scholarly journals Organization Ethics in Healthcare

2000 ◽  
Vol 9 (2) ◽  
pp. 145-146 ◽  
Author(s):  
Patricia H. Werhane ◽  
Mary V. Rorty
Keyword(s):  
Patient Care ◽  
Clinical Ethics ◽  
Professional Ethics ◽  
Applied Ethics ◽  
Care Patient ◽  
Professional Relationships ◽  
Healthcare Organizations ◽  
Clinical Patient ◽  
Organization Ethics ◽  
Professional Guidelines

Bioethics, clinical ethics, and professional ethics are mature, well-developed fields of applied ethics that focus on medical research, patient autonomy and patient care, patient–healthcare professional relationships, and issues that arise in clinical and other medical settings. However, despite these developments, little attention has been paid to the organizational aspects of healthcare in these fields. This is surprising, because in the last 30 years healthcare has become more and more institutionalized in provider, management, and insurer organizations. Despite JCAHO's preoccupation with organizational ethics during the last decade, the philosophical underpinnings of their requirements have been less explored in the literature. Clinical ethics remains preoccupied with clinical patient care and professional ethics with individual professional guidelines; even the American College of Healthcare Executives focuses primarily on healthcare managers, not on healthcare organizations.

Business Ethics, Stakeholder Theory, and the Ethics of Healthcare Organizations

2000 ◽  
Vol 9 (2) ◽  
pp. 169-181 ◽  
Author(s):  
PATRICIA H. WERHANE
Keyword(s):  
Business Ethics ◽  
Patient Care ◽  
Stakeholder Theory ◽  
Financial Support ◽  
Professional Ethics ◽  
Clinical Care ◽  
Codes Of Ethics ◽  
Healthcare Organizations ◽  
Professional Codes ◽  
Professional Codes Of Ethics

Until recently (before managed care), business issues in healthcare organizations (HCOs) were relatively insulated from clinical issues, for several reasons. The hospital at earlier stages of its development operated on a combination of charitable and equitable premises, allowing for providing care to be separated from financial support. Physicians, who were primarily responsible for clinical care, constituted an independent power nexus within the hospital and were governed by their own professional codes of ethics. In exchange for a great deal of control over their conditions of practice, they took almost complete responsibility for patient care. Thus clinical and professional ethics could to some extent be compartmentalized from the business issues—a much easier feat when, as in much of the last few decades, virtually all care was reimbursed from some source or other. In addition, many HCOs were not categorized or treated as businesses, although of course they were presumed to be governed by the same expectation for good management as any other organization.

Occupational Exposures in the Homecare Environment: Piloting an Observation Tool

2021 ◽  
pp. 108482232098691
Author(s):  
Elizabeth Bien ◽  
Kermit Davis ◽  
Susan Reutman ◽  
Gordon Gillespie
Keyword(s):  
Home Care ◽  
Patient Care ◽  
Occupational Safety ◽  
Occupational Exposures ◽  
Care Patient ◽  
Home Healthcare ◽  
Occupational Hazards ◽  
Cross Sectional ◽  
Direct Observations ◽  
Occupational Setting

The population of home healthcare workers (HHCWs) is rapidly expanding. Worker tasks and the unique home care environments place the worker at increased risks of occupational exposures, injury, and illness. Previous studies focusing on occupational exposures of HHCWs are limited to self-reports and would benefit from direct observations. The purpose of this study is to describe the occupational hazards observed in the unique work environment of home healthcare. HHCWs and home care patient participants were recruited from one home care agency in the Midwest to be observed during a routine home visit. This cross-sectional study used a trained occupational health nurse for direct observation of the occupational setting. Standardized observations and data collection were completed using the Home Healthcare Worker Observation Tool. The observer followed a registered nurse and occupational therapist into 9 patient homes observing visits ranging from 22 to 58 minutes. Hazards observed outside of and within the home include uneven pavements (n = 6, 67%), stairs without railings (n = 2, 22%), throw rugs (n = 7, 78%), unrestrained animals (n = 2, 22%), dust (n = 5, 56%), and mold (n = 2, 22%). Hand hygiene was observed prior to patient care 2 times (22%) and after patient care during 5 visits (56%). Observations have identified hazards that have the potential to impact workers’ and patients’ health. The direct observations of HHCWs provided opportunities for occupational safety professionals to understand the occupational exposures and challenges HHCWs encounter in the home care environment and begin to identify ways to mitigate occupational hazards.

scholarly journals Pediatric Endocrinology in the Time of COVID-19: Considerations for the Rapid Implementation of Telemedicine and Management of Pediatric Endocrine Conditions

2020 ◽  
Vol 93 (6) ◽  
pp. 343-350
Author(s):  
Molly O. Regelmann ◽  
Rushika Conroy ◽  
Evgenia Gourgari ◽  
Anshu Gupta ◽  
Ines Guttmann-Bauman ◽  
...  
Keyword(s):  
Patient Care ◽  
Care Patient ◽  
The Novel ◽  
Patient Privacy ◽  
Pediatric Endocrinology ◽  
Quality Of Patient Care ◽  
Care Outcomes ◽  
Novel Coronavirus ◽  
The Impact

<b><i>Background:</i></b> Pediatric endocrine practices had to rapidly transition to telemedicine care at the onset of the novel coronavirus disease 2019 (COVID-19) pandemic. For many, it was an abrupt introduction to providing virtual healthcare, with concerns related to quality of patient care, patient privacy, productivity, and compensation, as workflows had to change. <b><i>Summary:</i></b> The review summarizes the common adaptations for telemedicine during the pandemic with respect to the practice of pediatric endocrinology and discusses the benefits and potential barriers to telemedicine. <b><i>Key Messages:</i></b> With adjustments to practice, telemedicine has allowed providers to deliver care to their patients during the COVID-19 pandemic. The broader implementation of telemedicine in pediatric endocrinology practice has the potential for expanding patient access. Research assessing the impact of telemedicine on patient care outcomes in those with pediatric endocrinology conditions will be necessary to justify its continued use beyond the COVID-19 pandemic.

scholarly journals Managing ethical issues in patient care and the need for clinical ethics support

2015 ◽  
Vol 39 (1) ◽  
pp. 44 ◽  
Author(s):  
Evan Doran ◽  
Jennifer Fleming ◽  
Christopher Jordens ◽  
Cameron L Stewart ◽  
Julie Letts ◽  
...  
Keyword(s):  
Patient Care ◽  
Clinical Ethics ◽  
Ethical Issues ◽  
Public Hospitals ◽  
Cross Sectional Survey ◽  
Convenience Sample ◽  
Clinical Ethics Support ◽  
Ethical Environment ◽  
Ethics Support ◽  
A Priority

Objective To investigate the range, frequency and management of ethical issues encountered by clinicians working in hospitals in New South Wales (NSW), Australia. Methods A cross-sectional survey was conducted of a convenience sample of 104 medical, nursing and allied health professionals in two NSW hospitals. Results Some respondents did not provide data for some questions, therefore the denominator is less than 105 for some items. Sixty-two (62/104; 60%) respondents reported occasionally to often having ethical concerns. Forty-six (46/105; 44%) reported often to occasionally having legal concerns. The three most common responses to concerns were: talking to colleagues (96/105; 91%); raising the issue in a group forum (68/105; 65%); and consulting a relevant guideline (64/105; 61%). Most respondents were highly (65/99; 66%) or moderately (33/99; 33%) satisfied with the ethical environment of the hospital. Twenty-two (22/98; 22%) were highly satisfied with the ethical environment of their department and 74 (74/98; 76%) were moderately satisfied. Most (72/105; 69%) respondents indicated that additional support in dealing with ethical issues would be helpful. Conclusion Clinicians reported frequently experiencing ethical and legal uncertainty and concern. They usually managed this by talking with colleagues. Although this approach was considered adequate, and the ethics of their hospital was reported to be satisfactory, most respondents indicated that additional assistance with ethical and legal concerns would be helpful. Clinical ethics support should be a priority of public hospitals in NSW and elsewhere in Australia. What is known about the topic? Clinicians working in hospitals in the US, Canada and UK have access to ethics expertise to help them manage ethical issues that arise in patient care. How Australian clinicians currently manage the ethical issues they face has not been investigated. What does this paper add? This paper describes the types of ethical issues faced by Australian clinicians, how they manage these issues and whether they think ethics support would be helpful. What are the implications for practitioners? Clinicians frequently encounter ethically and legally difficult decisions and want additional ethics support. Helping clinicians to provide ethically sound patient care should be a priority of public hospitals in NSW and elsewhere in Australia.

Nursing staff-led behavioural group intervention in psychiatric in-patient care: Patient and staff experiences

2018 ◽  
Vol 27 (5) ◽  
pp. 1401-1410 ◽  
Author(s):  
Johanna Salberg ◽  
Fredrik Folke ◽  
Lisa Ekselius ◽  
Caisa Öster
Keyword(s):  
Patient Care ◽  
Nursing Staff ◽  
Group Intervention ◽  
Care Patient ◽  
Staff Experiences

Cost accounting as a tool for managing profitability in healthcare organizations

2021 ◽  
pp. 42-49
Author(s):  
L.M. Korchagina
Keyword(s):  
Patient Care ◽  
Cost Accounting ◽  
Management Tool ◽  
Effective Management ◽  
Strategic Decisions ◽  
Healthcare Organizations ◽  
Common Problems ◽  
The Right ◽  
A Company ◽  
The Company Managing

Cost accounting is an effective management tool that allows a company to measure profitability by collecting key information by recording and tracking the data necessary for the most efficient and profitable operation of the company. Managing costs to maintain profitability is a top priority in all industries, which means relying on data to make smart and informed decisions. Cost data is the basis for strategic decisions. Having the right information available is key for every decision-maker. The article examines the issues of cost accounting, as well as problems related to profitability management in healthcare organizations. The author considers the most common problems that make it difficult to effectively account for costs and analyze the directions of patient care in medical organizations.

scholarly journals Use of Headings and Classifications by Physicians in Medical Narratives of EHRs

2011 ◽  
Vol 02 (02) ◽  
pp. 143-157 ◽  
Author(s):  
K. Harno ◽  
P. Nykänen ◽  
K. Häyrinen
Keyword(s):  
Patient Care ◽  
Care Patient ◽  
Narrative Text ◽  
Care Plan ◽  
Medical Specialties ◽  
Secondary Use ◽  
Use Of Data ◽  
Icd 10 ◽  
Medical Narratives ◽  
Specialist Groups

Summary Objective: The purpose of this study was to describe and evaluate patient care documentation by hospital physicians in EHRs and especially the use of national headings and classifications in these documentations Material and Methods: The initial material consisted of a random sample of 3,481 medical narratives documented in EHRs during the period 2004-2005 in one department of a Finnish central hospital. The final material comprised a subset of 1,974 medical records with a focus on consultation requests and consultation responses by two specialist groups from 871 patients. This electronic documentation was analyzed using deductive content analyses and descriptive statistics. Results: The physicians documented patient care in EHRs principally as narrative text. The medical narratives recorded by specialists were structured with headings in less than half of the patient cases. Consultation responses in general were more often structured with headings than consultation requests. The use of classifications was otherwise insignificant, but diagnoses were documented as ICD 10 codes in over 50% of consultation responses by both medical specialties. Conclusion: There is an obvious need to improve the structuring of narrative text with national headings and classifications. According to the findings of this study, reason for care, patient history, health status, follow-up care plan and diagnosis are meaningful headings in physicians’ documentation. The existing list of headings needs to be analyzed within a consistent unified terminology system as a basis for further development. Adhering to headings and classifications in EHR documentation enables patient data to be shared and aggregated. The secondary use of data is expected to improve care management and quality of care.

Expert Clinical Testimony and Professional Ethics

1979 ◽  
Vol 7 (3) ◽  
pp. 347-357 ◽  
Author(s):  
Louis S. Berger
Keyword(s):  
Clinical Ethics ◽  
Professional Ethics ◽  
Current Practice ◽  
Psychological Trauma ◽  
Remedial Action ◽  
Psychiatric Assessment ◽  
The Subject

The practice of giving expert clinical testimony about a psychological or psychiatric assessment in the presence of the subject of that evaluation is examined. The potential that this practice has for inflicting psychological trauma to the subject is considered, and discussed in the context of the principles of professional clinical ethics. It is proposed that current practice may violate certain of these principles. Suggested remedial action is outlined.

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