In Let it Pour – My first assignment as Executive Assistant, Chris Smith takes the reader thru his first day at Faith Community Hospital as Executive Assistant. He has a great attitude and appreciation for life, even though it's raining outside. During his first meeting with his boss Pat, he realized it was not only raining outside but it was pouring inside Faith Community Hospital. Chris is given an assignment directly from pat to compose a preliminary report that will from the basis for a presentation. In the report Chris needs to give an informative analysis of all the problems that Pat mentioned within the hospital. Pat wants his report to consist of the current issues, the options to correct these dilemmas and what steps they plan on actually.
The pertinent issues identified during the meeting in no particular order where: patients who refuse to take certain medical services, staff members who refused to provide certain services. In addition to these issues are the unclear unwritten directives, and different objectives of staff-members, causing tremendous loss of power by caregivers. Including unauthorized pro-bonos and payment options/installments, along with uncertain and unstated insurance policies, and exams. Not to mention unspecified, vague regulatory directives from insurance companies, Medicare, Medicaid. Plus increasing insurance premiums, 7% decrease in patient population.
Per the mission statement Faith Community Hospital is founded on spiritual heritage and values to promote the health and well being of the people in the community. (Case Analysis, 2004). Adequate health care is being misinterpreted and is placing patients, including staff members, at risk. The repeating problem that surfaces during the entire article was the loss of control over procedures and lack of official code of ethics standards. Staff members at Faith Community Hospital have an obligation to operate in ways that will merit confidence and the respect of the community. Health caregivers and staff members serve as moral mediators; affecting every patient. The commitment and obligation to individuals affect the well-being of every member and therefore bears full responsibility on the caregivers. For instance, the issues with CPS seeking to take custody of a baby and threatening to file charges do to lack of care rendered.
The only solution that comes to mind is to devise a code of ethics for the organization to operate through. This would probably solve the majority of the internal problems the hospital is currently experiencing. A code of ethics serves as a standard of conduct governing and guidance of ethical behavior among healthcare personnel. Faith Community Hospital delivers healthcare services, thus they must safeguard the rights and interest of patients. Hospitals have roles as health care providers, and employers, these functions include special responsibilities for ethical conduct and practices that extend beyond meeting legal and regulatory standards. As moral advocators, Faith Community Hospital is a health care organization that requires balance among interest and values of patients. A code of ethics can assist to better identify and understand the ethical aspects of polices and procedures. Consequently, creating guidelines such as a code of ethics provides clear instructions on how to maintain such rights and interest as moral mediators.
Given that the patients are the primary concern the greater part of the code of ethics needs to consist of the employee responsibilities. For instance, communicate with patients regarding their rights and risk through particular healthcare services rendered to them. Avoid maintaining personal relationships that will hinder their improved care quality, while constantly acknowledging and respecting the customs. In many instances, the article mentions patient wishes and authorizations, clearly conflicting with the interest of the health care staff. The code of ethics needs to consist of the exercising of authority and the impact of information when making such decisions. A healthcare member needs to practice professional relationships in such a way that all those individuals affected are assured that critical decisions are carried out in the best interest of the patient and hospital. In addition, always work to recognize and meet the needs of the community. In the article there was a situation that occurred pertaining to pro-bonos and care rendered with authorization or clearance, because personal emotions became involved. For that reason all staff members need to assure everyone, including the poor, have reasonable access to healthcare services. Ordering fruitless exams for the terminal ill is a result and lack of judgment; caregivers must acknowledge this when decisions on services such as these arise.
The responsibility of all employees to follow the guidelines of the code of ethics will ensure the survival of the hospital. Since Faith is a community-founded hospital, there are rules that need to be presented to ensure the continued existence. The central directive is to maintain values and ethics with at Faith Community Hospital. This includes performing all procedures with honestly, respect and understanding that healthcare professionalism reflects the hospital. Certainly, comply with neighboring, state and federal laws. (cite) Nevertheless, be honest with the entire hospital, withholding no information that can lead to unreasonable expectations especially concerning patients.
When any organization carries out such regulations and codes its important to also stress the consequences of violations, this is done only to emphasis the level of importance. Every member has the responsibility to report any violations of the code. In order to obtain control and be in command of Faith Community Hospital; it is imperative that all staff members, caregivers, physicians' follow the codes and regulations set forth.
The problem of unauthorized payment options was also persistent in the dilemmas within Faith Community Hospital. Financial counselors need to be put in place to handle all billing and invoicing to patients. Having a set form of regulations for counselors to follow will provide stability that this organization desperately needs. In addition, Faith Community Hospital has experience a 7% decrease in patient population, this is the evidence of poor customer service, and unstable regulations. Financial counselors can handle all insurance questions, policies, cost of care, and also discuss payment arrangements. This is a community-founded hospital and naturally there will be patients that require health care and have no forms or needs of providing payment, and for this reason financial assistance will be provide. Creating this department will eliminate personal pro-bonos from caregivers and pharmacist providing payment installments.
Pat mentioned to Chris that Faith Community Hospital receives revenues from a variety of sources. The current problem is the lack of inconsistency on the percentage paid to the hospital. A solution to that issue is to form a financing sub-department to best specialize, identify and categorize patients, ensuring proper obtainment of reimburses by such sources. According to Medicare payment options for rural hospitals: the name game – Medicare/Medicaid, written by Marmouget & Wolters the following applies:
'Within the framework of Medicare laws and regulations governing payments for acute-care services are various options affecting payments to individual hospitals, many of which are directed at rural hospitals.' (Marmouget & Wolters 2002). Medicare is the federal health care insurance program for eligible people. (Marmouget & Wolters 2002). Those community members who are eligible should be categorized under this department. Faith Community Hospital portion of income is Medicare and that is funded by federal tax on income that is paid partly by the employee, and partly by the employer. That is guaranteed steady income. Medicaid on the other hand is a program that assist patients who are less fortunate and need met certain requirements. But since Medicaid play hospitals lower then the rates of Medicare the financing dept should avoid this method. (Marmouget & Wolters 2002). Conducting contracts and negotiating the hospital pays from insurances agencies should always be written and guaranteed. Another option to consider is capitation:
'The hospital receives a negotiated amount per patient enrolled in the health care plan per month. The hospital agrees to assume the risk of potential costs of the care of the patient in exchange for a predictable revenue stream whether or not those services are used. Under this system, the hospital is rewarded for using only the most appropriate services.' (Ferris, Glaichen, Portenoy, Von 2001).
Faith Community Hospital depends on their medical staff to deliver quality care to the entire community regardless of financial status. Due to the 7% decrease in patient population that Pat discussed Chris is forced to seek out other options to provide better use of resources to the hospital. An article by Sutter Medical Center of Santa Rosa provides a great insight on handling such decreases. Sutter Medical Center participates in collaborating health needs assessments from which the communities needs and priorities are identified. (Sutter Santa Rosa, 2004). Faith Community Hospital can also benefit from this type of assessment by surveying and planning the range of health care tendered that the community seeks. This type of planning can benefit the hospital by surveying resources and dollars to be allocated in ways that will most be the most meaning full to the people they serve. For the time being, Faith Community Hospitals depends on their medical staffs to deliver quality care and they rely on physicians to share their commitment to serving all patients without regard to financial status.