You are the healthcare manager in a university medical center. After an inspection, JCAHO, your accreditor, notes that patient satisfaction surveys give you a low rating. Although your hospital has a great track record for disease detection, treatment, and monitoring, patients routinely rate their experience at and satisfaction with the hospital as low.
In follow-up interviews with patients, JCAHO discovers that patients felt they and their families were not well-informed about upcoming procedures and options. They had a general feeling of uncertainty about their care and treatment. One former patient stated, "The doctor spent more time talking with the medical residents and student nurses than with me!"
Answer each of the following questions in a paragraph of 5-7 sentences (for a total of 4 paragraphs):
Which ethical principles would you apply to this scenario? Which ethical theorists would you use to guide you? Refer to your textbook, putting all direct citations in quotes.
Which parts of the AHA's Patient Care Partnership document would you apply to this scenario? Refer to specific parts of the document, putting all direct citations in quotes.
Which parts of the ACHE Code of Ethics would you apply to this scenario? Refer to specific parts of the document, putting all direct citations in quotes.
Describe an "action plan" to present to the accrediting body (JCAHO) to convince them you're serious about improving your patient satisfaction scores.
Full Answer Section
Applying the AHA's Patient Care Partnership:
The AHA's Patient Care Partnership document directly addresses the issues at hand. Section 2 ("Shared Decision-Making") emphasizes the importance of involving patients in treatment decisions, ensuring they have access to complete information and understand their options ("The patient has the right to be informed about risks, benefits, and alternatives of proposed procedures or treatments…" - AHA Patient Care Partnership). Section 3 ("Communication and Collaboration") underscores the need for clear communication with patients and families, including timely updates and responsiveness to questions ("Health care professionals... have an obligation to communicate effectively and respectfully with patients…" - AHA Patient Care Partnership). Applying these principles will be crucial in improving patient satisfaction.
ACHE Code of Ethics:
The ACHE Code of Ethics also provides relevant guidance. Principle 2 ("Ethical Responsibilities to Patients") demands commitment to patient well-being and respect for their dignity and autonomy ("healthcare executives hold patient welfare in the highest regard…" - ACHE Code of Ethics). Principle 9 ("Communication and Transparency") underscores the importance of open and honest communication with all stakeholders, including patients and families ("healthcare executives communicate openly and honestly with… patients/clients…" - ACHE Code of Ethics). Adhering to these principles will be essential in regaining patient trust and improving communication.
Action Plan for JCAHO:
My action plan for JCAHO would detail concrete steps for immediate improvement and long-term change. This would include:
- Enhanced Patient Education: Implementing pre-procedure workshops, detailed handouts, and readily available staff to answer questions.
- Improved Communication Practices: Training staff on active listening, respectful communication, and addressing patient concerns promptly.
- Physician Engagement: Encouraging doctors to prioritize patient communication, devoting sufficient time to patient interactions, and explaining procedures clearly.
- Patient Feedback System: Creating a readily accessible system for patients to voice concerns and suggest improvements.
- Regular Performance Monitoring: Implementing regular surveys and audits to track progress and identify areas for continued improvement.
By demonstrating a commitment to these actions and implementing them with transparency and accountability, I aim to convince JCAHO that we are serious about improving patient satisfaction. Ultimately, the goal is to create a patient-centered care environment where informed communication, shared decision-making, and respect for patient autonomy are at the core of every interaction.
This situation highlights the importance of ethical principles and clear communication in healthcare. By prioritizing patient well-being, respecting their autonomy, and implementing practical action plans, healthcare institutions can build trust and confidence, leading to improved patient satisfaction and, ultimately, better healthcare outcomes.
Sample Answer
Addressing Patient Complaints: An Ethical Action Plan
Ethical Principles and Theorists:
This scenario raises concerns about several core ethical principles: autonomy, informed consent, and beneficence. Patients have the right to self-determination ("autonomy") and deserve clear information to make informed choices about their care ("informed consent"). Additionally, we have an obligation to provide the best possible care that benefits patients ("beneficence"). Recognizing these principles, I would draw on the work of John Stuart Mill who championed individual autonomy and informed consent ("On Liberty"). Beauchamp and Childress' "Principles of Biomedical Ethics" would also guide my approach, emphasizing informed consent, beneficence, and respect for patient autonomy.