Frontiers of Health Services Management - Fall 2013 - (Page 44)

by clearly articulating what they expect from staff. Setting clear expectations can be accomplished using various strategies. for example, organizations can create policies that reflect ethical behavior, such as defining and handling conflicts of interest. However, creating No tool is more powerful the policy is not enough— than one’s own example training on the policy, discussing the ethical basis in demonstrating the importance of ethics and for it, and monitoring its effectiveness are also organizational values. required. too often, expectations placed on staff regarding organizational values are vague, lacking concrete language that takes into consideration each staff member’s specific position. the expected values-based behavior should be thoroughly discussed during the hiring and orientation process for all staff. additionally, organizational values can be embedded in each staff member’s position description. incorporating organizational values in performance evaluations sends a powerful message about their importance. Creating a Values-Based Culture one cannot emphasize enough the importance of culture reflecting the organization’s values. as Brinkley comments, “culture drives performance.” a misalignment occurs when an organization’s culture and its formally stated values are not in sync with daily practices and actions. as a result, gaps in the quality of care, staff morale, and the image of the organization in the community widen. Makary (2012) writes in his book Unaccountable that the extreme variations in the quality of healthcare among various hospitals can be explained by variations in organizational culture. Because of the importance of congruence between culture and quality of care, leaders need to regularly assess any misalignment through formal review processes and audits and develop and implement strategic plans to right a culture that is failing to align with the moral compass. Encouraging and Supporting Ethical Practices values-based leadership is framed by the moral responsibility to ensure that alignment exists between our common morality, organizational values, and actual clinical or administrative practices. Healthcare executives cannot be unaware of or ignore the lack of congruence between empirically driven clinical practice standards and actual practices. the manner in which a staff member acts and makes decisions must correlate to the organization’s values. However, Wennberg, Berkson, and rider (2008) have described how just the opposite is often occurring, by the overuse of noneffective care, the underuse of effective care, and the lack of true shared decision making. Such practices should raise ethical indignation because of wasted financial resources and patient deception—the failure to align practices with our common morality—which dictates that we act in the best interest of the patient through valuebased, patient-centered clinical care. Using and Supporting Leaders as Local Ethics Resources all leaders encounter ethical issues and conflicts. When they do, they must be able to recognize them—situations in which competing values are at play. By recognizing a decision point as having an ethical conflict or uncertainty, the leader can reflect on the challenge by applying ethical reasoning. When the challenge is particularly problematic, consultation with the facility’s ethics resources, such as 44 • f ro ntier s o f h ea lt h s e rvic e s m a na g e me 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