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 5

3. © 2010 Jones and Bartlett Publishers, LLC Agenda: Introduction to external influences Macro and micro accountability Why is it needed? How does the public protect itself? “Organization Analysis” exercise Advocacy and staff competency Summary

4. © 2010 Jones and Bartlett Publishers, LLC Introduction to Section II Health care is not an island. Why did the book start with this statement? How does the community influence your business? It regulates you (5). The market influences what you do (6).

5. © 2010 Jones and Bartlett Publishers, LLC Community Influences It expects social responsibility (7). Technology has a huge influence (8). The section we will be studying is about how the external world influences our actions and our ethics.

6. © 2010 Jones and Bartlett Publishers, LLC Quis Custodiet Ispos Custodes? What does this title mean? Why was it chosen? Why does the public need protection from us?  We have a monopoly.  We have absolute power?  History lessons?

7. © 2010 Jones and Bartlett Publishers, LLC Who will guard the guardians? Why does the public need protection from us?  They fund us; do we spend their money wisely?  We are not above ethics violations.  Other ideas??

8. © 2010 Jones and Bartlett Publishers, LLC How does the Community Protect Itself? Limit your boundaries; Examples? Structure your business; Examples? Limit your individual power; Examples? Increase their knowledge; Examples? Complain? To whom?

9. © 2010 Jones and Bartlett Publishers, LLC You are Accountable! On the macro level to external regulators. On the micro level to patients, families, staff, immediate community.

10. © 2010 Jones and Bartlett Publishers, LLC What is your Responsibility? Know your organization. Things to know about it include its mission, vision, and values. You should know its policies and procedures. Know your confronters. Reading and researching becomes important here.

11. © 2010 Jones and Bartlett Publishers, LLC What is your Responsibility? “Organizational Analysis” Exercise Group assignments: Aquinas: JCAHO; Kant: AHA; Mill: HIPAA laws; Rawls: NCQA Answer 3 questions  Who or what are you? What do you want from health care? What ethics principles support your actions?

12. © 2010 Jones and Bartlett Publishers, LLC What does it mean to be an advocate? Five minute brainstorm: Why would anyone want a to be health care administration major? An advocate for the community states your community’s position. How does this exercise relate to the definition of an advocate?

13. © 2010 Jones and Bartlett Publishers, LLC How do you become an Advocate? Stay informed; how do you do this? Get involved; how? Remember who you are.

14. © 2010 Jones and Bartlett Publishers, LLC Assuring Competent Staff How can you assure competency before you hire (recruitment)?  Review and update job description; why?  Interviews; what would you ask?  Reference checks; why?

15. © 2010 Jones and Bartlett Publishers, LLC Background Checks Why such an emphasis? The information age means greater scrutiny which can be an advantage when you are the employer.

16. © 2010 Jones and Bartlett Publishers, LLC Areas for Background Checks Driving record, bankruptcy, past employers Educational records, character references, medical records Drug tests, sex offender records, criminal records Court records, etc. Release for some but not all

17. © 2010 Jones and Bartlett Publishers, LLC Who is responsible for making the assumptions true statements? How can you do this after you hire (retention)?  Mandatory orientation  Mentoring programs  Continuing education

18. © 2010 Jones and Bartlett Publishers, LLC Incompetence happens… Why would someone not be competent? Examples from clinical professionals? Examples from managers? What is your obligation? HCA motto: Ancora Imparo!

19. © 2010 Jones and Bartlett Publishers, LLC How about YOU? When you graduate, what will happen? What do you have to do?  Find meaning in work  Create mission and ethics statement  Mentor?  CEUs  Other ideas?

20. © 2010 Jones and Bartlett Publishers, LLC Case Discussion Was Lawanda Person incompetent? Was the nurse supervisor incompetent? What is the family feeling? What is the impact on the facility?

21. © 2010 Jones and Bartlett Publishers, LLC Homework Answer the following question about your assigned topic: what is this? Who uses it? What ethics issues need to be considered? Aquinas=acupuncture, Kant=massage therapy, Mill=herbal medicine, Rawls=naturopathy