Top of Form
Background:
Last week the class read information on ethics and learned about the different ethical principles that can be applied within a healthcare environment. This week, you read about communication, cultural competency, and health literacy, which will be applied to this week’s assignment. As a healthcare administrator, working in the field of healthcare can be very rewarding yet challenging at times, which may require you to address complex situations. Healthcare administrators are the leaders of an organization, they establish the tone of ethical behavior within an organization and can generate a culture that embraces shared values based on ethical guidelines, principles, and practices. Additionally, healthcare administrators ensure that there are ethical resources available to assist decision makers when ethical issue arise. During your career as a healthcare administrator, you may serve on different committees, including an ethics committee, which may address a wide array of ethical dilemmas. Your ability to understand the role of ethics in healthcare is critical.
Assignment Scenario:
You are a director within your healthcare system at one of the local healthcare facilities and serve as an ad hoc ethics committee member. Your healthcare system’s ethics committee is a multidisciplinary team composed of physicians, nurses, social workers, administrators, chaplains, and other employees. The primary ethics team members include your Committee Chair, which is your Chief Nursing Officer, your company’s Legal Counsel, a Local Ethics Advisor, and several ad-hoc members. A situation has recently occurred at your facility, the ethics committee has requested your assistance to review the information and will require you to present this information at the next meeting.
There are four cases that you may select to complete this assignment, two from an eBook, one for an Arxis Financial, and one from the AMA Journal of Ethics on a case in Long Term Care. Information for the cases has been provided below. You will complete the Ethical Decision-Making Steps Template for this assignment. Supporting external evidence will need to be presented using APA 7th Edition formatting. Provide at least four references from the last five years, collected from the weekly course content, and you may include a maximum of two additional resources outside of the weekly content from your own personal research. Include a coverage page and a reference page with your Ethical Decision-Making Steps Template. Click this hyperlink for the template: Ethical Decision Making Steps Template
Links to the support you in your assignment:
Option 1 and Option 2: eBook Cases
There are two cases presented in Chapter 4, starting on page 54, of the Organizational Behavior and Theory in Healthcare: Leadership Perspectives and Management Applications eBook.
Link to UMGC Library eBook: Organizational Behavior and Theory in Healthcare: Leadership Perspectives and Man
29
CHAPTER 3
Interpersonal and Gendered
Communication
For the purpose of this text, we are going to use the following as working
definitions:
■ Communication competence: the ability to effectively exchange and process
information with others
■ Context: setting or situation
■ Empathic listening: letting speakers talk without interruption and demon-
strating the listener’s support without evaluating the speaker or provid-
ing instruction, instead encouraging the speaker to find a solution
■ Feedback: using statements or questions to demonstrate listening to a
sender or to encourage clarification from a receiver
■ Gender: gender may not be constant or easily determined by others and
is different from a person’s sex; it is demonstrated by how an individual
chooses to behave/act, that is, masculine, feminine, or more likely some-
where in between
■ Gender identity: a person’s perception of his or her masculinity or
femininity
■ Goal competence: the capability to construct goals and choose a plan(s) to
accomplish them
■ Interpersonal (also known as dyadic) communication: interactions between
two people who know each other and share common goals (e.g., friends, lov-
ers, family members, professionals, and a provider and a patient); it is not
the same as an infrequent conversation between a customer and a store
clerk or a restaurant waitperson
■ Interpersonal relationship: a bond between two people who share common
goals requiring effective interpersonal communication for its develop-
ment and/or maintainenance
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30 Health Communication for Health Care Professionals
■ Nonverbal communication: behaviors that are not word based; messages
transmitted via observable or experienced actions (eye contact, touch, vocal
volume, tone, etc.)
■ Role competence: the skill to assume various social/professional roles based
on the context and communicators’ goals
■ Self-disclosure: sharing highly personal information with only a very
limited number of most intimate friends/lovers
■ Sex: male or female, generally anatomically obvious to self and others;
determined by presence of a vagina in a female or a penis in a male
■ Verbal communication: literally what you hear or say when in a conversa-
tion with one or more interactants
■ I N T E R P E
65
CHAPTER 4
Provider–Patient Communication
For the purpose of this text, we are going to use the following as working
definitions:
■ Active listening: Showing the other person in an interaction that you are
listening through nonverbal cues like nodding, eye contact, and/or lean-
ing toward the speaker; and by giving verbal feedback (restating what
was heard, or by asking questions to assure accuracy)
■ Audience analysis: Assessing the other person in an interaction to deter-
mine his or her first language, literacy, and education level—both ver-
bal and written—in order to properly tailor a message to meet that
person’s needs, expectations, and abilities to assimilate the information
communicated
■ Closed-ended questions: Queries intended to gain specific responses,
“How long have you had a cough?” or “Are you coughing up some-
thing?” or “How high was your fever?” Generally used to limit the feed-
back from the respondent and to obtain specific information sought by
the communicator
■ Empowerment: Providing patients with information they can use to par-
ticipate in their health care decision making
■ Narratives: The stories patients respond with in answer to open-ended
questions, such as, “How are you doing?” or “How are you feeling today?”
■ Open-ended questions: Inquiries that encourage narratives—expanded
responses—not short answers
■ N A R R A T I V E S
In American culture we use storytelling—narratives—to make sense of the
world. We begin by reading and telling stories to infants about their parents,
siblings, the family history, and so forth. We use oral histories and photos from
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66 Health Communication for Health Care Professionals
books to inform and engage. Throughout all aspects of American life, stories
are used make sense of our lives. One of the major uses of narratives is discuss-
ing health issues with friends and family.
Reflection 4.1. Think of a recent sickness, an upper respiratory illness (URI),
sometimes called a “cold,” or a sore throat, and so forth. When you were discuss-
ing how you felt and how your life was impacted (work, school, plans, etc.) with
a friend or family member, how did you describe what you were experiencing or
had experienced? Be as detailed as possible in your recounting of your part of
143
CHAPTER 8
Health Care Organizational
Communication
For the purpose of this text, we are going to use the following as working
definitions:
■ Human behavior theory: Theoretical perspective that focuses on the
employees and their motivations
■ Interdependent: Elements of an organization (individual or group) that
work independently but contribute collaboratively to assure effective
task/goal outcomes
■ Organizational communication: Information sharing that is internal
(employees/members) and external (customers, stakeholders)
■ Scientific management theory: Theoretical approach to organizing that
takes an objective/scientific perspective
■ Stakeholder: A person or group that contributes to the work and/or goals
of an organization, which may be an employee, stockholder, group, or
organization; for example, a group of orthopedic surgeons who are not
paid by a hospital but who do surgery and treat their patients there,
would be nonemployee, group stakeholders
■ Stockholder: A person or group who owns stock in an organization and
expects to earn dividends on his or her or their investment
■ Vender: A person or group who does business with an organization
(e.g., hospital-bed manufacturer)
■ O R G A N I Z A T I O N A L C O M M U N I C A T I O N
At its most basic level, communication is required for organizing. Therefore,
the way we think of organizations: family, school, corporation, nonprofit,
health care, and so forth, are based on how communication is used to both
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144 Health Communication for Health Care Professionals
create the company/entity as well as inform others— internal and external—
about its particular mission, values, and goals. Consequently, the way we
view one health care organization versus another is based in large part on how
it communicates. For example, St. Jude Children’s Research Hospital is similar
to many other hospitals in its commitment to health care delivery; however,
its mission is to research and treat children’s illnesses without charging par-
ents for the cost of their child’s hospital visits. The Connecticut (CT) Hospice
is an inpatient health care organization, but unlike St. Jude, the CT Hospice is
organized around the goal of focusing on enhancing dying patients’ and their
families’ qualit
2 1 1
I m p o r ta n t t e r m s
l e a r n I n g o B j e c t I v e S
C H A P T E R 8
T E A M W O R K A N D
C O L L A B O R AT I O N
After reading this chapter, you will be able to do the following:
➤ Explain the role of teams in healthcare organizations
➤ Describe the importance of effective teams to patients and staff members
➤ Evaluate the impact of organizational culture on team success
➤ Identify characteristics of effective teams
➤ Understand the concept of groupthink
➤ Evaluate how peer review and teamwork help bring about better patient care
• Adjourning stage
• Authoritarian leadership style
• Collaboration
• Democratic leadership style
• Forming stage
• Groupthink
• Interprofessional team
• Laissez-faire leadership style
• Norming stage
• Organizational culture
• Performing stage
• Storming stage
• Team
• Teamwork climate
00_Cellucci (2375) Book.indb 211 2/14/19 3:32 PM
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E s s e n t i a l s o f H e a l t h c a r e M a n a g e m e n t2 1 2
Ben Delozier, director of the stroke recovery unit at St. John’s Rehabilitation Institute, closed his
office door and sighed. Most of the time, he liked his work. Helping someone lead as normal a
life as possible after a stroke was gratifying. The patients exerted great effort to recover, and
they appreciated his and his staff’s help in the rehabilitation process. Most of the time, he
also liked the professional staff members with whom he worked. They were smart and worked
independently, which allowed him to adopt a laissez-faire leadership approach, and the cul-
ture of the recovery unit reflected this laissez-faire style. Most team members did their jobs
without involving Ben directly. And, most of the time, this organizational culture that stressed
independence and a team orientation worked well.
St. John’s staff members were divided into interprofessional teams that focused on
each individual’s therapy. A nurse, a speech pathologist, an audiologist, a physical therapist
(PT), and an occupational therapist (OT) would come together to plan, implement, and evalu-
ate the specific rehabilitation treatment for a patient. The team members, who came from
about the same hierarchical level, worked together to help the patient recover. “Restore the
body, empower the spirit” is a philosop
Healthcare Management Ethics
No one would deny clinical and
administrative healthcare profession-
als regularly encounter ethical chal-
lenges. For clinicians, the challenges
may relate to a conflict regarding
withholding or withdrawing life-
sustaining interventions or breaching
patient confidentiality. For the execu-
tive, the conflict may involve a deci-
sion concerning a needed service that
is a financial drain on the organiza-
tion or the abusive behavior of a
highly productive administrator.
Ethical conflicts are best
addressed when all the
people who are legitimately
involved have an
opportunity to discuss their
values, perceptions and
concerns in an open and
respectful environment.
What is the same for clinician and
executive decision makers is the
potential for an ethical conflict or
controversy. All ethical conflicts are
characterized by a number of com-
mon components. An ethical conflict
occurs when an uncertainty, a ques-
tion or a controversy arises regarding
competing ethical principles, per-
sonal values, or organizational and
professional ethical standards of
practice. Examples of such standards
include the American College of
Physicians’ Ethics Manual or the
American College of Healthcare
Executives’ Code of Ethics.
Once an ethical conf lict is identi-
fied, the challenge becomes how
healthcare leaders and other staff
involved in the situation should
respond. The use of a systematic
process can enhance the analysis
leading to a response that is ethi-
cally justifiable. For the clinician,
executive or ethics committee mem-
ber, applying a systematic process
can diminish the possibility of
making quick decisions lacking
thoughtful ref lection and sound
ethical reasoning.
The Importance of a Standard
Process for Resolution
A little over a decade ago, I was
changing positions. Because I
talked frequently about the impor-
tance of systematic ethical reason-
ing, during a farewell gathering, I
was given a small poster that hangs
in my office today. It reads, “Ethics,
schemethics; f lip the damn coin.”
The cynicism serves as a constant
reminder of the need for the
opposite—to always apply a care-
fully developed process to address
ethics conf licts. The process will
take time and effort, yet it can lead
to ethically defensible decisions
rather than convey the general atti-
tude, “Because I said so.” The pro-
cess can foster a focused application
of ethical principles, institutional
values and policies to ethical con-
f licts. It promotes thoughtful and,
hopefully, respectful dialogue
between the parties involved in the
ethical conf lict.
Unlike some decision-making mod-
els, the application of a uniform sys-
tematic process for addressing both
clinical and administrative issues is a
subtle-but-important distinction. It
emphasizes that a process should not
be based on such a distinction, in no
small part because the distinction
between clinical and administrative
Ethical Decision-Making Steps:
Healthcare Administrator’s Presentation to the Ethics Committee
Administrator’s Instructions
: Complete this form, the Ethical Decision-Making Steps as defined by the American College of Healthcare Executives (ACHE), based on your selected ethical case study you selected as defined within the assignment prompt. You will be presenting this information during your next ethics committee meeting. Provide a response to each step below, ensuring that sufficient details are provided with supporting evidence. (Your supporting external evidence will need to be presented in APA format using in-text citations and remember to include a separate APA formatted Reference Page that your executive leaders may refer to in order to obtain additional information on your responses. Your references should be from the last five years, collected from the Week 3 to Week 5 course content, and you may include a maximum of two additional resources outside of the weekly content from your own personal research.)
Place an X in front of the Case that you have decided to present to your ethics committee:
_____ Option 1 from the eBook – HealthT Seeks Healthier Employees
_____ Option 2 from the eBook – CEO Misuse of Company Funds?
_____ Option 3 PDF – HealthSouth: A Case Study in Corporate Fraud
_____ Option 4 PDF – Ethics and Intimate Sexual Activity in Long-Term Care
Complete the following ethical decision-making steps below for your selected case: (Note: Appropriately adjust the spacing below for each step to provide your information based on the case option that you selected.)
Step One: Recognize the Background (The Circumstances Leading to the Ethics Conflict.)
Step Two: Identify the Specific Ethical Question(s) that Need Clarification.
Step Three: Consider the Related Ethical Principles and/or Organizational Values
Step Four: Determine the Options for Response(s).
Step Five: Recommend a Response(s).
Step Six: Anticipate the Ethical Conflict.
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