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I will never forget my biggest ethical dilemma. It happened when I was a director of case management at a large medical center in New York City. It was the day after Thanksgiving.
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One solution to perennial problems such as ethics issues might be the formation of an organizational ethics committee. Different from a clinical ethics committee, an organizational ethics committee deals with organizational dilemmas that should be solved in a formalized manner.
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Now that the Centers for Medicare and Medicaid Services (CMS) has launched a program that adjusts Medicaid payments for provider-preventable conditions, including healthcare-acquired conditions, it's essential for case managers to work with physicians to make sure all conditions that are present on admission are clearly documented on a patient's chart.
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The ethical decision-making process is similar to the case management process and the nursing process. The steps include:
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A major vein was torn during a Whipple procedure at a hospital that performs the procedure a few times a year, according to a case reported on The Law Med Blog.
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Several incidents of infection control breaches have been reported in recent months among ambulatory surgery providers:
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(Editor's note: This issue includes the second part of a two-part series on how a hospital addressed a wrong-site surgery. Last month, we looked at the details of the event and how the facility responded. This month, we look at what specific changes were made and how the top leader started networking with other CEOs on safety issue.)
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To improve patient safety by encouraging providers to speak up about their concerns, managers should focus on the influences that have the strongest effect on behavior, suggest the authors of The Silent Treatment, a report released by the Association of periOperative Registered Nurses, the American Association of Critical-Care Nurses, and VitalSmarts, a training company in Provo, UT.
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