All Entries Tagged With: "ethics"
Nurses targeted after anonymous complaint about physician
Two registered nurses from Winkler County Memorial Hospital in Kermit, TX are being prosecuted for reporting complaints to the Texas Medical board about a physician’s standard of practice, according to the local CBS affiliate.
The American Nurses Association (ANA) has joined the Texas Nurses Association (TNA) to criticize the state’s response. Both associations worry about the precedent the action sets for future nurse whistle blowers who advocate for patient safety. An initial hearing on the nurses’ motions to dismiss the case was held July 15 but no ruling was made.
The nurses sent an anonymous letter to the Texas Medical Board. The Winkler County Sheriff’s Department then received a harassment complaint from the physician, and initiated the investigation that resulted in criminal charges. The Texas Medical Board has notified the sheriff’s department that the complaints were confidential and not subject to subpoena. TNA has set up a fund for the nurses’ legal fees.
What do you think of this case, will it hold?
Does “ethics checklist” have a place at your hospital?
In the last year, much has been made of the power of checklists. Peter Pronovost and his team from Johns Hopkins succeeded at proving a checklist used in Michigan ICUs helped reduce or prevent central line infection rates. Recently this was replicated in hospitals around the country. The World Health Organization (WHO) Surgical Safety Checklist was proven to reduce surgical errors by one third in operating rooms around the country, and has been incorporated into the IHI’s latest campaign.
Last month the British Medical Journal published a study about a new type of checklist–an ethics checklist. This article in American Medical News provides a more in-depth look at the checklist and uses. Some interesting questions come out of the use of this new checklist, which is currently being piloted at Washington Hospital Center in Washington, D.C. One of these is are checklists becoming an of-the-moment solution for many patient safety concerns?
The American Medical News article contains feedback from both Pronovost and Atul Gawande, director of the WHO initiative. Both agree that checklists alone will not change the behavior of healthcare workers. For specific interventions they have succeeded because of commitments to culture change and an understanding of why the checklist is useful.
The ethics checklist contains items such as ensuring patients’ ideas about treatment , end-0f-life wishes, and family situation/ interactions are all clear. Those who are piloting the checklist are excited about the potential it has to integrate ethics questions more easily into patient care.
What to do with non-urgent ED patients
Emergency departments (ED) across the country are suffering from overcrowding. There are many reasons for the plethora of people in today’s EDs, from hospital closings to primary care physician shortage. At University of Chicago Medical Center’s ED, part of the problem was that 40% of the 80,000 patients who show up every year don’t need emergency care, according to a Wall Street Journal post. So the University of Chicago Medical Center decided to redirect those non-urgent patients to other local health clinics to receive care. United States Sen. Chuck Grassley (R-IA), among others, have questioned this method.
I know our readers must deal with crowded EDs every day. What do you think of this method? How does your hospital handle overcrowded EDs?
Ethics and patient safety: Should you tell patients they can get better care elsewhere?
Earlier today I was reading a posting on the topic of ethical responsibilities from one of our sister publications, HealthLeaders Media and was struck by how the topic directly relates to patient safety. The question at hand is If we have the opportunity to tell patients about the possibility of receiving higher quality care at another organization nearby, should we do so? The question puts two competing ideas against each other: the need to care for patients to the best of our ability, even if that means directing them elsewhere, and the need to also keep our own hospital functioning by caring for patients. Of course, this question is inextricably linked to the topic of money and payment which makes it increasingly more difficult to answer.
The HealthLeaders column, written by Jay Moore, brings up that often, the answer is complex simply because there are so many different ways to measure quality care within healthcare. [more]
