healthcare system to deliver high-quality and cost effective care, it must transform from a fee-for-service system to a value based system. Koltov and Damle (2014) describe a program, Physician Quality Reporting System (PQRS), which uses a combination of incentive payments and payment adjustments to ensure proper use of care. The curriculum promotes recording of quality material by eligible professionals (EPs). This program is designed to give EPs the chance to assess their quality of care by comparing their performance on a certain criteria with that of their other colleagues. If this program launched successfully, the economic burden on government health insurance would significantly reduce allowing funds to be allocated elsewhere in the health care system.…
HCR ManorCare is a leading healthcare provider in the United States that specializes in skilled nursing care. Along with providing the best care for our patients, HCR ManorCare, as stated in the “Standards of Business Conduct” expects nothing less than the best from its employees. This document covers everything they expect ethically and professionally from its employees while providing the information they need to ensure they are informed of the repercussions if the policies are not followed. KEY POINTS HCR ManorCare lists four key points that ensure that their employees maintain and ethical and honest work environment, which will lead to an ethical and honest company. First is “you should not ever knowingly falsify any documents or give…
Medical practices have changed tremendously throughout the years. Thanks to the many medical advances and innovations, problems that would arise in the past are solved before they even happen. However, doctors and medical professionals have been taking advantage of those that are oppressed in society. The method of choosing the least well off in society for medical studies are extremely unethical and those who are already victim to the many injustices of the medical field are owed reparations. To the hundreds of thousands of people that suffered at the hands of those who are supposed to help them lose all sense of trust that they once gave to doctors and scientist.…
According to Ed 's physician, if he is not placed on a ventilator, he will die within a few days from pneumonia and lung congestion causing low levels of oxygen. These situations are ethically tough to evaluate, as their is never a right or wrong answer, but more so using one 's best clinical judgement if the patient still holds the capacity to make sound decisions. If the physician believed as if Ed 's symptoms are effecting his decision making ability, then I believe Dr. Goldstein 's act of calling Bert was ethically sound. "It is a patient 's written directive to continue or to withhold treatment or to administer painkilling drugs if the person has incurable disease, illness, or condition via which the patient has become incompetent and…
The measuring and reporting on healthcare quality is very important, because it gives the employees, consumers and employers not only the ability to make informed decisions but also helps them to look for the best available care. The assessment of healthcare quality is more than informing buyers and consumers about their choices. It’s about giving feedback to health plans, medical groups and doctors so they can address and improve any quality issues (NCQA, n.d.). The two methods of quality measurement that I chose are the plan-do-study-act (PDSA) and the lean six-sigma.…
This case study considers the ethical implications of the actions of nurses, that cased several near miss medical events and one medical mistake that could have been fatal. It addresses the actual issue raised by the case and how the issues are of ethical concern based on the principles of medical ethics and professional code of ethics. It reveals how various medical code of ethics guides the healthcare administrator response to the ethical issue. Case Study: We’ve Got You Covered…
Managed Care is a health care delivery system set up to manage cost, quality, and utilization. Medicaid Managed care allows for the delivery of Medicaid health benefits and additional services through contracted arrangements between Medicaid agencies and Managed Care Organizations (MCOs), that accept a set number per member per month (capitation) payment for services. By contracting with various types of MCOs to deliver Medicaid program services to beneficiaries, states can reduce Medicaid program costs and manage utilization of healthcare services. Keep in mind the goal is to improve health plan performance, quality, and outcomes.…
A mother Chelsea Reed and her son Justin were rushed into the hospital after they were injured in a car accident. Mrs. Reed has a head laceration and a fractured wrist. Her son is suffering from internal bleeding and needs to have emergency surgery to stop the bleeding. The doctor informs Mrs. Reed that Justin has lost thirty percent of blood volume and will be transfused before going into surgery to make sure he does not bleed out on the operation table. As a single mother, Mrs. Reed solely responsible for informing the doctor that she does not want blood to be used to increase the blood volume in her son.…
ETHICS IN HEALTHCARE: HELLING VS CAREY 1 Examining Ethical Decision Class Two Assignment The A Team Spring 2016 Belhaven • Shanda Steele: Responsible for the introduction (Answering questions 1 through 4) • Myeshia Clark: Responsible for the additional content (Answering questions 5 through 8) • Kathy Smith: Responsible for the conclusion (Answering questions 9 through 12) ETHICS IN HEALTHCARE: HELLING VS CAREY 2 Examining Ethical Decision Determining which decisions are accurate in making ethical decisions, can be seemly tricky. Most individuals have their own sense of morality that they live by, in which this can cause confusion when making a fair decision. For an example, most will…
A conflict between a physician and patient on the course of treatment is a common topic that arises in bioethical conversation. This case explores the topic of paternalistic choices dealing with patient autonomy and when it is ethically reasonable for a physician to intervene and decide as to whether an individual is competent to make decisions about their own care. The patient in the case, Mr. Howe was asked to make a lifesaving medical decision while in duress and not fully understanding the procedure and the potential outcome if he refused. In this case I believe the physician made the correct decision to intubate Mr. Howe against his explicit instructions not to. The physician made a determination that the patient was not accurately expressing his wishes as if he was of sound mind.…
The Centers for Medicare and Medicaid Services (CMS) implemented quality measures under Medicare, as well as various states under Medicaid. These quality measures incentivize providers through reimbursement in what is known as pay-for-performance. This value-based purchase program, ties quality measures with hospital reimbursement (Shi & Singh, 2015, p. 481). According to CMS’s website, there are thirty-three quality measures covering four separate quality sections, including, “patient/caregiver experience, care coordination/patient safety, preventive health, and at-risk population” (2015, para. 1). These measures are tacked through surveys, claims, electronic health records (EHRs), and through the ACO Group Practice Reporting Option (GPRO) Web Interface (Centers for Medicare and Medicaid Services website, 2015).…
In addition to ethical issues faced in healthcare organizations, are legal issues. According to Pozgar (2016), laws are enacted to regulate human behavior for the benefit of society. Laws are a basis for conduct in our society and if breached can lead to serious implications. Public policy is the principle of law that holds that no one can do that which tends to be injurious to the public or against the public good (Pozgar, 2016, p. 240). Though not directly involved with patient care, a health services administrator should enhance the overall quality of life and well being of individuals under their organizations care.…
“Ethics are not optional in medicine,” as stated by director of health policy and public health Alexander E Limentani in a recent edition of British Medical Journal. For centuries, doctors have debated whether ethics and honesty go hand in hand or if there may be some exceptions to the truth. For instance, fifty-five percent of physicians say they often or sometimes describe a patient's prognosis in a more positive manner than the facts might support. Imagine looking a young child in the eyes, telling them they only have a few months to live while they have their whole life ahead of them When faced with the choice, would you want to live with the heartbreaking news you had terminal cancer or live the rest of your life carefree and unknowingly…
The refusal of observations by John could potentially place his health at risk by preventing early detection of deterioration, this left the MDT with a moral dilemma. When discussing ethical dilemmas it was important in John’s case to involve all members of the MDT. Rich and Butts (2014) suggest that ethical decisions should involve all healthcare professionals in a patients care intervention. Similarly Finlay (2008) encourages the involvement of the patient in discussing ethical problems along with the healthcare professionals (in Ellis, 2015).…
Actions that are right or wrong is all a matter of a difference of opinion amongst individuals. What they learn from their family, where they grew up, what institutions they attend, their religious views, and their reflection of themselves and the world around them, all influence their morals and ethical beliefs. New ideas are constantly emerging causing us to consistently review and reconsider our beliefs. One idea that emerged and caused ethical consideration is the goal of keeping ill persons alive. This first came in the nineteenth century and has since given rise to moral questions on the care for patients.…