Ethical and Legal Concepts Required of HCO - Research Paper Example

Ethical and Legal Concepts Required of HCO Introduction The fundamental aspect of every health care delivery service is ensuring the safety of the patients who come to the organization. To all the players in healthcare service delivery, such as patients, family members, healthcare professionals, and caregivers, safety is very important to prognosis, treatment, and care. Apart from offering healthcare services to the patients, healthcare professionals are also committed to quality services through excellent provision of their services. Healthcare organizations across the world have a challenge of ensuring safety to all patients who seek healthcare services. Several patients have been affected by the issue of patient safety; therefore, the significance of patient safety in high quality healthcare delivery is highly rated. In recent times, healthcare organizations have invested significantly in providing high quality healthcare services by enhancing the capacity of the healthcare systems, recruiting highly trained professionals, and providing new treatments as well as technologies. The paper will review literature sources on patient safety and high quality health care delivery, present the statistics and magnitude of the issues affecting the area, and analyze the ethical and legal concepts that may be essential to the healthcare organizations, which protects the safety of the patients. This paper is an analysis of the ethical and legal concepts required of healthcare organizations to ensure the delivery of high quality healthcare that protects patient’s safety. Statement of the Issue to be investigated In the present world, dynamic changes have been witnessed in healthcare organizations because of the changes in the patterns of medical practice, modifications in reimbursement systems, shortages of health professionals, and application of new technologies. However, the healthcare organizations have a duty to improve healthcare services they offer to meet high quality services. Providing quality healthcare services has several benefits to the healthcare organizations, such as enhancing efficiency, minimizing costs, and augmenting the market share. However, healthcare organizations have ethical obligations to improve the quality of healthcare services they offer to their clients (Jennings, 2007). Quality service in healthcare provision is an imperative policy consideration in the United States because of the high medical error rates during the provision of health services. According to Buchbinder and Shanks (2011), quality healthcare delivery is important because of several problems of medical errors, which affects patients when quality in healthcare delivery is compromised. Medical errors due to poor quality in healthcare organizations result in approximately 44,000 to 98,000 casualties yearly in America. According to the World Health Organization (WHO), research demonstrates that 1 out of every 10 patients admitted in healthcare organizations in United States suffer an unfavorable event. Certain unfavorable events are inevitable treatment complications of which half of them have a potential to be prevented. It therefore demonstrates that 1 out of 20 patients suffer from preventable adverse events in healthcare organizations. Further, 8% of these patients often die from the medical errors (Emslie, Kirstine, & Martin, 2002). It was approximated that more than a million medical errors take place annually in America. Out of these errors, around 44,000 to 98,000 cases are reported to be deadly. Medical errors due to poor service delivery cost the country approximately $29 billion each year in form of direct medical costs, lost income, and efficiency. These figures represent a very serious problem that warrants immediate attention and appropriate intervention to ensure patients’ lives are saved and government expenditure on medical problems minimized (Redhead, 2005). Patient safety is both an international, and a national issue of importance. There has been a rising emphasis throughout the globe on safety of patients in form of legislative changes, policy reformations, and improved care standards through quality improvement measures and initiatives. Internationally, research studies indicate that between 4% and 16% of patients admitted in healthcare organizations undergo one or more undesirable events. As noted earlier, half of these cases are preventable if proper measures and quality services are provided. As a result, it is essential to develop measures and strategies to minimize and tackle the problem of medical errors, leading to poor patient safety and ultimately poor quality of health services (Commission on Patient Safety and Quality Assurance, 2008). Addressing the problems of quality healthcare will translate to improved health for both the patients and the general society. If the problem of quality healthcare delivery is not addressed, several issues may arise, such as increased loss of lives, reduced profit levels, compromised efficiency levels, and increased government expenditure on medical costs. Poor quality of health services delivered to patients would reduce the patient safety levels and expose the nation to increased health risks. Patient safety and high quality healthcare delivery go hand-in-hand; thus, to increase the patient safety levels, it is important for the issue of quality to be addressed through various initiatives and appropriate measures (Emslie, Kirstine, & Martin, 2002). Research Sources Ethical analysis of healthcare organizations is conventionally emphasized by healthcare professionals instead of organizations. Institutions like Managed Care Organizations (MCOs) are primarily considered to be a hindrance to ethical health care delivery. MCOs have been increasingly criticized for offering financial incentives to lessen care, leading to conflict of interest for physicians as well as eroding the conventional trust between doctors and patients. Healthcare organizations have received slight concentration regarding positive ethics. The need to improve patient care in healthcare service delivery is demonstrated in the progressive discoveries in production and modern care delivery. The healthcare organizations are responsible for providing and coordinating the capital, monetary, human, and information supplies necessary for modern style of healthcare. Consequently, healthcare organizations are structurally and functionally fundamental in modern healthcare. They are the natural attention of responsibility for enhancing care quality (Jennings, 2007). Healthcare organizations are tasked with the function of offering health care to individuals; hence, it is accountable and responsible for providing quality improvement in healthcare delivery. The modern healthcare is intrinsically unsteady and dynamic. It operates on the edge of change, steered by normative commitments to enhancing patient care quality. In addition, modern healthcare are tasked with treating diseases through well recognized factors, including technical, regulatory, social, financial, and scientific. Quality improvement is contained in the primary function of healthcare organizations in enhancing the health of patients and advancing scientific knowledge (Jennings, 2007). Healthcare organizations are the principal organizational representatives responsible for this social principle. Healthcare organization is an important representative in progressing modern healthcare; therefore, quality improvement is its significant role. Alternatively, if advancing care quality was tasked to the health professionals, quality improvement management would entail social process, which reasonably fit in health care organizations (Jennings, 2007). To improve quality of the healthcare provided by the healthcare organizations and increase patient safety, the federal government legislated frameworks to help in achieving quality care. Patient Safety and Quality Improvement Act was approved to institute legal protections for medical error data and reports, encouraging deliberate reporting of information on such errors. The reporting systems would provide information for the hospitals to identify the weak points in their system for improvements to ensure quality care and patient safety. The Patient Safety Information System is an example of a national reporting system for providing medical error reports. To limit the litigation issues that may arise out of the voluntary information provided by physicians in healthcare organizations, the federal government has sought alternatives to protect data from the reporting systems through legislations like Freedom of Information (Pozgar, 2011). Cases of medical errors may be a violation of the right of the patients, and hence may warrant litigation. Health professionals are faced with issues like administering drugs to patients who may result in undesirable drug events. Patients fall victims of injuries resulting from errors in prescriptions, dispensation, and administration of medications. Physicians may for instance, prescribe antibiotics to patients suffering from allergies as a result of the medications. Moreover, certain nurses fall victims of failing to dilute intravenous solutions appropriately (Pozgar, 2011). According to CRS Report for Congress on Health Care Quality, outcome from studies showed that unpleasant drug events take place in 6.5% to over 20% of patients hospitalized. Approximately 25% to 50% of these cases are because of medication errors, which can be avoided. Results on medication safety in United States, among patients of Medicare in outpatient environment, demonstrated that around 180,000 of Medicare’s population experienced deadly or life-threatening unpleasant drug events each year (Redhead, 2005). The healthcare organizations in United States suffer due to poor quality care despite the presence of highly trained health professionals, increased biomedical research as well as rich modern technology. The healthcare environment desired and needed by patients should measure and manage clinical care to achieve the desired clinical results for both the patients and the health professionals. Except reliability and safety are achieved in healthcare organizations, the chances of medical errors will progressively rise each day. It is impossible to bank on reliability and safety in delivery of health services; otherwise, every other day in hospital would increase the possibility of a patient getting harmed (Rothman & Blumenthal, 2010). The primary responsibility of the healthcare organizations should be to improve safety, quality, and satisfaction of their patients. Satisfaction of the patients and quality care ought to be increasingly the focus of healthcare. Safety of the patients must be prioritized by healthcare organizations to provide quality services (Morrison, 2011). In quality healthcare delivery, which guarantees patient safety, the patient ought to be the source of control; healthcare professionals should not regulate the care. Making decisions should be based on evidence since professional autonomy motivates service variability. Openness and transparency must replace secrecy because safety is an element of the system and not an individual responsibility. The top most priority for healthcare organizations should be to minimize the risks faced by the patients in healthcare services (Morrison, 2011). Patients should be educated on the guiding principles, which ensure that patient safety is achieved. More learning systems ought to be established in place of accountability systems. Professionals in healthcare industry encounter several problems arising from complexities of the large healthcare systems and treatment of patients. To tackle these issues, a strong knowledge base and skills is necessary in offering quality service according to the needs of the patients and the expectations of the organization (Morrison, 2011). Federal regulation, which formally made information technology-enabled healthcare a subject of national policy, established reward system and penalties for hospitals and physician as a means of improving quality care and increasing patient safety. As a result, legal risks will arise out of failing to practice healthcare without using modern health information practice tools to improve quality of services provided (Rothman & Blumenthal, 2010). Several legal issues arise out of operation of healthcare operations, ranging from corporate and professional negligence to liability under different regulatory and financials legislations. Certainly, healthcare professionals are continually under legal exposure. Health plan administrators and insurers are shielded by the law from incurring corporate and professional liability resulting from any negligence concerning administration of their medical coverage plans. Medical liabilities and malpractices breaks down the relationship between the patients and physicians. Further, the legal principles defining the law of medical negligence are inclined toward patients (Rothman & Blumenthal, 2010). Legislative frameworks, such as Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule, are established to enable healthcare organizations covered under the law to allow patients access to medical records as an initiative to ensure improved quality care. The digitized personal health records enable patients to improve their access to health information. The health professionals are tasked with the duty of transparency to their patients under the legal doctrine of informed consent. Medical professionals have the duty of conveying substantial information to their patients in an appropriate manner to help the patient make informed decision about care (Rothman & Blumenthal, 2010). Appropriate implementation of HIPAA would ensure that patient information such as privacy, confidentiality, and security is guaranteed. The HIPAA legal standards are applicable to all health information in varied formats with limitation on access to personal identifiable information and disclosure of the said information. Patient safety is further promoted through Emergency Medical Treatment and Active Labor Act (EMTALA) that prohibits Medicare-participating healthcare organizations from forcing patients out of their emergency departments. Any patient in need of emergency attention is guaranteed healthcare service whether or not they are eligible for the services (Pozgar, 2011). To achieve progressive patient safety and ensure quality care delivery, personalized healthcare is an essential initiative in which healthcare services, including health monitoring as well as medical consultations, ought to be personalized based on the context of every patient. Patients can be educated and monitored on health services according to different needs of the patients. Such initiatives would be worthy in sharing and accessing information between health professionals and doctors (Nugent, McCullagh, McAdams, & Lymberis, 2005). Conclusion Following the literature reviewed, the fundamental aspect of every healthcare delivery service is ensuring the safety of the patients who come to the organization. Healthcare organizations across the world have a challenge of ensuring safety to all patients who seek healthcare services. Several patients have been affected by the issue of patient safety; therefore, the significance of patient safety in high quality healthcare delivery is highly rated. Quality service in healthcare provision is an imperative policy consideration in the United States because of the high medical error rates during the provision of health services. The paper has reviewed literature sources on patient safety and high quality health care delivery in healthcare organizations. It has presented the statistics and magnitude of the issues affecting the area, and analyzed the ethical and legal concepts that may be essential to the healthcare organizations in delivering high quality healthcare. In recent times, healthcare organizations have invested significantly in providing high quality healthcare services through improving their healthcare services, enhancing the capacity of the healthcare systems, recruiting highly trained professionals, and providing new treatments as well as new technologies. The federal government legislated frameworks to help in achieving quality care. Patient Safety and Quality Improvement Act was approved to institute legal protections for medical error data and reports, encouraging deliberate reporting of information on such errors. HIPAA Privacy Rule was established to enable healthcare organizations covered under the law to allow patients access to medical records as an initiative to ensure improved quality care. Patients should be educated on the guiding principles, which ensure that patient safety is achieved. Openness and transparency must be increased in communicating information to the client to enhance informed decision-making. More learning systems ought to be established in place of accountability systems. References Buchbinder, S. B., & Shanks, N. H. (2011). Introduction to Health Care Management. Burlington, Massachussetts: Jones & Bartlett Learning. Commission on Patient Safety and Quality Assurance. (2008). Building Culture of Patient Safety. Dublin: Stationary Office. Emslie, S., Kirstine, K., & Martin, P. (Eds.). (2002). Improving Patient Safety: Insights from American, Australian, and British Healthcare. Retrieved from World Health Organization: http://www.who.int/patientsafety/journals_library/Improving_Patient_Safety.pdf Jennings, B. (2007). Health Care Quality Improvement: Ethical and Regulatory Issues. Marilyn Bailey, NY: Garrison. Morrison, E. E. (2011). Ethics in Health Administration: A Practical Approach for Decision Makers. Sudbury, Massachussetts: Jones and Bartlett Publishers. Nugent, C. D., McCullagh, P. J., McAdams, E. T., & Lymberis, A. (Eds.). (2005). Personalised health management systems : the integration of innovative sensing, textile, information and communication technologies. Amsterdam: IOS Press. Pozgar, G. D. (2011). Legal and Ethical Issues for Health Professionals. Sudbury : Jones & Bartlett Learning. Redhead, S. C. (2005). Health Care Quality: Improving Patient Safety by Promoting Medical Errors Reporting. Washington, D.C.: Congressional Research Service. Retrieved from http://www.law.umaryland.edu/marshall/crsreports/crsdocuments/RL3198302042005.pdf Rothman, D. J., & Blumenthal, D. (2010). Medical Professionalism in the New Information Age. New Brunswick, N.J.: Rutgers Univ. Press. Read More