EILEEN E. MORRISON
A Practical Approach
For Decision Makers
SECOND EDITION
© 2010 Jones and Bartlett Publishers, LLC
Class 5
© 2010 Jones and Bartlett Publishers, LLC
Agenda:
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Introduction to external influences
Macro and micro accountability
Why is it needed?
How does the public protect itself?
“Organization Analysis” exercise
Advocacy and staff competency
Summary
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Introduction to Section II
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Health care is not an island. Why did the
book start with this statement?
How does the community influence your
business?
It regulates you (5).
The market influences what you do (6).
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Community Influences
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It expects social responsibility (7).
Technology has a huge influence (8).
The section we will be studying is about how
the external world influences our actions
and our ethics.
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Quis Custodiet Ispos
Custodes?
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What does this title mean? Why was it
chosen?
Why does the public need protection
from us?
 We have a monopoly.
 We have absolute power?
 History lessons?
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Who will guard the guardians?
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Why does the public need protection
from us?
 They fund us; do we spend their
money wisely?
 We are not above ethics violations.
 Other ideas??
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How does the Community Protect
Itself?
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Limit your boundaries; Examples?
Structure your business; Examples?
Limit your individual power; Examples?
Increase their knowledge; Examples?
Complain? To whom?
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You are Accountable!
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On the macro level to external
regulators.
On the micro level to patients, families,
staff, immediate community.
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What is your Responsibility?
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Know your organization.
Things to know about it include its mission,
vision, and values.
You should know its policies and
procedures.
Know your confronters.
Reading and researching becomes
important here.
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What is your Responsibility?
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“Organizational Analysis” Exercise
Group assignments: Aquinas: JCAHO;
Kant: AHA; Mill: HIPAA laws; Rawls:
NCQA
Answer 3 questions
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Who or what are you? What do you want
from health care? What ethics principles
support your actions?
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What does it mean to be an
advocate?
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Five minute brainstorm: Why would anyone
want a to be health care administration
major?
An advocate for the community states your
community’s position.
How does this exercise relate to the
definition of an advocate?
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How do you become an
Advocate?
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Stay informed; how do you do this?
Get involved; how?
Remember who you are.
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Assuring Competent Staff
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How can you assure competency
before you hire (recruitment)?
 Review and update job description;
why?
 Interviews; what would you ask?
 Reference checks; why?
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Background Checks
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Why such an emphasis?
The information age means greater
scrutiny which can be an advantage
when you are the employer.
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Areas for Background Checks
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Driving record, bankruptcy, past
employers
Educational records, character
references, medical records
Drug tests, sex offender records,
criminal records
Court records, etc.
Release for some but not all
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Who is responsible for making the
assumptions true statements?
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How can you do this after you hire
(retention)?
 Mandatory orientation
 Mentoring programs
 Continuing education
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Incompetence happens…
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Why would someone not be competent?
Examples from clinical professionals?
Examples from managers?
What is your obligation?
HCA motto: Ancora Imparo!
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How about YOU?
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When you graduate, what will happen?
What do you have to do?
 Find meaning in work
 Create mission and ethics statement
 Mentor?
 CEUs
 Other ideas?
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Case Discussion
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Was Lawanda Person incompetent?
Was the nurse supervisor incompetent?
What is the family feeling?
What is the impact on the facility?
© 2010 Jones and Bartlett Publishers, LLC
Homework
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Answer the following question about
your assigned topic: what is this? Who
uses it? What ethics issues need to be
considered?
Aquinas=acupuncture, Kant=massage
therapy, Mill=herbal medicine,
Rawls=naturopathy
© 2010 Jones and Bartlett Publishers, LLC