A. Root Cause Analysis A Root Cause Analysis is an organized process used to determine the processes that lead to sentinel events. A sentinel event is defined by Cherry & Jacob as “an unexpected occurrence involving patient death or serious physical or psychologic injury or the risk thereof.” (Cherry & Jacob, 2011, p. 444) The objective of a Root Cause Analysis is to identify the factors which caused the sentinel event and to identify flaws in the system which can be corrected in order to prevent a repeat of the event in the future. A RCA is not used to blame individuals, and is not applicable when the event is intentional, or caused by negligence or a criminal act. RCA focuses on failures in the system that can be corrected. (Huber & Ogirnc, 2014) Before beginning the Root Cause Analysis, a multidisciplinary team is selected to review the events involved in the sentinel event.
This means that the agencies identify needs and improvement areas pertaining to the care of the patient to ensure standards throughout all hospitals and health care facilities. The professional nursing organizations (PNO), such as the American Nurses Association have the care of the nurses and patients for the agenda and according to Cherry & Jacob these “organizations monitor public policy and offer avenues for their members to learn about health policy, they serve as an invaluable resources for reliable information related to policy issues and policymakers.” (2011)(p. 489). These professional organizations support the efforts of the nurses in all states and reflect guidelines for all nurses to adhere to provide the best possible care for the patients. As an example, the ANA notifies members of upcoming legislation that will impact the nurses at hospitals, nursing homes and clinics. Through this interaction the nurses are better informed as to what is happening in the political arena, such as patient ratios and shift lengths, this may impact the ability to care for patients or allow the care to improve.
Health care organizations must make it imperative that all administrators, managers, leaders, physicians, nurses, and all other employees act at all times in an honest and ethical manner in connection with their services to patients. The principles of integrity and accountability are extreme vital in a health care organization’s success, as well as ensuring patient safety. Failures to act in an ethical manner can result in legal ramifications and negative publicity for the organization. Ethical concepts in Health care Ethics are vital in health care, and every health care professional must possess ethics. Ethical concepts that will be discussed are.
A person who deliberately obtains or discloses an individual’s health information in violation of the HIPAA faces a fine of $50,000 as well as up to one year of prison time. Criminal penalties increase to $100,000 and up to five years prison time if the wrongful conduct involves false pretenses, and to $250,000 and up to ten years imprisonment if the wrongful conduct involves intent to sell, transfer, or use individually identifiable health information for commercial advantage, personal gain, or malicious harm. Criminal Sanctions are enforced by the Department of Justice. All employees must be trained immediately after they receive the job. Usually the head of the department trains the employees, one that has perfect knowledge of the HIPAA rules and regulations.
The quality of the disclosure is certified by the audit committee and the Company’s outside auditors. The certification required under Section 302 is a change under the Security and Exchange Commission. The certification required under section 906 is an amendment to the U.S. Criminal Code. The overlap of certifications increases the penalty for inaccurate disclosure and/or failure to disclose the required information (Deming, 2006). Sarbanes-Oxley Act is designed to make all personnel accountable for their action or inactions.
There are so many things that the Medical Law and Ethics course has covered that pertains to the healthcare field. This includes situations that have to do with patients, healthcare workers, laws & procedures, and patient confidentiality, which I will now tell about briefly. The Medical Law and Ethics course has covered many situations pertaining to the relationships between healthcare workers and patients. Healthcare workers must make sure that a patient understands any procedures that they may be given, and they must have the patient’s consent to give the procedure. If the consent is not given by a patient the practice, physician, or the healthcare worker can be held liable in a lawsuit.
Policies are arising in several directions to prevent the intentional, or unintentional, slip of information. Each facility should adapt their own personal rules and regulations regarding the issue of social media and patient privacy. In a law suit regarding a potential violation of the HIPAA, The General Hospital Corporation and Massachusetts General Physicians Organization Inc. agreed to a substantial fine to the U.S. government (U.S. Department of Health and Human Services, 2011). This type of fine sets the example that a violation of patient’s privacy and rights is strictly prohibited. Within social media, a disgruntled employee may also use the sites to damage confidential information regarding a patient.
It is also in place that employers must report deaths. RIDDOR is in place for “work related” incidents to be reported. The type of injuries that need to be reported are – • The death of any person (Regulation 6) • Specified Injuries to workers (Regulation 4) • Injuries to workers which result in their incapacitation for more than 7 days(Regulation 4) • Injuries to non-workers which result in them being taken directly to hospital for treatment, or specified injuries to non-workers which occur on hospital premises. (Regulation 5) COSSH 1994 COSSH is control of substances hazardous to health. COSSH requires employees to carry out the correct risk assessments and to ensure that employees are aware of the hazards.
Direct trust follows strict guidelines and rules related to the operation of security and trust-in system used for the health care direct exchange. Direct Trust employs its trust and security framework as a foundation for an accreditation and audit program for direct implementers/service providers, including health internet service providers (HISPs), Certification Authorities (CAs) and registration Authorities (RA). Direct Trust disperses digital certificates, aka (trust anchors) from service providers. This is done so that direct messages can be sent and/or received among providers without the need for one negotiation between depending parties, instead of having to exchange trust anchors with each other one at a time, all can obtain the trust anchors from one centralized source. (Florida HIE,
The Code articulates the enduring values of medicine as a profession. As a statement of values to which physicians commit themselves individually and collectively, the code is a touchstone for medicine as a professional community. It defines medicine's integrity and the source if of the profession's authority to self- regulate. The code of Medical Ethics is a living document, evolving as changes in medicine and the delivery of health care raise new questions about how the profession's core values apply in physicians' day to day practice,. The Code links theory and practice, ethical principles and real world dilemmas in the care of patients.