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Patient Advocate and Healthcare Culture

Updated on August 8, 2019
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The growth of for-profit enterprise in health care has become a passionately debated phenomenon. Investor owned companies, which have come about in just the past 20 years, have made a business of providing health services and achieved great size and diversity (Gray, 1986, expression xvii). Working in the healthcare setting, I am on the clinical side of patient care, I strive to protect and be the voice for all my patients. Being a part of a for-profit healthcare system, I did not realize how this can impact my abilities to provide the best care for my patients. The growing involvement of investor owned healthcare companies takes several forms. As has been discussed, these corporations have begun to purchase hospitals in which research is done. In addition to the teaching hospitals already discussed, at least one nonteaching hospital can be cited. Corporations also enter agreements with researchers, or companies such as pharmaceutical manufacturers, enabling them to use the health care companies' multiple facilities or data bases for research purposes Healthcare organizations have become more business rather than healthcare in my opinion (Carney, 2011, p. 1). This as lead to many ethical issues within these institutions. For profit health organization are designed to move money that should be used for the sick in to investors accounts, they are not obligated to provide uncompensated care to the uninsured or low-income population ("," 2015, p. 1). These problems within the health organizations are only doing this because the public policy allows it. Working within a for profit organization, I am a from runner of the ethical dilemmas. In the surgical department, we must always have a backup operating room for emergency heart surgery, but there is no extra room. This give an unsettling feeling, because learning from experience an organization must always be prepared for emergencies. When brought up with administrators, they turn a blind eye. the main driving forces have been a nearly universal demand by payors for lower costs and the simultaneous massive influx of equity capital seeking profit from health care.5 Also contributing, to a lesser extent, have been the extraordinary personal gains often attainable by health care executives and corporate directors who facilitate the restructuring process and the marked decline in federal subsidies for nonprofit. From the viewpoint of public and nonprofit hospitals, additional factors have been the cuts in Medicare and Medicaid and the increasing demand for free care by a growing number of uninsured. The sad part of this issues is nothing will get done until someone dies, or injury occurs. Another issue I notice in a for profit institution is the flexing full time employees and causing them to lose their hour and placing the risk of loss of healthcare insurance ("The Issue Of Profit In Health Care," 1997, p. 1). The system changes have the potential for major negative impact on accessibility, quality and accountability of health services. The changes are manifested not only in the hegemony of for-profit corporations in the burgeoning managed care sector but also in the widespread sale or transfer and conversion of hospitals to for-profits ("The Issue of Profit In Health Care," 1997, p. 1). Being a part of this organization, I find very hard to handle, but with the increase in for profit healthcare organizations it is becoming difficult to be a part of a true healthcare system.

In healthcare, Organization culture are evolving reflections of the shared and learned values, beliefs, and attitudes of an organization. As a perioperative healthcare provider, I am there for the patient and act accordingly to deliver quality patient care. I see more than an injury that requires correction. As a surgical technologist, I am there for the patient and not just the injury or condition they require to be fixed. I am there to help the patient navigate the system and I am considered a problem solver and a guardian. Being a part of a strong organizational culture, I am ready to stand for the safety of the patient. Being employed by a for-profit healthcare organization, I am consistently refreshing my memory on public policy knowledge of that organization and prepared to state my argument if it affects patient care. If I run into a major dilemma, I will brainstorm the key attributes of my organizations culture.

Individual Attributes: as a surgical technologist, I am of sound and mine and understand my role in the patient care process.

o Organization Structures: I understand if I go against my organization, I can be affected by losing my job and not being able to find another one

o Organizational Culture: as a surgical technologist, I must uphold the values by being the advocate for the patient and provide quality care.

o Societal Expectations: If I am faced with an ethical dilemma, I know society expectations of me are to provide quality care for patients during surgery.

Knowing I have a passion for helping others and doing the right thing, I am trying to find a way to do right by my patients without losing my career. With my values and beliefs, I must learn how to fight from the outside. In the Guerilla Government, Individuals that were not satisfied with the outcome of an organization’s methods. In this case of the for-profit healthcare system, a group of techs gotten together to communicate with the human resources department in hopes of a resolution on the flexing the staff. After this step, if no resolution is reach, the next step would be to go to the press and leak information about the facility in hopes there will be changes.

In this for-profit healthcare organization, the risk of patient mortality is higher yet preventable. This challenge places large amount of strange on the employees. The conflict that present is the debating between clinical staff and administration. The company does not realize the liability it places on its employees when the standard guidelines are not being met. As of now if we are doing heart surgery, and an emergency heart comes into the hospital, we are incapable of completing the surgical procedure. The 1st reason is due to no operating room suite open and 2nd no heart team to complete the case. The organization is wanted to save money and will take people off the schedule just to make a profit. This also effects people within the organization to lose their healthcare, which in turns causes employees to find another company to work for. Overall the system changes are resulting in a fast-spreading presence of large for-profit hospital chains that are pursuing mergers with other institutions. Usually this results in an irreversible loss of capacity from the public or nonprofit sector ("The Issue Of Profit In Health Care," 1997, p. 1). With high turnover rates, creates less functioning operating suite because you will have more new employees. The organization fails because it trying to save a dollar. The ripple effects of a for profit organization only seems negative.

This organization has no strategies yet, because the turnover rate is so high. If there was one to be put into place, it would consist of setting the priorities first then work from the most important to the least. I would start with the ethical decision-making model and using the attributes of the core values of the organization. Knowing the company is still for profit, I would not change the aspect of quality patient care. This means although I am not obligated to health and assist the community with care, I will still encourage the staff to engage in community health. This will show the patients and families that we care, and we are here.

In order to address these issues within a for profit healthcare organization, one must be prepared for push back from the investors. I would follow these steps to start the pathway for change in the organization:

• Professionalism in Medicine and Surgery: Patients lack in information and understanding about who, specifically, is participating in their surgical procedures, and what role each participant will play. It is clearly the responsibility of the primary attending surgeon to clarify these roles to the patient during the surgical informed consent discussion and process (Holt, 2016, p. 1).

• Surgical Innovation: Innovation in surgery is most commonly the result of creative attempts to solve individual patient problems. Sometimes, innovation occurs with a truly novel idea when someone completely changes the way they do something. However, more commonly, innovation happens as a result of small changes that allow us to move forward (Angelous, 2014, p. 1)

• Ethics to innovations of surgical procedures: Understand that new ways of completing surgical procedures, I will understand that some surgeons will not want to change in technique. This means I must maintain the required equipment for both new and old procedures being performed. The patient has a fundamental, ethical right to self-determination in her/his healthcare decisions. Such autonomy about what happens to a patient’s body requires both disclosure about all important aspects of the surgical procedure (Holt, 2016, p. 1).

Introducing new culture into the organization will not be an easy task but encouraging the positive for the change can help with more people being transparent.

An analysis of the factors that would affect the implementation of the recommendations by using the ethical decision-making model

Using the ethical decision model, I can see how this can impact my implementation. The administrators and investors are their own organizational culture as well and they see money and more money. In exploring culture further, it is evident that a value influence in health care delivery is value-for-money. This demand causes conflict and unrealistic expectations of care delivery among clinicians and as a result it is likely that some clinicians misunderstand the ethical tension existing between cost efficiencies and quality-of-care (Carney, 2011, p. 1). When applying their attributes, I can see the negative impact being:

• Organization Structures: An investor-owned corporation is ultimately governed by its owners (stockholders), who elect the board of directors. The stockholders accepted the risk of purchasing stock in the expectation of gaining an economic return that is larger than would be available through nonequity forms of investment, such as the purchase of bonds.

• Organizational Culture: The board of directors makes broad policy decisions and employs the top management of the corporation. In health care and other fields, top officials of the corporation not only serve on the board but also have significant holdings of the corporation's stock

• Societal Expectations Some theorists suggest that whereas the status of management in for-profit organizations rests substantially on profitability, managerial

prestige in the not-for-profit organization rests much more on the size and reputation of the institution (Gray, 1986, p. 1).

I can see a positive outcome for the patient and the organization. Looking at the for-profit organization, it is not obligated to provide care if not compensated. If as a healthcare organization we still did engage in community activities, we can promote the hospital services while helping those in much needed care. Providing this type of service for the community draws more people to the facility. If promoting innovation and transparency in the operating room, this can open the door for breakthrough technology from doctors and staffers in the organization. Having the require staff for specialty needs and emergency cases can lower the risk of patient mortalities and law suits.

The issues I raised in this article relates to human rights, equality, and justice. Patients are human’s healthcare providers take care of when injury or illness occurs. Every patient has the right to medical care no matter their race, sex, social status etc. Healthcare organizations are values driven and consequently strive for excellence in meeting the needs of their patients in a caring, healing, quality focused and safe environment (Carney, 2011, p. 1). Developing a culture of healthcare safety is a global priority whereby open reporting where adverse events are reported, analyzed and learned is needed K found that a correlation existed between healthy workplace environments and healthy patients. The competencies needed to achieve high reliability in order to ensure safe patient care but in for-profit organization, medical providers are being told not to provide optimal care for these patients because of their inability to pay (Carney, 2011, p. 1). Therefore, I am not able to understand how hospitals are able to get away with this injustice. With the high rate of unemployed people, many of these individuals are without coverage. When patient is not able to pay, healthcare organization should be required to provide quality care. How does this consider equality? If the USA is the land of the free, does this include healthcare? I am assuming not. The operating room is a setting where patients’ lives are held in the balance, that depends upon careful planning and preparation and meticulous execution of these plans. Within an operating room, the course of surgery is much like an performance, where each performer has a specific job to do, yet they must all be done in the harmony of safety, placing the patient’s well-being as the most important priority. The operating room is not a “haven” from ethical dilemmas, but rather a focused application that balances of the ethical principles of autonomy, beneficence, nonmaleficence, and social justice (Holt, 2016, p. 1).


References

Angelous, P. (2014). Surgical ethics and the challenge of surgical

innovation. Southwestern Surgical Congress: Edgar J. Poth Memorial Lecture. Retrieved from https://www.americanjournalofsurgery.com/article/S0002-9610(14)00457-7/fulltext

Carney, M. (2011). Influence of organizationalculture on quality healthcaredelivery. . https://doi.org/10.1108/09526861111160562

Daily Briefing primer: What’s the difference between for-profit and not-for-profit hospitals. (2015). Retrieved 2018, from https://www.advisory.com/daily-briefing/resources/primers/whats-the-difference-between-for-profit-and-not-for-profit-hospitals

Gray, B. H. (1986). For-Profit Enterprise in Health Care. . https://doi.org/10.17226/653

Holt, R. (2016). Ethical Challenges in the Operating Room. . Retrieved from https://www.enttoday.org/article/ethical-challenges-operating-room/?singlepage=1

The Issue Of Profit In Health Care. (1997). Retrieved 2018, from https://www.apha.org/policies-and-advocacy/public-health-policy-statements/policy-database/2014/07/30/09/10/the-issue-of-profit-in-health-care

Voight, P. (2009). Our Value as Nurses. Our Value as Nurses, 89, 821. Retrieved from https://eds-a-ebscohost-com.ezp.waldenulibrary.org/eds/pdfviewer/pdfviewer?vid=14&sid=fcde6d11-2bdb-42ac-90c3-e30495402647%40sdc-v-sessmgr01

Healthcare Culture

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