been treated unfairly by a MCO, these organizations have to remember their ethical practices. Patients have rights and the MCOs have keep their health the main focus. They should not put the patient's health in harm and give them the compassionate care they deserve. MCOs will be around in the future and there will be ethical issues in the future. Hopefully, they will be able to have a new approach to these issues and address them more appropriately.
And the Band Played On
HIV/AIDS began to affect our population in the 1980s and has been detrimental to our society. This illness has killed millions around the world and continues to infect individuals everyday. In a class on Community Health I watched a movie named "And the Band Played On". This movie discussed the HIV/AIDS epidemic from the beginning and gave a closer perspective to how HIV/AIDS affect individuals from a researcher, family member, infected person, and society viewpoint. One of the main issues in the movie discussed how many homosexual men were contracting the disease in bath houses. These were spa-like businesses that allowed men to have sexual intercourse.
There was one character in the movie who was a French-Canadian flight attendant. He was suspected of infecting several men with HIV. Since this was the beginning of the epidemic he was in denial that he was infected. Researchers from the CDC (Centers for Disease Control and Prevention) began to investigate him. They asked him how many sex partners did he have and he admitted to sleeping with thousands of men around the world. After conducting more research on him they found that there were at least 40 men in the United States who were infected with HIV as a result of this flight attendant.
Although this was person was not the main subject of the movie, his role was most devastating to me. It difficult to see him because there are characters like him in real life. These individuals are infecting others without any remorse. This behavior is unethical and those who knowingly infect others lack ethical moral, values, and principles. Nonmaleficence is the ethical principle that is especially disregarded because it discusses causing no harm. Infecting others with HIV is causing a lot of harm to the person who is infected. Those who participate in this behavior also violate the values of compassion, respect and honesty.
It is important that more people are educated on the topic of HIV/AIDS so that we can prevent incidents like these. Ethics can play an important role in certain individuals who contract HIV. Hopefully one day our society will be able to get some control over this epidemic. Until then preventing people from contracting the disease and helping those who are infected is imperative.
There was one character in the movie who was a French-Canadian flight attendant. He was suspected of infecting several men with HIV. Since this was the beginning of the epidemic he was in denial that he was infected. Researchers from the CDC (Centers for Disease Control and Prevention) began to investigate him. They asked him how many sex partners did he have and he admitted to sleeping with thousands of men around the world. After conducting more research on him they found that there were at least 40 men in the United States who were infected with HIV as a result of this flight attendant.
Although this was person was not the main subject of the movie, his role was most devastating to me. It difficult to see him because there are characters like him in real life. These individuals are infecting others without any remorse. This behavior is unethical and those who knowingly infect others lack ethical moral, values, and principles. Nonmaleficence is the ethical principle that is especially disregarded because it discusses causing no harm. Infecting others with HIV is causing a lot of harm to the person who is infected. Those who participate in this behavior also violate the values of compassion, respect and honesty.
It is important that more people are educated on the topic of HIV/AIDS so that we can prevent incidents like these. Ethics can play an important role in certain individuals who contract HIV. Hopefully one day our society will be able to get some control over this epidemic. Until then preventing people from contracting the disease and helping those who are infected is imperative.
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