...MEDICAL ERRORS 2 Abstract Patients rely on health care professionals and institutions for their safety and well-being (“Quality and patient,” 2009). According to Agency for Healthcare Research and Quality (2000), “medical errors are responsible for injury in as many as 1 out of every 25 hospital patients; an estimated 48,000-98,000 patients die from medical errors each year. Errors in health care have been estimated to cost more than $5 million per year in a large teaching hospital, and preventable health care-related errors cost the economy from $17 to $29 billion each year”. In addition to the monetary cost of errors, the physical and psychological costs such as pain, loss of loved ones, human suffering, disability or death are the greatest indelible mistakes. Medical errors lead to distrust of the health care system and drive patients away from visiting doctors leading to poor utilization of the health care system and consequently worse health care. Researchers estimate that about half of all medication errors are preventable. They suggest that when a medication error occurs, it is not the result of a single mistake, but rather a series of breakdowns in the health care delivery system therefore, this suggests that more checks and balances in patient care could prevent or remediate medication...
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... In order to promote a culture that promotes patient safety, the hospital’s Incident Reporting Policy is based upon a foundation of nonpunitive approach to incident/occurrence reporting. The hospital leadership will encourage open and honest reporting of injuries and hazards to patients, visitors and staff, this process will be nonpunitive in nature for all persons reporting incidents throughout the organization. Incidence/occurrence investigations will be viewed as an opportunity for education/process improvement, and will focus on processes and systems, rather than human error. Disciplinary action will be limited to only those employees who engage in willful or malicious misconduct, or those occurrences in which the employee failed to report an incident or hazard to patients in a timely manner. II. Responsibility A. All hospital employees, medical staff members, volunteers, and contract service members will participate in the hospital-wide incident reporting program. All incidents such as those listed as follows will be reported to the department of quality management: 1. Incidents involving inconsistencies with written hospital policies and procedures—informed consent, bedrails, patient...
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...January 11th, 2014 R.G. Generally Accepted Accounting Principles Every organization consists of an accounting department that manages the finances. The key element to maintaining any hospital, ambulatory care center, or private medical office is to have a structured financial statement and a team of accountants to audit the establishment. The generally accepted accounting principles that are reviewed include entity concept, going-concern concept, matching principle and cash vs. accrual accounting, the cost principle, objective evidence, materiality, consistency, and full disclosure. The “certified professional accountants are required to indicate whether an audited set of financial statements is in compliance with generally accepted accounting principles” ( (Finkler, Kovner, & Jones, p.104, 2007). The entity concept focuses on the object of study whether it may be a hospital, urgent care center, nursing school, or a private medical office. The intention of the concept is for identification purposes. It is related to health care, for example, a hospital may be affiliated with a long term care facility, a nursing school, and medical office. The hospital is considered as one entire entity. A long term care facility, nursing school, and medical office are considered subentities. The financial statements are prepared separately for each of the identified subentities. The second factor of the generally accepted accounting principle is the going-concern concept. The goal when...
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...Business Ethics in a Hospital Setting Darlene V Nickerson Columbia Southern University Abstract Business ethics in a hospital setting includes a review of many areas. Ethical considerations include the areas of patient care, nursing ethics, physician ethics, patient privacy, and medical billing practices. This paper will touch on ethical concerns for each of these topics. Keywords: hospitals, ethics, patient care, nursing, physicians Business Ethics in a Hospital Setting When beginning a discussion of business ethics in a hospital setting it is important to take a broad approach. Because a hospital is a business and also a treatment facility, the ethical concerns must be considered not only for areas such as billing and privacy but also for ethics related to the appropriate care of patients, nursing ethics, and physician ethics. The ethics of the treatment methods employed based on the patient’s condition must also be considered. Ethics and Patient Care I believe that when discussing the ethical implications of patient care it is helpful to review a real-world scenario. One highly publicized case involved Terri Schiavo and her husband’s fight to stop her tube feedings as there was no hope for her recovery (VandeKieft, 2005). One reason for the high visibility of this case in the media occurred because the patient's husband and the patient's family disagreed on the diagnosis (VandeKieft, 2005). Terri suffered a cardiac arrest due to severe hypokalemia (low potassium...
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...The medical liability system needs reform to promote better patient safety and lower health care costs. In this paper I plan to show different types of reform that are needed in the medical liability system and how those changes will impact patient safety and cost. Also discussed will be the governments backing (or not) of medical liability reform. The current medical liability system was designed to provide monetary compensation to patients who suffer injury due to medical negligence. The system also works to reduce the chances of future patients being harmed by preventable medical errors. However, most individuals in the healthcare industry do not believe it accomplishes any of these goals. The biggest issues, as reported by critics of the system, are the cost and access of liability coverage, impact on patients’ safety, and the administrative costs of lawsuits. To address the shortcomings of the system, some reform has been introduced to modify the current tort system. Included in these reforms are Full disclosure/early offer programs, Certificates of merit programs, Caps on damage awards, periodic interim payment rules, joint and several liability reform, collateral source rule reform, screening panels and health courts. All of these programs are designed to lower the costs of Medical Liability insurance for the health care provider as well as addressing the safety of patients in various ways. They also give both the patient and the health care provider peace of mind because...
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...o Include a brief description of each principle and the intention behind the principle. o Relate each principle to health care. Entity concept - The entity is the person or organization that is the focus of attention. A large medical center that includes a hospital, nursing school, medical school, and long-term care facility is an entity. Accounting records may be kept for that entity as a whole. However, the hospital, nursing school, medical school, and long-term care facility that make up the medical center are each entities as well. Financial records could be maintained separately for each of these subentities. When financial statements are prepared, it is important to identify the specific identity of the entity to which the statements relate. All accounting transactions must take the perspective of the entity for which the financial statements report. For example, suppose that we are interested in learning about the finances of the nursing school. Suppose further that the nursing school purchased some supplies from the hospital but has not paid for them. On the financial records of the nursing school entity, there would be an account payable to indicate the obligation to pay for the supplies. On the records of the hospital entity there would be an account receivable because it has not yet been paid for the supplies it provided. Going-concern concept - The second critical GAAP is that of the going concern. There is a presumption when accounting records are prepared...
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...Financial Disclosure Management by Nonprofit Organizations1 Ranjani Krishnan, Michelle H. Yetman, Robert J. Yetman* Eli Broad College of Business, Michigan State University, East Lansing, MI 48824. Tippie College of Business, The University of Iowa, Iowa City, IA 52240 ______________________________________________________________________________ Abstract This paper examines how nonprofit organizations respond to incentives to manage their publicly available financial information. Prior research identifies two operating ratios donors commonly use to evaluate the efficiency and effectiveness of nonprofits (i.e., the program service ratio, defined as the fraction of total expenses committed to advancing the charitable mission of the organization, and the fundraising ratio, defined as the ratio of fundraising expenses to donations revenue). Nonprofit managers have an incentive to over-report the expenses classified as program services and under-report the expenses classified as administrative and fundraising in order to improve these ratios. We examine whether nonprofits respond to these incentives, and we find evidence consistent with opportunistic cost shifting to improve the program service and fundraising ratios. Additional analysis finds that smaller nonprofits that are more reliant on donations revenue manipulate their operating ratios to a greater extent. JEL classification: M4; L3 Key words: Nonprofit organizations, earnings management, disclosure, hospitals. __...
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...III. Security and Privacy Issues of electronic medical records Although it has been around three decades, moving from paper-based to electronic medical records might still face some issues and challenges. These issues can be classified as information use and disclosure; information viruses and errors; secondary use of the information; unauthorized access; and external or internal attacks. Therefore, electronic medical record needs a high level of anonymity, and privacy and security are considered as the most essential obstacles that face this anonymity. There are different laws in the United States that care about the patient’s rights of security and privacy, such as the Health Insurance Portability and Accountability Act (HIPAA). However,...
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...A patient always have a right to see their medical records, it is the law that medical records are available upon request with a small fee. The law also states in the policy that there is a limit of who has access to the records and to be released to without a written consent from the patient. When there an amendment needs to be made the patient or who is requesting the amendment needs to write a letter. The letter needs to outline why you think it is wrong and what the correction is. The basic information needs to be put into the letter, your name and the date of service in your letter, and then staple your letter to the copy of the page that contains the error. Make sure that the correction is written exactly as you think it should be and also make sure it is easy for the provider's record person to read, so that the right corrections can be made. Patients have the right to have restrictions on their use and disclosure at any time. The request that is made by an individual or by the PR to restrict the use or the disclosure of PHI has to be made in writing on a form that is prescribed by a DMH. Except for when an accommodation has been approved by accordance from section III.B. Then at that point a request can be made at any time. The medical records are legally owned by the physician, although it is the patient’s records. Since the records were created by the physician, then they have the rights to them. On the other hand it is the law that patients have the right...
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...June 9-13, 2012 – Baltimore, Maryland 2012 ASHP Summer Meeting Management Case Study Submission and Format Guidelines Management Case Studies are 20-minute platform presentations followed by a 10-minute question and answer period. ASHP is seeking management case studies in specific topic areas: • Informatics • Leadership / Administration • Medication Safety • Clinical Conundrums This document will assist you in the preparation of your submission for a Management Case Study (MCS). The number of accepted management case studies will be limited and it is anticipated to be a highly competitive process. Each primary author is allowed only one submission. Due to ACPE Standards regarding active learning, a standard format will be required for final slide presentations which will utilize the learning objectives and self-assessment questions that you prepare for your submission. Thank you for your interest in presenting at the 2012 ASHP Summer Meeting! For assistance with preparing learning objectives and self-assessment questions, visit: http://www.ashp.org/menu/Education/OnlinePrograms.aspx and select ‘Education’ from the drop-down menu What is a Management Case Study? Introduction • The case study method was pioneered by the Harvard Business School in the early 1900s and still stands as a popular and effective teaching strategy in business education. • • The case method relies on information about people and events in a true-to-life situation that represents a problem to be analyzed...
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...Negligence Paper Jennifer Zuber HCS/478 April 11, 2016 Susan Lawson Negligence Paper In 1711, Alexander Pope wrote in a poem, "To err is human." Errors happen in every walk of life and every career path, but there are some areas where and error could be the difference between life and death or profound injury. The healthcare field is one of those areas. Over time, health care has evolved. There are now so many practices and protocols in place so that errors may be avoided. It is understood that there are some errors that may occur due to being human, and then there are other mistakes that should never happen, such as surgically amputating the wrong limb. There are so many safeguards in place to prevent such errors from happening. Negligence is a general term that denotes conduct lacking in due care (Guido, 2014). Malpractice sometimes referred to as professional negligence, is a more specific term that addresses a professional standard of care as well as the professional status of the caregiver. To be liable for malpractice, the person committing the civil wrong must be a professional, such as a physician, nurse, accountant, or lawyer (Guido, 2014). Gross negligence is an act or omission “which when viewed objectively from the standpoint of the actor at the time of its occurrence involves an extreme degree of risk, considering the probability and magnitude of the potential harm to others; and of which the actor has actual, subjective awareness of the risk...
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...to hold oneself accountable for poor decision-making or bad behavior. On the other hand, organizational ethics are the principals and standards by which businesses operate. They are best demonstrated through acts of fairness, compassion, integrity, honor and responsibility. The key for business owners and executives is ensuring that all employees understand these ethics. One of the best ways to communicate organizational ethics is by training employees on company standards. While ethical behavior in medical practice has been demonstrated to be beneficial to patients and medical staffs, unethical behavior has caused significant injury to them. Performing ethical behavior in healthcare by, for example, preserving patient confidentiality, medical staffs should respect patients’ autonomy, abide by their obligation to reciprocate patients’ trust, and preserve public confidence in the staff-patient relationship in healthcare. In a long run, patients who trust their medical providers to safeguard their secrets are more likely to seek prompt care for stigmatized health conditions and to disclose sensitive information necessary for appropriate treatment and diagnosis (Chou-Kang, C. June, 2010). Nowhere Hospital conducts all business and establishes all contractual relationships within appropriate federal and state laws and regulations. Business is conducted using competitive bidding, fair billing, timely payment, prudent buying, and ethical conduct, including identification...
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...Generally Accepted Accounting Principles Healthcare is continually evolving and has become a business and an economic force in current society. Historically, stakeholders such as physicians and other health care professionals are adept at making clinical and health-related decisions. However, they often lack the ability to make informed financial decisions. Many have come to realize financial criteria and cost-effective health care delivery is paramount to the success of modern healthcare systems. Therefore, stakeholders recognize the need and relevance of financial knowledge to make informed decisions (Cleverly, Jones & Cleverly, 2011). Concept and purpose of Generally Accepted Accounting Principles Organizations, including health care facilities, employ accountants to oversee the financial endeavors of the organization. Generally accepted accounting principles are rules created by the Financial Accounting Standards Board to regulate financial accounting and prepare the organization’s financial statements (Finkler, Kovner & Jones, 2007). Generally accepted accounting principles or GAAP is widely used in the health care industry(Pounder, 2011). The principles provide industries with a framework for tracking and monitoring the organization’s financial circumstances. GAAP helps in preparing the four most important financial statements relevant to the facility’s economic well-being. The financial statements are balance sheets, statements of operation, cash flow, and change in...
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...some aspects always seem to be overlooked. On May 17, 2011, Ricardo Alonzo-Zaldivar wrote an article for azcentral.com relating to the vulnerability of electronic medical records and its effects on patient privacy. In this document I will be discussing the issue on patient privacy and confidentiality. I will be touching base on the population it affects, arguments used within this article that support electronic medical records, ethical and legal issues involved. Along with the issues I will be discussing the managerial responsibilities and proposed solutions that may help in maintaining patient privacy under regulation that are being proposed within this article. The issue on patient privacy is nothing new and out of the ordinary within the health care field. According to the American Medical Association’s (AMA) Council on Ethical and Judicial Affairs the main purpose of a healthcare professional’s ethical duty is to maintain patient confidentiality and to allow the patient to be able to make a truthful disclosure of their personal information to the physician placing their trust that the physician will protect the confidential nature of the information disclosed. Unfortunately, physicians cannot entirely control the access to electronic medical records. If patients distrust and have the anxiety that their medical records will not be private, they might tend to tell their doctors less, or even to the point they refuse to seek care. The issue on privacy does not affect a certain...
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...hospital after an incident of medical errors on a patient. Patient safety became her priority. Morath attended some training that gave her a lot of impetus and skills to bring out effective management in the children’s hospital. This brought change and improved the performance of the hospital. Morath started by putting a core team of personnel in place to help in designing and launching the patient safety initiative. She took charge in the hospital and by August 1999, she had sought assistance of many people who were highly respected in the organization. Morath partnered with the hospital’s medical director to get his input and support so that she could make him understand her strategy for enhancing patient safety since she believed that leadership of the medical director would be very instrumental in creating support for the doctors and nurses in the children’s hospital. She then set out to accomplish major tasks which include making presentations to hospital staff about research on medical errors, conducted focus groups to learn more on patient safety and then developed a detailed strategic plan for the patient safety initiative (Edmundson, Roberto & Tucker, 2007). Morath provided the hospital staff with evidence on the size and scope of medical problem of medical errors in USA. She presented data from Harvard medical practice study on the frequency and causes of medical errors. She observed that many people were initially reluctant to believe that errors might be a significant problem...
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