Medical Case Scenarios

Description of Case This case is about a clinical department manager who has successfully brought a failing department to a department that is very efficient. The manager has used her skills to help improve satisfaction among the patients, families, nurses, and physician satisfaction. She has also found ways to increase patient volume and finances. This manager made such an impact that she was promoted to administrator of one of the hospitals suites. When she arrives at her new job she realizes that some of the things she did to improve things at her old job would also help in this area of the hospital. She decides to talk to the staff about this and the staff is reluctant to change. They feel that things are going great in their area so
there is no need to change anything. The administrator is still wanting try her hand at quality improvement in the hospital suite, but she doesn’t want to get the employees angry nor does she want to lose the great staff she already has in that area.
Relevant Stakeholder and Values
There are multiple stakeholders in this case study, all of which are very important to the organization. The administrator is a one of the stakeholders because she wants to make a change to improve her new area and her title would be on the line if it went wrong. The patients are stakeholders because they would be the ones to benefit from the quality improvement measures that would be put in place. The most relevant stakeholders in this case study are the employees who are reluctant to make a change in their area. The employees feel that they are doing fine and there are no problems so they shouldn’t have to make any changes. They are the ones who will either make this work or fail. The hospital as a whole would be a stakeholder because quality improvements could affect the whole organization such as money savings and processes. The community would be stakeholders because if the hospital cannot provide quality services and sustain, the community would suffer from not having a hospital in the area. Local and Federal governments are also stakeholders because if the hospital produces quality care they would have to pay their full reimbursement to the hospital, if the hospital proves to not produce this the governments would withhold payments.
Role of Administrator The role of the administrator is to continue pushing for quality improvements within the organization and departments.
The administrator would have to convince the employees that what they do will make things even better and might make the work arena an even better and happier place to work. The administrator should involve and engage the employees by having them come up with ways to make their work processes more efficient, regardless if they think they are already doing fine. She needs to show that anything they do to improve is her areas are not only going to help the patient but could help the organization as a whole and might aide in saving jobs if finances are not that good. She also needs to explain to the staff that they have a moral obligation to the patients and society to produce quality sustainable healthcare and that means making changes once in a while. “A healthcare’s organizational obligation to engage in QI derives from its moral obligation to achieve the societal values for healthcare; fulfilling of the moral obligation by an organization is substantially dependent on the organizations leaders and mangers” (Filerman, Mills, & Schyve, 2014). To get the employees on board she needs to make sure she is communicating effectively, educate the employees, provide resources to conduct activities and reward those who are on board (Filerman, Mills, & Schyve,
2014).
Ethical Principles Illustrated (Beneficence, Non-, maleficence, Respect for Autonomy, Fairness, Truthfulness, Justice) One of the ethical principles illustrated is beneficence. Hospitals are there to provide care to anyone and everyone. “An integral part of work as a professional is the foundational ethic of beneficence; an understanding of this ethic of care compels the individual health practitioner to consider his or her calling to the high standards of professionalism as a moral imperative; one that advocates for high standards and strives for the greater good” (Kinsinger, 2009). Non-maleficence is illustrated by improving processes so you do the patient no harm. Justice is demonstrated by showing dedication to the patients by trying to improve processes to help them receive care that is exceptional for all patients. “Fidelity requires loyalty, fairness, truthfulness, advocacy, and dedication to our patients; by keeping a commitment and is based upon the virtue of caring” (Uden, Stacy, & Lough, 2014). By committing to continue to improve and make things better for the patients it shows that the hospital is being fair, truthful and dedicated to the patient’s welfare, it also shows justice since this is all being done for everyone and not just one person or group on particular.
Conclusion/Final Decision The final decision of quality improvements should be the administrator regardless if the employees want it or not.
“Only the leaders and managers of an organization can shape a sustainable QI culture in the organization” (Filerman, Mills, & Schyve, 2014). The administrator should tell the employees that regardless of what they think they are going to be doing QI projects; then ask for volunteers. If no one volunteers then she should assign certain people to work on projects and tell them that these are goals she is putting in place and that this will also influence their yearly evaluations. If the employees know that this will affect them personally then they may be on board to really make a difference and help with the QI projects. She needs to let the employees know that this is part of their job and “engaging in QI is not only the right thing to do ethically, it is in the interest of the healthcare organization and the organization’s leaders and managers themselves” (Filerman, Mills, & Schyve,
2014).
Summary of Learning What I have learned from this is that there needs to be continual change to make a difference. Healthcare is constantly losing money it has to change processes and the way they do things to save money and still provide quality care for the patients. Employees are a very important part of quality improvement and as a healthcare worker, it is their moral obligation to make sure that their performance and processes enhance the health of the patients and do not harm them. “Using change management techniques is designed to reduce the discomfort of the stakeholder’s with the changes to be made and with the compromise of their goals and values; thus can reduce associate moral distress all affected employees” (Filerman, Mills, & Schyve, 2014).