H.C. Quality:Wild Card

This is my last assignment for this class. I just finished posting my responses to other students quality improvement projects. I am happy that it was an assignment. I enjoyed looking at other students work. It almost works as a comparison to understand what I may have done wrong or misinterpreted. This helps me to do higher quality work in the future.

For my wild card I am going to do a current event in the news related to health care quality. The article is titled, Doctors critize insureres over ranking and it from the wallstreet juornal. The raticle talks about how doctos are critizing insurers for ranking groups based on cost or quality. They say it is swaying the popion of paients on where they seek care. Insurers say they are working to ensure that the rating are accurate and transparent. Consumers can get lower out of pocket charges if they see a doctor in a preferred ranking. Doctors are saying that these rankings are unreliable and often inaccurate. Doctors can be ranked higher is they order less "questionable" tests or if they have more favorable patient outcomes.

I think it is a good thing that insurance companies are doing this. Not only does it help to control costs overall for health care but it also helps the patient make a more informed decision on where they seek health care. If the rating are accurate and reliable then they are serving a purpose. This is something that could be regulated by a third party to ensure that the rating are not bias. I can see a few flaws in this. Doctors may be more inclined to order less test if they re being rated on the fact that they may have ordered a questionable test. This could result is less quality of care for the patient. This could also reduce access to care if the Doctor began to refuse the type of insurance all together. The Doctor may decide to switch to accepting a different insurance in place that doesn't use ranking. This could hinder access for the patient.

Ethics Week 8

Yeah last blog! I'm happy to be almost done with this semester. I finished my third mini paper, which actually ended up being my favorite. I wrote the paper on patient autonomy for end of life decision making. The Great Debate is all finished up. It was fun and way different from doing a face to face debate. It was much easier to respond to the opposition when you have time to write a well thought out response. The only assignments I have left to do are three more decision board response which I will finish up over the next two days. I am going to follow the same trend for my blog this week and reflect on the interesting points in the reading for the week.

In the Perry book we didn't have a case to read but just a general section titled the ethics of managing people. It was a good conclusion to the book. Ethical dilemmas involve people making decisions and managers must support their employees and provide them with the tools necessary to make ethical decisions. Employees are a resource that is essential to the success of an organization and they should have a safe work environment. They should be protected from harassment and discrimination. It is the Managers job to make sure this thought becomes a realization. It must be extremely difficult for managers to not only work about their duty to the organization to perform financially and productively but to also protect employees and support them emotionally. This section make me think about the case in this book where the female intern worked with a male mentor and CEO. The CEO was trying to protect himself and the intern from potential wrongful actions associated with a sexual attraction. His actions back fired and he was accused of discrimination. It must be like walking on egg shells. This class has almost scared me to take a management position. I am an indecisive person in nature and i picture myself stressing my life away trying to figure out ethical dilemmas. I am sure when put in the actually situation it will come more naturally to make decisions. I think I have thus far prepared myself through education.
The rest of the chapter is almost like a handbook for ethical behavior in the day to day duties of a manager. I think I will keep this book to help alleviate my stress when trying to make ethical decisions.

The chapters in the Hofmann book are similar in topic to those of the Perry book. I was going to write my third mini paper on accountability but in the end switched to autonomy. I think accountability is an important topic. Accountability seems to be addressed in several ways. First organizations are accountable for their actions and should report their performance and errors to the public. This ensure that the public is well informed and able to make decisions for their best interest. Organizations are also accountable to their employees, as addressed in the first section of the Hofmann reading. Organizations are accountable for setting ethical and moral standards for employees to follow. These standards require explicit attention, articulation, education, practice, re informant and rewards. Basically you cant ask employees to act ethically and morally if you, the health care organization or executive, are not doing the same. This seems simple and seems to make sense, however some organizations find it difficult, or they just choose not to follow. Which ever the case it is important for any organization, especially a health care organization to set an ethically example for their employees and the community. If the health care organization which is utilized for saving lives and treating people, isn't ethical then who is?

Ethics Week 7

This weeks readings reminded me of my debate discussion. The first section Hofmann book talks about civic responsibility, and how it is difficult to manage limited resources under ethical and economic challenges while still aiming to improve community health. In my debate I am the affirmative side and the topic is whether health care organizations should be able to refuse demands for futile treatments. As one of my main points I talk about limited resources and the fact that health care organizations have a duty to promote overall community health and ensure that the proper resources are there when patients need them. Meaning they should not be "wasted" on futile treatments. We just finished our Q&A session and I will be writing my closing statement in the next few days. I found the debate enlightening. It was interesting to see both points of view, and that both points of view could be considered right. Which actually confuses me even more about ethical decision making. It is difficult to understand where to draw the line and what can be justified. Especially when talking about the life of a human being. Is it ethical to demand resources when then is no positive outcome and they would benefit another? How can you possible make that decision! I am very glad I am not a doctor, because I don't think anything would get accomplished. I would never be able to make a decisions. From a managements perspective I think it is easy to look at facts and analysis the situation for what its worth, without emotions. When you have that one on one connection with the patient and you can actually see and feel their pain, then it can be hard to do what is right for the overall community, not just that individual patient.

The next two sections in the reading for Hofmann discuss advertising in health care and its ethical implications. I actually watched another group debate this during my last semester. This too is also a difficult subject, one where the complexity of the situation is highlighted. Health care is a business and therefore has an objectives to produce revenues. However health care also has an objective to serve the patients best interest, which can be saving a patients life. Typically other businesses do not have this sort of complexity. Trying to meet both objectives and do it in an ethical manner is the real challenge. In regards to advertising the message can be bias and can be twisted. To ensure the organization is advertising to the consumer in an ethical way all relevant data must be presented in order to ensure the consumer is well informed. The consumer should not be persuaded to do purchases a medical product, medication, procedure or visit a certain health care organization if it is not in their best interest. Consumers should be able to make well informed decisions on what is best for them. Health care organizations should make themselves visible to the public. Knowledge is the key.