Healthcare Administration - Term Paper Example

? Healthcare Administration Healthcare Administration The root causes of the complaints about the clinic. In the healthcare profession, clinical negligence is an act of omission or commission by a healthcare officer; the treatment offered does not match the accepted medical standards. The negligence may cause damage or death to the patient. In order to diagnose the cause of the complaints, the chief operating officer should establish that: the healthcare officers owed a duty of care to the complaining patients; there was a violation of that obligation; the violation caused injury to the patient and damages has occurred as a result of that injury (Showalter, 2012). Based on the four elements, the chief operating officer will analyze what might have caused the complaints. The operating officer should prove that the healthcare personnel responsible for treating or handling the patients owed them a duty of care. This analysis will include evaluation of all healthcare persons attached to the emergency room such as, nurses, doctors and ambulance services among others. The operating officer will analyze why the healthcare officers did not offer the patients the required standard healthcare services. Breach of duty analysis will identify whether the personnel’s action matches the standards of competent healthcare experts in the same field. Where a body of standards is used to establish whether the doctor was not negligent, such standards must be logical and rational (Showalter, 2012). The operating officer also establishes the causation of violation of duty of care by the doctor. In establishing what damages were caused to the patient, the operating officer must seek to identify whether the damage was caused by negligence of the healthcare personnel or limitations in resources at the emergency room. The officer should interrogate the available resources in the emergency room against the high turnover of patients to know the cause of complain against the clinic. A strategic plan for overcoming the problems associated with the current ER. The strategic plan will involve optimization of the patients’ pathway in the emergency room. Currently, the emergency room is experiencing an increased demand for emergency services. This growth is attributable to an increased in the number of minor and moderate injuries, which has overstretched the facility capacity and resources. The current system of admission is using static information to plan and manage the incoming patients, admissions and discharging and is unable to provide sufficient information for capacity planning (Richards & Rathbun, 1999) Dynamic information system will be capable of highlighting peak volumes and suggest shortage of capacity as perceived by the staff. Capacity planning is based on averages although peak number of patient in ER at a certain time of the day or month is critical. Dynamic System Simulation can be used as a decision making tool readily available, cheap, and efficient to use and optimize in several processes. It mimic an actual process over by including basic hypothesis of a “what if” analysis. The information system will help the clinic produce information to be used in making appropriate decisions, solve capacity problems of emergency room and facilitate the planning process by the management (Journal of Trauma Management & Outcome). The “Good Samaritan Law” effect on the appropriate treatment of the ER patients Good Samaritan refers to a person who offers aid in an emergency situation to a person wounded on a voluntary basis. The person giving care to a stranger owes the stranger a duty of being reasonably careful. In the medical sense, a Good Samaritan is a professional medical practitioner who gives medical care to a person in an urgent situation. The rescuer helps the sick without any duty to care and with no monetary compensation expected in return. An example is a medical practitioner who comes upon a motor vehicle accident spot. The person who responds and offers aid to injured acts as a Good Samaritan and has no obligation for care to the victims and expects no compensation. However, the several lawsuits have been failed against medical personnel who acted as Good Samaritan for negligence. According to Richards and Rathbun (1999), Dr. Kildare lost a lawsuit for helping a victim of an accident. Dr. Kildare played a Good Samaritan with disastrous results in the People Versus Kildare. The doctor performed an emergency operation on Frances Marlowe, a crash victim. Later on, while recuperating in hospital, Marlowe discovered that his leg was paralyzed and sued the doctor and his hospital for negligence. However, most of the lawsuits under the Good Samaritan Act have not sustained (Richards & Rathbun, 1999). Though the Act protect from liability a person who decides to help a third party, that person actions must be within the limited bounds. The Act protects the rescuer benevolent action to someone in need of medical care, but does not encompass “gross misconduct” or “willful misconduct” (Richards & Rathbun, 1999). A rescuer is deemed to be liable for gross misconduct if his or her action is taken without regard to the safety of others. Willful misconduct is considered to be an action that is under all probability likely to cause harm to another person. The Good Samaritan Act helps to uphold the rescuer to observe due diligence in helping a person in urgent need for medical care. How the different levels of emergency services (basic, intermediate, transfer, and trauma) should be prioritized in the strategic plan. Emergency Medical Service (EMS) is offered by various individuals using different methods. The extent of the EMS is determined by country, state, and individual health facilities, and each has its own approach on how to provide emergency medical services. In the United States, Advanced Care Support (ASL) and Mobile Intensive Care Units (MICU) services must be provided by paramedics. The level of service available is categorized under Basic, Intermediate, transfer and trauma. The four categories should be prioritized in the strategic plan of a health facility (Moskop, Sklar, Geiderman, Schears, & Bookman, 1999). Under basic level emergency service, there should be a first responder at the scene of an accident who provides the basic care such as cardiopulmonary resuscitation (CPR). First responders should be dispatched by the ambulance services. At the intermediate level, there should be an ambulance driver who should have basic medical qualifications and whose responsibility is to drive the ambulance. According to Richards and Rathbun (1999), ambulance driver may be trained in radio communication and emergency response driving skills. Ambulance Care Assistant (ACA) is supposed to perform patient transport duties such as wheelchairs cases and stretcher. The Emergency Medical Technician (EMT) performs various emergency care duties. At the intermediate level care, the advance life support team takes charge of any complication during the transfer phase. While transferring patients, an advanced, professional team will be required to handle any emergencies. This includes a paramedic who has a higher level of key skills than the technician and can perform cannulation and cardiac monitoring among other duties. The critical care paramedics have specialized skills in transporting critically ill patients from an accident scene to the receiving hospital with a high degree of care (Richards & Rathbun, 1999). After arrival at the hospital, a team of registered nurses and physicians should receive the patient and take charge of the situation. The physician should decide either to take the patient to the hospital directly or resources for advance care transferred to the patient where they lie. The model of care in an Emergency Medical Service can take either the physician-led or pre-hospital specialist led approach. Formulate a plan to treat adults, minors, emancipated minors, or incompetent adults in the new ER organization. In providing medical care to adult, the physician should offer patients the necessary the disclosures about the disease they are suffering from in order for them to make an informed consent to the prescribed treatment. It is impractical and unnecessary for the doctor to make all the disclosure since it is time consuming. Further, it can result in a patient refusing to take a medical procedure that is highly beneficial to their health. Adequate disclosure is the information that a patient need to make an informed decision. An adult patient makes the final consent on the treatment prescribed by the doctor (Hickey, 2007). The decision to consent or refuse treatment for a minor is bestowed on the parent or guardian. Parents are required to demonstrate due diligence in the interest of their incompetent children’s decision on treatment. Similar to other minors, emancipated minors may be incompetent to make a sound medical consent. However, since the child has been freed from the legal control of parents, their decision may be bidding depending on the emancipation (Hickey, 2007). An adult may become incompetent because he or she is unconscious after undergoing a surgical procedure. The doctor has the duty of beneficence to the patient. The physician should inquire whether the patient has executed the power of an attorney for matter pertaining to healthcare. This document should identify the person who is entrusted to make a medical decision on behalf of the patient. Where the power of an attorney is absent, the physician can turn to a surrogate person to make such a decision. A procedure to provide care to those who refuse to consent to treatment. The physician has a duty to provide the patient with the necessary information to assist him, or her make an informed consent. A competent adult has the final say in the administering of treatment by the physician. In case the patient refuse to oblige to the prescribed treatment, the physician should seek clarification of the reason behind the refusal to establish whether the patient is acting out of lack of understanding of the medical condition falling short of decision making capacity. The physician should seek to understand the patient’s concerns about the treatment before offering further advice to validate his or her concerns. Validating makes the patient feel he or she is heard and the concerns raised are appreciated by the doctor (Hickey, 2007). Using sound judgment, the doctor should try to establish a win-win situation. In case the patient refusal to treatment will have an adverse effect on their health, the doctor should inform the patient in an honest way. References Hickey, K.  “Minors' Rights in Medical Decision Making”. JONA's Healthcare Law, Ethics, and Regulation 9 (3) (2007): 100-104. Print. Journal of Trauma Management & Outcome. (2008). Strategic emergency department design: An approach to capacity planning in healthcare provision in overcrowded emergency rooms. Bern: Zimmermann, H. Moskop, J. C., Sklar, D. P., Geiderman, J. M., Schears, R. M. & Bookman, K. J. “Emergency Department Crowding, Part 2—Barriers to Reform and Strategies to Overcome Them.” American College of Emergency Physicians 53 (5) (2008): 612-615. Print. Richards, E. P. & Rathbun, K. (1999). Medical Care Law. Maryland: Aspen Publishers. Showalter, J. S. (2012). The law of healthcare administration (6th ed.). Chicago: Health Administration Press. Read More