Frontiers of Health Services Management - Fall 2013 - (Page 20)

Ensure That Healthcare Is Available and Accessible to the Community Served if the organization’s mission statement is consistent with the acHe Code of Ethics in aiming “to create a more equitable, accessible, effective and efficient healthcare system,” then revenue strategies and program initiatives should reflect the healthcare needs of the community. are new initiatives designed to meet community need, or are they designed to produce new demand and new revenue? How does the organization address the problem of charity care, and how are Responsible healthcare charges set for those not leaders want to be otherwise covered by government health programs known, and want their or commercial insurers? organizations to be known, approximately 58 for unwavering integrity in percent of healthcare community hospitals in the business practices. United States enjoy nonprofit tax status (aHa 2012, 8). Spencer foreman, former president of Montefiore Medical center in Bronx, new York, has spoken eloquently on the ethical obligation of nonprofit teaching hospitals to accept responsibility for the healthcare needs of their communities, however difficult and seemingly intransigent those problems may be. He describes this obligation as “an implicit social contract . . . in exchange for large amounts of public financial support” (foreman 2004, 1154). Nurture an Institutional Culture Grounded in and Supportive of the Organization’s Mission and Objectives in a Health Affairs article, chassin and loeb (2011) urge healthcare delivery systems to become high-reliability organizations—organizations committed to achieving consistently high quality in patient care and safety. they note that achieving this goal requires committed leadership, the application of proven quality improvement methods, and a culture of trust. achieving a culture of trust—that is, a culture that promotes honest dialogue about our strengths and opportunities to do better—requires leaders who accept the mantle of cultural and moral leadership and who display moral courage. organizational codes of conduct and codes of ethics insist on honesty and transparency; organizational actions must promote the same. one way to do so is to publish a column—perhaps titled “cases from Patient Safety” or something similar—in an internal employee newsletter. the column can openly share redacted versions of sentinel events and near misses that occur at the leader’s hospital. these cases can serve as a vehicle to celebrate the culture of transparency that led to reporting the incident, the open and nonpunitive process through which the error or event was investigated, the lessons learned and the actions taken to prevent recurrence. at the suggestion and strong encouragement of patient safety and quality improvement staff, i initiated such a process when serving as the director of a veterans Health administration medical center. although initially viewed with skepticism by some, the process was received positively by staff and was subsequently cited as an organizational strength by the Department of veterans affairs office of inspector general. Process improvement methods succeed when staff are empowered to call attention to systems that are not working well or processes that can be improved. leaders should ask if their actions encourage this behavior. Does the organization provide mechanisms for bringing forward constructive suggestions for improvement 2 0 • f ro ntier s o f h ea lt h s e r vic e s ma na g e m e nt 30 :1

Table of Contents for the Digital Edition of Frontiers of Health Services Management - Fall 2013

Frontiers of Health Services Management - Fall 2013
Contents
Editorial
The Case for Values as a Basis for Organizational Culture
A Moral Compass for Management Decision Making: A Healthcare CEO’s Reflections
Ethics, Values, and Decision Making
Wanted: Morally Courageous Leaders
The Imperative of a Moral Compass–Driven Healthcare Organization

Frontiers of Health Services Management - Fall 2013