Doing the Right Things Right or the Wrong Things Well

Author(s):  
Vahé A. Kazandjian

The measurement and evaluation of healthcare services’ quality is faced with the challenge of describing its appropriateness. Is the right service rendered for the specific disease? Or do our measures quantify the efficiency of producing these services without first assessing if they were needed? Eventually, it is a question of accountability about the processes and outcomes of the care, which are expected to both demonstrate the social responsibilities of health care professionals and gauge the expectations of patients, families, and communities. The purpose of this chapter is to explore the determinants of what and why patients expect from healthcare and caring. Within the concept of accountability, the role of physicians as educators rather than exclusively healers of disease is explored.

Author(s):  
Vahé A. Kazandjian

The measurement and evaluation of healthcare services continues to be challenged when the appropriateness of the services is its focus. Good outcomes do not mean the services were needed or that the process of delivering care was efficient. Further, patient and family satisfaction with the care episode is influenced by the promises the healthcare system in general and physicians in particular made to the patients. As such, physicians have the dual role of educating patients while they are managing their health status changes. Eventually, it is a question of accountability about the processes and outcomes of the care, which are expected to both demonstrate the social responsibilities of health care professionals and gauge the expectations of patients, families, and communities. The purpose of this article is to explore the determinants of what and why patients expect from healthcare and caring. Within the concept of accountability, the role of physicians as educators rather than exclusively healers of disease is explored.


Author(s):  
Vahé A. Kazandjian

The communication between health care professionals and patients should go beyond the communication about the management of the disease – it should encompass educating patients about the knowledge available to treat the disease, the processes in place to enhance safe, effective and sustained performance. Accountability about the processes and outcomes of the care are expected to both demonstrate the social responsibilities of health care professionals and gauge the expectations of patients, families, and communities. The purpose of this article is to explore the determinants of what patients expect from healthcare and caring; how providers of care use available knowledge (or pseudo-knowledge) to apply their craft, and how information technologies assist in both the application of the available knowledge and the goodness of that application. Special focus is given to the role of physicians as educators rather than exclusively healers of disease and managers of patient complaints.


2002 ◽  
Vol 9 (5) ◽  
pp. 472-482 ◽  
Author(s):  
Deirdre Hyland

The purpose of this article is to examine whether patient/client autonomy is always compatible with the nurse’s role of advocacy. The author looks separately at the concepts of autonomy and advocacy, and considers them in relation to the reality of clinical practice from professional, ethical and legal perspectives. Considerable ambiguity is found regarding the legitimacy of claims of a unique function for nurses to act as patient advocates. To act as an advocate may put nurses at personal and professional risk. It may also be deemed arrogant and insulting to other health care professionals. Patient autonomy can be seen as a subcategory of the right of every individual to self-determination, and as such is protected by law. However, it is questionable whether the traditionally paternalistic approach to health care provision truly respects the autonomous rights of each patient. The author considers examples and cases from the literature that resulted in professional and/or personal difficulties for the nurses involved, and also reflects on an incident from her own practice where a positive outcome was achieved that demonstrated compatibility between the concepts under consideration.


2018 ◽  
Vol 35 (1) ◽  
pp. 91-107 ◽  
Author(s):  
Shannon Jaskela ◽  
Juliet Guichon ◽  
Stacey A. Page ◽  
Ian Mitchell

When health care professionals know the right thing to do, but are prevented from doing so, they can suffer from moral distress. Although moral distress in nursing has been studied extensively, it has been a neglected topic with regard to the social work profession. This paper presents findings of a qualitative descriptive study on health care social workers’ experiences of moral distress, focusing mainly on the situations that caused such moral distress. The effects of moral distress, the coping strategies these social workers used to deal with their experience and the common theme of “pushing the rules” are also presented. Finally, we offer recommendations, which were made by participants, to assist social workers with decreasing the effects of moral distress. By following these recommendations, social workers’ experience of moral distress may decrease which will, in turn, positively affect the organizations for which they work and the patients they serve.


2005 ◽  
Vol 32 (5) ◽  
pp. 668-675 ◽  
Author(s):  
Wylie Burke

With growing knowledge about the role of genetics in health, genetics education for health care professionals has taken on increasing importance. Many efforts are under way to develop new genetics curricula. Although such efforts are primarily the responsibility of health professional schools and professional societies, the public health system is an important stakeholder, and different sectors of public health have opportunities to enhance educational efforts. These include the development of authoritative information sources about the clinical utility of genetic susceptibility and pharmacogenetic tests, creation of networks that link professionals in underserved regions to educational materials and consultative backup, and sponsorship of forums for multidisciplinary discussion of controversial issues. Public health input can help to ensure an appropriate emphasis on health outcomes as new genomic tests and technologies come into use, thus helping to protect society from the social and medical costs of genetic tests with limited clinical value.


SOEPRA ◽  
2020 ◽  
Vol 5 (2) ◽  
pp. 254
Author(s):  
Christina Nur Widayati ◽  
Endang Wahyati Yustina ◽  
Hadi Sulistyanto

Patient Safety was the right of a patient who was receiving health care. A nurse was one of the health professionals in a hospital having a very important role in realizing Patient Safety. In realizing Patient Safety Panti Rahayu Yakkum Hospital of Purwodadi had involved the role of the nurses. In carrying out their role the nurses could support the protection of the patient’s rights. The nurses performed health care by conducting six Patient Safety goals that were based on professional standards, service standards and codes of conduct so that the Patient Safety would be realized.This research applied a socio-legal approach to having analytical-descriptive specifications. The data used were primary and secondary those were gathered by field and literature studies. The field study was conducted by having interviews to, among others, the Director of Panti Rahayu Yakkum Hospital of Purwodadi, Head of Room and Chairman of Patient Safety Committee, nurses and patients. The data were then qualitatively analyzed.The arrangement of nurses’ role in implementing Patient Safety and the patient’s rights protection was based on the Constitution of the Republic of Indonesia of 1945, Health Act, Hospital Act, Labor Act, and Nursing Act. These bases made the hospital obliged to implement Patient Safety. The regulations leading the hospital to provide Patient Safety were Health Minister’s Regulation Nr. 11 of 2017 on Patient Safety, Statute of Panti Rahayu Yakkum Hospital of Purwodadi (Hospital ByLaws), Internal Nursing Staff ByLaws. In implementing Patient Safety Panti Rahayu Yakkum Hospital of Purwodadi had established a committee of Patient Safety team consisting of the nurses that would implement six targets of Patient Safety. Actually, the Patient Safety implementation had been accomplished but it had not been optimally done because of several factors, namely juridical, social and technical factors. The supporting factors in influencing the implementation were, among others, the establishment of the Patient Safety team that had been well socialized whereas the inhibiting factors were limitedness of time and funds to train the nurses besides the operational procedure standard (OPS) that was still less understood. Lack of learning motivation among the nurses also appeared as an inhibiting factor in understanding Patient Safety implementation.


Author(s):  
Elise Paradis ◽  
Warren Mark Liew ◽  
Myles Leslie

Drawing on an ethnographic study of teamwork in critical care units (CCUs), this chapter applies Henri Lefebvre’s ([1974] 1991) theoretical insights to an analysis of clinicians’ and patients’ embodied spatial practices. Lefebvre’s triadic framework of conceived, lived, and perceived spaces draws attention to the role of bodies in the production and negotiation of power relations among nurses, physicians, and patients within the CCU. Three ethnographic vignettes—“The Fight,” “The Parade,” and “The Plan”—explore how embodied spatial practices underlie the complexities of health care delivery, making visible the hidden narratives of conformity and resistance that characterize interprofessional care hierarchies. The social orderings of bodies in space are consequential: seeing them is the first step in redressing them.


Author(s):  
Alfonso M. Cueto-Manzano ◽  
Héctor R. Martínez-Ramírez ◽  
Laura Cortés-Sanabria ◽  
Enrique Rojas-Campos

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