Specific Issues in the Healthcare Facility - Term Paper Example

Critical Thinking Essay: "Let It Pour" Introduction There are some very specific issues to be discussed regarding the need to improve our facility in these areas: Organization Communications Ethics/Practices Running Costs The first two problems are intertwined; when communications fail, organization deteriorates. Due to the broad definitions of the mission statement, it has been noted that certain members of staff are reticent to perform certain medical procedures due to their religious beliefs, or to perform controversial practices such as DNR without written authorization, which is required by law. It is also known that certain practices are carried out at no charge to the patient and payment arrangements, though non-conventional, have been made for uninsured patients or patients who cannot afford to pay for services and products. The current state of health care in our country is continually changing and is leaving the health care providers and practitioners with less and less power of their own to make decisions such as are promised in our mission statement. Due to increasing costs and lower patient loads, we may be forced to cut costs, but we aim to do this without sacrificing the quality of care our patients receive. Another issue is ethics. When protocol and law are diametrically opposed to ethics of an organization of any kind, the organization is threatened. Further problems arise from lack of a cohesive methodology that is honored by all staff members, above and beyond the mission statement. While we appreciate diversity, we must also remember to put the patient's needs first while honoring the law and the mission statement. As of late it is apparent that personal beliefs are perhaps affecting job performance and this will be addressed. Discussion First of all, let us declare that this meeting will be multilateral in terms of personal beliefs in regard to faith. In order for us to be proactive in addressing these issues together, we must be objective and look at facts rather than ideology. In this way we may, together, be able to gain some insights that will assist in making our team stronger in the face of current challenges and continuing changes. Communications A survey will be distributed which will be completed anonymously, asking for your feedback regarding this meeting and the plans to make some necessary changes. Your participation in this survey is important; we will be better able to determine which course to take based upon better communication between us. In terms of organization, as was stated before, communication is the key to organization. In viewing the current issues that we have internally, better communication needs to be established between departments. In order to accomplish this, equipment will need to be installed that will reduce the possibility of lost papers or documents. We will, of course, have hard copy backups of electronic documents and communications, but updating our communications system will encourage more streamlined interactions. Since we also have the human factor involved in the communication process with widely diverse opinions and practices, we will implement monthly, moderated meetings for all practitioners for a period of six months in order to encourage a cohesive team. We will also be organizing the same meetings for our management teams; any conflicts will be thoroughly discussed with the goal of resolution. Utilization of a qualified, impartial third party will be performed, if need be. The key is not necessarily agreement but cooperation. Improved communication will increase efficiency, which will help in cutting costs without affecting our quality of care. Practices I will site the DNR issue as an example. Every staff member will acquaint themselves with the current DNR guidelines, written by Mark H. Ebell (1994) from American Family Physician. While details of the current laws are not covered, these guidelines give very good general advice on what to consider in DNR cases. Note that many medical procedures or the withdrawal of such involve consent documents by the patient or a designated decision-maker. There can be no exceptions. In cases such as these, the patient's needs must be met under the law, no matter the personal beliefs of the person in attendance. Since medical care, at its best, is cooperation between medical staff and the patient and since many people are reluctant to think about death, hence have no written provisions, we will put forth an effort to encourage our community to have such documents or responsible persons available. This information will be presented in the least frightening or invasive way possible, and will serve to further alleviate miscommunications between patients, family and staff in the cases of the terminally ill or potential DNR preferences. In regard to patient refusal to undertake any procedure or medication, that is the patient's right, but it is not the right of the attending practitioners to make that decision. While we are obligated to do "all we can," there is not much we can do if a patient of sound mind refuses treatment. These issues will be addressed in the survey mentioned before. Regarding costs, our financial analyst reports that 28% of our costs are fixed; this leaves 72% of costs with fluctuation. Efficiency is the main issue to address; yet in this industry that often cuts into quality of care. We do not aim to cut staff; we aim to cut costs. What is the core of the problem of costs Lower patient loads. That is not the fault of anyone; it is, in fact, a good sign for the community at large because preventive health care on the part of the public is being practiced. There is no doubt that we are dedicated to our mission; yet we must address the issue of unauthorized pro-bono services. As popular as it is with the patients and the media, we must cease this practice and put a sliding scale payment practice in its place. This would be implemented upon proof of no insurance and depleted funds. In the event that there is no other alternative than pro-bono outpatient service, authorization will be needed in order to be able to document our services. In regard to the issue often brought up about unnecessary testing of terminally ill patients, we will be conducting an internal study to determine the frequency of this practice and whether or not it is successful. While it is important to provide good relations and comfort for our patients, we do need to address what is cost-effective and productive in terms of terminal patient care. While we are not the only facility that engages in what is deemed unnecessary testing, it is our sole responsibility to deliver the best care we can while keeping an eye on what is not necessary or productive for the comfort and care of the terminally ill. In regard to prescription medications, it is known that we dispense medicines even if a patient is not able to pay. There is inherently nothing wrong with providing our patients with what they need in terms of medication, but we can also ease the financial burden on the hospital by installing a co-pay policy. This will no doubt be the object of some amount of negative reactions from the community, but in researching other facilities it seems that the co-pay system is viable (Ulysses Torassa, April 7, 1999). Patients' Demands As our national health care system continues to deteriorate and our costs increase due to circumstances beyond our control, we must address what is within our control as a business. In addition to our dedication to care of the community reflected in the mission statement, it is good to bear in mind that each of us is a part of the business of delivering quality care. The cooperation of each member of the staff is critical to our success in achieving our facility's goals while also keeping the integrity of the system intact. As the times and rules change, we must be able to educate our patients in regard to what we can and cannot supply. With the current emotional atmosphere regarding health care and the enormous challenges that our residents and practitioners face with decreasing power to practice what they studied, it is important for us to take our patients with us as we move ahead with the internal reforms that must be made. This means educating our community. In order to inform the community about options, we will offer publications such as newsletters to keep our patients, shareholders, all staff and the community updated. As unpopular as it is, it is best to face facts and for all to be informed as much as is possible. The costs of postage and printing will be offset in the not-so-long term by encouraging cooperation from our community. Ethics We are in the field of medicine. We must adhere to a code of ethics in addition to the mission statement. While practitioners face the ongoing stress and burden of patient and insurance demands, the question of ethics becomes an individual burden rather than a collective understanding. Under the pressure of continually changing rules, laws and regulations coming from outside of our facility's walls, we must not allow ourselves to become despondent or without empathy. It is during these times that attention to ethics is especially important. Our mission statement is succinct, yet it leaves too much room for misinterpretation. Since this problem seems to be worsening, a facility-wide Code Of Ethics will be formed. This will assist in bringing disparaging minds into more of a focus pertinent to the greater good of the entire community, with regard to the diverse and talented minds employed here and dedicated to the further improvement of our capacity to function in the face of current and future adversities. Ethics is a universal practice and is not owned by any one faith or practice. By installing an internal Code Of Ethics, we will have clear directives that will hopefully augment the mission statement and encourage certain standards regardless of religious beliefs. Another goal is to relieve the personal burdens of staff by encouraging mutual understanding and support rather than divisive mind-sets. Conclusion We are likely to face more challenges in the near future with the ever-changing politics now raging around medical care. Even the best intentions can have adverse consequences. While there is little we can do as a single facility in the face of a nationwide health care crisis, we can certainly utilize the best of our abilities in our chosen careers. We can also outreach to other facilities and organizations with the goal of reform and restoration of quality medical care without the agonizing shackles of bureaucracy. We need not move forward in a more cohesive manner and remember that we are here to care for our community, and for each other. In this profession it does no good to overly assert our personal beliefs on each other or our patients. Although our mission statement emphasizes spiritual heritage, we must understand that we are in troubled times where all of our abilities are used in our chosen careers to help our facility move into the future with the dignity it deserves; as individuals it would do us good to question ourselves a little more deeply when our beliefs interfere with what needs to be done. References Ebell, Mark H. (Nov. 1, 1994), Practical Guidelines For Do-Not-Resuscitate Orders. American Family Physician. Retrieved October 12, 2005 from: http://www.findarticles.com/p/articles/mi_m3225/is_n6_v50/ai_15863864 Torassa, Ulyssees. (April 7, 1999), Medication Payment Policy Stirs Uproar. SFGate.Com. Retrieved October 13, 2005 from: http://www.sfgate.com/cgi-bin/article.cgifile=/examiner/archive/1999/04/07/NEWS9074.dtl Read More