Css 330 - Critical Thinking Case Study

Critical Thinking Case Study

Anthony Mathew

Dean Rea

CSS/330

12 June 2004

As a not for profit organization we must insure that we provide the best possible treatment while maintaining a close watch on our expenses. We must maintain a high degree of professionalism by following all directives, guidelines and rules. By doing this we prevent mistakes from happening that could jeopardize or organization and our patients.

Currently we are experiencing a wide variety of problems that are negatively affecting our ability to effectively care for our patients while maintaining costs to the prescribed limits. It has come to my attention that some staff members are writing their own directives to either add to or take away from current directives. The directives are in place for the safety of our patients and staff. Changing a directive could result in the failure to treat a patient resulting in court action that not only affects the treating physician but also the stockholders. Not only is this a legal matter, but it also has ethical implications. Is it ethical to treat one patient and not another? No, we should strive for the ethical treatment of all our patients. Directives will only be changed or amended by senior management and only with the approval of the board and current attorneys. This will be done to insure an effective and safe environment for the staff and our patients.

Due to the changes to the directives by certain staff, not everyone is on the same sheet of paper, or following the same guidelines. This has resulted in staff not providing to the best wishes of the patient or to the patients family. For example, a DNR means just that, do not resuscitate, this is not an arguable topic. If a patient or their family has requested this it is no longer up to the staff not to follow it. This is a prime example of staff not working towards the best interests of the patient and their loved ones.

Not only are the changes to directives effecting service, some patients are not accepting the treatments and some staff are not providing certain treatments. We must do everything in our power to provide the patient the best treatment possible. If a patient does not want a certain treatment then it is up to us to explain the need for it to them in a way they will understand.

Another problem facing our hospital at this time is the rising costs of providing quality health care, while maintaining our not for profit status. At this time our costs have risen and our reimbursements have remained the same, causing the hospital to take a loss. "Look at how much our costs have increased compared to last year. A year ago, our costs were $217.00 per patient per day. On the last report that I received from accounting, that figure had risen to $240.00. Two questions came immediately to mind when I saw this number: Are we running a less efficient operation? Can we reduce costs without impacting quality?" Pat. CSS/330