1. © 2010 Jones and Bartlett Publishers, LLC A Practical Approach For Decision Makers SECOND EDITION EILEEN E. MORRISON

2. © 2010 Jones and Bartlett Publishers, LLC Class Seven: Social Responsibility

3. © 2010 Jones and Bartlett Publishers, LLC Agenda: History of health care and social responsibility History of health care and social responsibility Balancing business and social responsibility Balancing business and social responsibility Prevention as social responsibility Prevention as social responsibility Public health and social responsibility Public health and social responsibility Quality assurance as social responsibility Quality assurance as social responsibility Case comments Case comments Exam questions??? Exam questions??? Summary Summary

4. © 2010 Jones and Bartlett Publishers, LLC Why does the Community expect Social Responsibility? Roots of health care are not in business. Roots of health care are not in business. Institutions began as way to care for sick and injured. Institutions began as way to care for sick and injured. Wealthy received care at home from physicians Wealthy received care at home from physicians Protecting the community from spread of contagious diseases was also important. Protecting the community from spread of contagious diseases was also important.

5. © 2010 Jones and Bartlett Publishers, LLC Do you know your history? Pest houses were used for contagious diseases. Pest houses were used for contagious diseases. Boston began first general hospital, but it was not for wealthy. Boston began first general hospital, but it was not for wealthy. Hospitals run by religious orders or community groups; ex. King's Daughters Hospital Hospitals run by religious orders or community groups; ex. King's Daughters Hospital Not great places to be!!! Not great places to be!!!

6. © 2010 Jones and Bartlett Publishers, LLC History Anyone??? After WWII, many changes in health care including: After WWII, many changes in health care including: –More government involvement. –Employer-based insurance to save money. Increased the need for a more business- centered approach but still had to keep our social responsibility. Increased the need for a more business- centered approach but still had to keep our social responsibility. What is our mission as a health care system? What is our mission as a health care system?

7. © 2010 Jones and Bartlett Publishers, LLC Balancing Business and Social Responsibility Make informed choices in strategic planning Make informed choices in strategic planning For Profit? Not for profit? For Profit? Not for profit? Profits can be used for socially responsible actions. Profits can be used for socially responsible actions. Question decisions and compare against mission. Question decisions and compare against mission. Act as a good steward or servant leader. Act as a good steward or servant leader.

8. © 2010 Jones and Bartlett Publishers, LLC Being Good Stewards of the Environment Being Good Stewards of the Environment What should we do to protect the environment? What should we do to protect the environment? Control waste? Control waste? Recycle? Recycle? Reuse? Reuse?

9. © 2010 Jones and Bartlett Publishers, LLC Blum Model… Arrow size describes contribution to health. Arrow size describes contribution to health. Environment is biggest. What’s included? Environment is biggest. What’s included? Lifestyle is choices and attitudes. Ex.? Lifestyle is choices and attitudes. Ex.? Heredity: Do you still have choices? Heredity: Do you still have choices? Medical Care Medical Care –Includes prevention, cure and care. Think money…. Think money….

10. © 2010 Jones and Bartlett Publishers, LLC What CAN be Done? What can you do for your own health? What can you do for your own health? What could organizations do to increase prevention? What could organizations do to increase prevention? How about employee wellness programs? How about employee wellness programs? What’s the payoff for doing this? What’s the payoff for doing this?

11. © 2010 Jones and Bartlett Publishers, LLC How can you help? Be a volunteer Be a volunteer Survey your organization for prevention efforts Survey your organization for prevention efforts Use teams to create new ideas for both employees and the community Use teams to create new ideas for both employees and the community

12. © 2010 Jones and Bartlett Publishers, LLC Public Health and Social Responsibility History goes back to Lemuel Shattuck’s Report of the Sanitary Commission of MA. History goes back to Lemuel Shattuck’s Report of the Sanitary Commission of MA. Found that death and disease could be prevented. Found that death and disease could be prevented. Prevention could save more lives than cure. Prevention could save more lives than cure. Date was1849!!!! Date was1849!!!!

13. © 2010 Jones and Bartlett Publishers, LLC The Mission of PH… Turncock (2001) says that it is preventing disease, injury, and disability AND Turncock (2001) says that it is preventing disease, injury, and disability AND Promoting health both physical and mental. Promoting health both physical and mental. How does PH work? How does PH work?

14. © 2010 Jones and Bartlett Publishers, LLC Impact of PH? 1900 life expectancy was average of 49 (48 for males, 50 for females) 1900 life expectancy was average of 49 (48 for males, 50 for females) 2007 life expectancy was 81 for F, 75 for M. Varies with ethnicity. 2007 life expectancy was 81 for F, 75 for M. Varies with ethnicity. If you were living in 1900, where would you be in your lifespan? If you were living in 1900, where would you be in your lifespan?

15. © 2010 Jones and Bartlett Publishers, LLC Impact of PH? In 1900, the leading causes of death were Pneumonia, TB, Diarrhea, Heart Disease, Liver Disease In 1900, the leading causes of death were Pneumonia, TB, Diarrhea, Heart Disease, Liver Disease In 2007, leading causes of death were Heart Disease, Cancer, Stroke, Chronic Respiratory, Accidents. In 2007, leading causes of death were Heart Disease, Cancer, Stroke, Chronic Respiratory, Accidents. Ages 15-24 leading causes of death were accidents, homicides, suicide, cancer, and heart disease. Ages 15-24 leading causes of death were accidents, homicides, suicide, cancer, and heart disease. Comments? Comments?

16. © 2010 Jones and Bartlett Publishers, LLC What made the Difference? 25 years of the increase is directly related to public health. 25 years of the increase is directly related to public health. Water treatment, milk pasteurization, no spitting laws Water treatment, milk pasteurization, no spitting laws Reportable diseases, vaccines, housing codes, inspectors, air pollution controls and… Reportable diseases, vaccines, housing codes, inspectors, air pollution controls and…

17. © 2010 Jones and Bartlett Publishers, LLC Public Health’s Status PH exists in a market-based economy. PH exists in a market-based economy. Conflicts have existed between medical care community and PH. Conflicts have existed between medical care community and PH. Collaborations are beginning to happen. Collaborations are beginning to happen.

18. © 2010 Jones and Bartlett Publishers, LLC QA and Social Responsibility QA addresses duty for beneficence and nonmaleficience QA addresses duty for beneficence and nonmaleficience Stewardship through quality assurance Stewardship through quality assurance Leapfrog Group and IOM keeps attention Leapfrog Group and IOM keeps attention Need to continually monitor standards Need to continually monitor standards Need be sure to collect “good” data Need be sure to collect “good” data May serve as a member of a QA Organization or on a facility QA team May serve as a member of a QA Organization or on a facility QA team

19. © 2010 Jones and Bartlett Publishers, LLC Case Discussion How did Dr. Francis Loreto demonstrate social responsibility? How did Dr. Francis Loreto demonstrate social responsibility? What were Blaise Loreto’s concerns? What were Blaise Loreto’s concerns? What lessons did you learn? What lessons did you learn?

20. © 2010 Jones and Bartlett Publishers, LLC Case Discussion: The PHA Why did Sandra Peoples work to get a grant? Why did Sandra Peoples work to get a grant? What was the impact of her efforts? What was the impact of her efforts? What lessons did you learn? What lessons did you learn?