Kimberly A. McCullough
College of Adult and Graduate Studies
HCA-615 Healthcare Law and Accreditations
Dr Timothy Hudson
Colorado Christian University
Root Cause Analysis
Ethics committees are necessary in a hospital setting in order to assist in complicated situations and choices hospitals face. They are not always knowledgeable on the case or subject matter but look out for the best interest of the patient. I believe that with education and guidance on cases they can actually assist the hospital on political actions that must be considered. As the chairman of the ethics committee for Cambridge Health Alliance Hospital in Somerville, Massachusetts, I must promote fair policies and procedures that the likelihood of achieving good, patient centered outcomes. (Post, F. L. & Blustein, J. 2015, p. 10-12). When my sub-committee team and I just completed the root cause analysis on Mr. Jones my sub-committee and myself got the impression that his EMR content standards should have be defined better in which would enhance efficiency, reduce redundancy, and to alleviate the documentation burden and improve integrity (Ransom, R.E., Maulik, S. J., Nash, B. D., & Ransom, B. S. 2014, p. 30-34). Other laws that my sub-committee and I saw that have impacted the risks associated with this situation is that there was no provided informed consent on file, and if there were documentation on Mr. Jones the physician could have decided how his treatment would go. (Health Professions Institute, Drake, E., Pitman, C.S., Dirckx, H.J. 2013, p. 2-8). As a chairman of the ethics committee and a CEO of this hospital, I would consult a chief executive officer because just in case I have to step out or going to other meetings at other hospitals I want to make sure my chief executive reinforce if needed so that they keep the transformation so that employees can adapt to every change successfully. (Pagano, P. M. 2017). When my chief executive officer reads the root cause analysis on Mr. Jones, they got the nurses involved because they were involved in his care and to create a culture of safety and quality, and support, and implement key systems critical to this effort. (Niles, J. N. 2018, p. 20-26). As a chairman of the ethics committee and a CEO of Cambridge Health Alliance Hospital why did I added new executives that need to be brought into this situation is because that they know how to seek help necessary, and that they dont judge people or processes too fast before knowing all the relevant facts. (Dye, F. Garman, N. A. 2019). One thing I have noticed as to reading this root cause analysis Mr. Jones should have been admitted sooner because if any concern about a physical or emotional symptoms and Mr. Jones should have blood taking first then tests. (Patel, M. A. 2007, p. 21-24). Guidelines for security and safety of healthcare and community service workers as to determining if law enforcement needs to be called in for a debriefing and will I be expecting any charges to any hospital staff? Cambridge Health Alliance Hospital has meetings once a month and we always hold regular debriefing with our staff so they can express their feelings and work through emotions and also when it comes to this root cause analysis about Mr. Jones as a hospital we have counseling to express feelings when patients pass away. (Oriot, D. & Alinier, G. 2018). Cambridge Health Alliance Hospital is a mandate reporter and if a staff member or patient get abused, we as a hospital are required to let the law enforcement know and if a patient or staff get arrested by the law enforcement official, they lose their license and cannot practice anymore. (Huberfeld, O. L. 2018). Cambridge Health Alliance Hospitals pharmacy staff must undertake new learning and the supportive environment to try new methods and when it came to Mr. Jones his medications the staff most importantly, must enhance the successful integration of the innovation and its potential to contribute humanistic, economic and clinical outcomes. (Nazar, Z. J., Nazar, H., White, S., & Rutter, P. 2019). When it comes to the Joint Commission failures in this Sentinel event Cambridge Health Alliance Hospital must sustain a resilient healthcare organization that is sensitive to operations and data collected and analyzed from a review of sentinel events and comprehensive systems analysis. (Geisler, 2003). Meaningful use sets specific objectives that eligible professionals or hospitals must achieve to qualify for the incentives. In Cambridge Health Alliance Hospital, the CMS standards are must provide notice and obtain acknowledging as soon as possible after the patients stay or visit Beijing. (Kelly, L. D. 2011). Another thing that sets specific objectives that eligible Cambridge Health Alliance Hospital, the CMS standards they must update their technology, which will make it easier for staff and making sure that the EMR are up to date, billing the procedures in a correct way so they can get paid on time and making sure the codes are in the correct order. (Pozgar, G. D. 2019). In this case which insurance policies might come into play in this case? Cambridge Health Alliance Hospitals allied health professionals gets Blue/Cross Blue Shield, dental, 401K, vacation time, after one year. Also, in this case Cambridge Health Alliance Hospital allied health professionals get if their children are under 2 years old can get MassHealth. (Helman, C. 2015, p. 45-50). Character transmission through leadership behavior is very important in healthcare and in the root cause analysis on Mr. Jones some ethical failures that I have noticed, and I encountered that failing to follow-up on an intervention, conducting assessments in unsatisfactory, and avoiding recommendations. (Dailor, A. N., & Jacob, S. 2011). Cambridge Health Alliance Hospital some ethical failures they always faced is lack of accountability, lacking moral compass and they often lose sight of other moral considerations. (Goldberg, S. D. 2017). Because Cambridge Health Alliance Hospital is a hospital that when it comes to their key interventions, they must follow directions when asked, interventions to improve health behavior, by providing excellent bed side manner, and monitoring and reinforcement. (Grol RP, Bosch MC, Hulscher ME, Eccles MP, Wensing M. 2007). The importance of a human resource in the Cambridge Health Alliance Hospital they help my staff in the provision of necessary tools to select employees in order to ensure that they adequately perform, they provide them to make the right decisions and extend their skills which they conduct new interviews for new staff on board, send out new policies, and having seminars to understand new policies that are needed. (Karuppan, C., Dunlap. N. Waldrum, M. 2016). In being a chair of the ethics committee for Cambridge Health Alliance Hospital I see poor handoff all the time, but we try when new ER physicians who comes in 3 to 11 shift must verbally communication should also accompany the written log and read back the information to ensure the information is understood. (Freshman, B. 2010). Working in a hospital as a chairman of the ethics committee in Cambridge Health Alliance Hospital the importance of ethics in this organization, we need to understand with the family and other stakeholders and as my hospital good communication channels and help this hospital to adopt good ethics. (Dracopolou, S. 1998). When it comes to costs for Cambridge Health Alliance Hospital some advantages are group deliberations and combined judgement of all members, helping other committees to understand new policies that are going on and talking about new revenue that would be coming in. (Maccoby, M., Norman, L. C., Norman, J., & Margolis, R. 2013). Some disadvantages in costs for Cambridge Health Alliance Hospital they try very hard to keep up getting money from fundraising, keeping up bookkeeping and balancing the budget. (Gapenski, C. L. & Pink, H. G. 2011). Sentinel events are likely the result of compound errors and, if properly analyzed and addressed, may provide important keys to strengthening the system and preventing future adverse events or outcomes. As for Cambridge Health Alliance Hospital some sentinel events that they deal with when patients come into the Emergency room the patients safety and well-being is the number one priority and another implementation of an action plan for strategies to reduce risks. (Reilly, J. M., & Markenson, D. D. 2011). Sentinel events that Cambridge Health Alliance Hospital deals with day after day they try very hard to sustaining a culture of safety and promoting continual performance improvement can help them prevent adverse outcomes. (JCAHO, 2000).
My thinking about health care from my Christian Worldview is very important to me because I really care for patients, residents, patient families and I like to try to get them well and taking care of them. Taking care for my mother has taught me to be a Christian servant, which means that I must be compassionate. As a Christian and my worldview in the healthcare field I know at times it is very difficult, but in the long run it is worth. As a Christian I am always exploring new ideas and knowledge and hopefully when I receive my masters degree in Business in Health Care Administration I am deciding to go into my doctorate program so I can learn a lot more in the health care world because I love to help sick patients and I like to sit down with them because sometimes theses patients do not have families who doesnt care about them. Also, working in a hospital can be rewarding also because I can work with other health providers like case managers, ex-ray technicians, operating room physicians. (Hebrews 13:5 King James Version) [Let your] conversation [be] without covetousness; [and be] content with such things as ye have: for he hath said, I will never leave thee, nor forsake thee.
Dailor, A. N., & Jacob, S. (2011). Ethically Challenging Situations Reported by School Psychologists: Implications for Training. Psychology in the Schools, 48 (6), 619631. Souzy (1998) Ethics and Values in Healthcare Management (Professional Ethics) (1st edition)
Dye, F. Carson, Garman, N. Andrew (2019) Exceptional Leadership: 16 Critical Competencies for Healthcare Executives (2nd edition).
Freshman, Brenda (2010) Collaboration Across The Disciplines In Health Care (10th edition). Published by Jones & Bartlett Publishers
Gapenski, C. Louis, & Pink, H. George (2011) Understanding Healthcare Financial Management, (1st edition).
Geisler (2003) Technology, Healthcare and Management (3rd edition). Hardback: Published by Praeger Publishers, Inc.
Goldberg, S. Daniel (2017) Public Health Ethics and the Social Determinants of Health (SpringerBriefs in Public Health). 1st edition
Grol RP, Bosch MC, Hulscher ME, Eccles MP, Wensing M. (2007) Planning and Studying Improvement in Patient Care: The Use of Theoretical Perspectives. Milbank Q. 85:93-138
Helman, Cecil (2015) Culture, Health and Illness: An Introduction for Health Professionals, Published by Elsevier Butterworth Heinemann
Health Professions Institute, Drake, Ellen, Pitman, C. Sally, & Dirckx, H. John (2015) Healthcare Documentation: Fundamentals and Practice (4th Edition)
Huberfeld, O. Leonard (2018) The Law of American Health Care (2nd edition)
Kelly, L. Diane (2011) Applying Quality Management in Healthcare (3rd. Edition). Published from Assoc. Of Univ. Programs in Health Administration
Karuppan, Dr. Corinne PhD, Dunlap, Dr. Nancy MD., Waldrum, Michael MD. (2016) Operations Management in Healthcare: Strategy and Practice (1st edition) Published by Springer Publishing Company, LLC. NY. New York
Maccoby, Michael, Norman, L. Clifford, Norman, Jane & Margolies, Richard (2013) Transforming Health Care Leadership: A Systems Guide to Improve Patient Care, Decrease Costs, and Improve Population Health. (1st edition).
Nazar, Z. J., Nazar, H., White, S., & Rutter, P. (2019). A Systematic Review of the Outcome Data Supporting the Healthy Living, Pharmacy Concept and Lessons from its Implementation. PLoS ONE, 14 (3), 119. J. Nancy (2018) Basics of the U.S. Health Care System (3rd edition) Published by VitalSource Technologies, Inc.
Oriot, Denis, Alinier, Guillaume (2018) Pocket Book for Simulation Debriefing in Healthcare (1st edition).
Patel, M. Anil (2007) LANGE Instant Access Hospital Admissions: Essential Evidence-Based Orders for Common Clinical Conditions (1st edition) Published by McGraw-Hill Companies, Inc.
Pagano, P. Michael (2017) Health Communication for Health Care Professionals (17 edition). Published by Springer Publishing Company
Post, F. Linda, Blustein, Jeffrey (2015) Handbook for Health Care Ethics Committees (2nd edition). Published by Johns Hopkins University Press, Baltimore, Maryland.
Pozgar, G. D. (2019). Legal Aspects of Health Care Administration (13th ed.). Published by Jones & Bartlett Learning, Burlington, Mass.
Ransom, R. Elizabeth, Maulik, S. Joshi, Nash, B. David, & Ransom, B. Scott (2015) The Healthcare Quality Book: Vision, Strategy, and Tools, (3rd edition)
Reilly, J. Michael, Markenson, S. David (2011) Health Care Emergency Management: Principles and Practice (1st edition).