Required Reading

ACHE. (2016). ACHE code of ethics. Retrieved from https://ache.org/abt_ache/code.cfm

Flite, C. A., & Harman, L. B. (2013). Code of ethics: Principles for ethical leadership. Perspectives in Health Information Management / AHIMA, American Health Information Management Association, 10(Winter), 1d. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3544144/

NAHQ. (2011). NAHQ Code of ethics and standards of practice for healthcare professionals. Retrieved from http://nahq.org/about/code-of-ethics

Airth-Kindree, N., & Kirkhorn, L. C. (2016). Ethical grand rounds: Teaching ethics at the point of care. Nursing Education Perspectives, 37(1), 48-50. doi:http://dx.doi.org/10.5480/13-1128

Benson, Michael D,M.D., F.A.C.O.G., Benson, Jordan B,C.P.A., J.D., & Stein, Mark S,J.D., PhD. (2016). Hospital quality improvement: Are peer review immunity, privilege, and confidentiality in the public interest? Northwestern Journal of Law and Social Policy, 11(1), 1-27.

Brothers, K. B., & Rothstein, M. A. (2015). Ethical, legal and social implications of incorporating personalized medicine into healthcare. Personalized Medicine, 12(1), 43-51. doi:http://dx.doi.org/10.2217/pme.14.65

Denecke, K., Bamidis, P., Bond, C., Gabarron, E., Househ, M., Lau, A. Y. S., … Hansen, M. (2015). Ethical Issues of Social Media Usage in Healthcare. Yearbook of Medical Informatics, 10(1), 137–147. Available in the Trident Online Library.

Fiscella, K., Tobin, J. N., Carroll, J. K., He, H., & Ogedegbe, G. (2015). Ethical oversight in quality improvement and quality improvement research: New approaches to promote a learning health care system. BMC Medical Ethics, 16(63). doi: 10.1186/s12910-015-0056-2. Accessed from http://bmcmedethics.biomedcentral.com/articles/10.1186/s12910-015-0056-2

Ghosh, K. (2015). Benevolent leadership in not-for-profit organizations. Leadership & Organization Development Journal, 36(5), 592-611.

Gillon, R. (2015). Defending the four principles approach as a good basis for good medical practice and therefore for good medical ethics. Journal of medical ethics, 41(1), 111-116.

Healthcare Financial Management Association [HFMA]. (2016). HFMA’s code of ethics. Accessed from https://www.hfma.org/code/

Kostkova, Patty P. (2016). Who owns the fata? Open fata for healthcare. Frontiers in Public Health, 4(4), 7. doi: 10.3389/fpubh.2016.00007

Kulshreshtha, P. (2015). Ethical leadership and contemporary organizational ethics: Principles and cases. Journal of Leadership, Accountability and Ethics, 12(1), 94-97.
Mascone, C. F. (2015). Navigating ethical dilemmas. Chemical Engineering Progress, 111(2), 3.

McLean, S. A. M. & Campbell, T.D. (Ed.). (2006). Applied legal philosophy: First do no harm: Law, ethics and healthcare. Abingdon, GB: Routledge.

Assignment Overview

There have been many cases of violations of ethical principles in medical and public health history. It is important to study these and understand not only what went wrong, but the implications of a failure to follow ethical principles, to ensure that these things do not happen again.

**Case Assignment

For this assignment, you will be creating a PowerPoint presentation. Three cases are listed below. For each case, you will provide a background and then apply at least the 4 basic ethical principles reviewed thus far in the course; you may research and apply additional ones. For each principle, explain why it was violated in this case. If you do not believe that the principle was violated, explain why. This should not be opinion, but should be your analysis of the cases and the principles; do not use first person. 

*Your slides should be in presentation format and your text should be in your speaker’s notes. You must include speaker’s notes. Remember to cite your sources.

*You will need to research the cases below. Be sure that you are using reliable sources for your information; peer-reviewed articles, academic books, government web pages and documents. You may use newspaper articles, but these should not be your principle and only source to discuss an individual case.

• The Tuskegee Experiment
• Henrietta Lacks and the development of the HeLa cell line
• Nazi Medical Experiments

Assignment Expectations

1. Conduct additional research to gather sufficient information to support your analysis.
2. Your presentation should have at least 6 slides, as well as a cover slide and reference slide.
3. Support your presentation with peer-reviewed articles, and use at least 6 references. For additional information on how to recognize peer-reviewed journals, see http://www.angelo.edu/services/library/handouts/peerrev.php
4. You may use the following source to assist in your formatting your assignment: https://owl.english.purdue.edu/owl/resource/560/01/

Discussion: Comparing Frameworks for Analyzing Organizations

Avedis Donabedian’s work generated a pivotal means of assessing organizational performance relative to structure, process, and outcomes. However, it is clearly not sufficient to view health care quality merely in terms of outcomes—the structures and processes that facilitate these outcomes are equally as important.

In this Discussion, you consider multiple frameworks that can be used to analyze an organization. As you proceed, consider how these frameworks allow you to examine the interplay of interdependent and related parts and processes that comprise the systems within an organization, as well as the arrangements or structures that connect these parts.

To prepare:

• Investigate and reflect on the systems and structures of an organization with which you are familiar. Consider the following:
  • What is the reporting structure?
  • Who holds formal and informal authority?
  • How many layers of management are there between the frontline and the highest office-holders of the organization?
  • How are interdisciplinary teams organized?
  • How is communication facilitated?
  • How well integrated is decision making among clinical personnel and administrative professionals?
  • How are particular service lines organized?
  • Which departments, groups, and/or individuals within the organization are responsible for monitoring matters related to performance, such as quality and finances?
• Select two of the following frameworks:
  • Learning organizations, presented in the Elkin, Haina, and Cone article
  • Complex adaptive systems (CAS), presented in the Nesse, Kutcher, Wood, and Rummans article
  • Clinical microsystems, presented in the Sabino, Friel, Deitrick, and Sales-Lopez article
  • Good to great, presented in the Geller article
  • The 5 Ps, presented in the ASHP Foundation article
• Review the Learning Resources for each of the frameworks that you selected. Also conduct additional research to strengthen your understanding of how to use each framework to assess an organization.
• Compare the two frameworks. How could each framework be used to identify opportunities to improve performance? In particular, how would you use each of these frameworks to analyze the organization that you have selected?

By Day 3

Post an analysis of the systems and structures of the organization you selected, sharing specific examples. Explain insights that you gained by comparing the two frameworks, and how each can be used to assess an organization, identify a need for improvement, and, ultimately, enhance the performance of an organization.

Hickey, J. V., & Brosnan, C. A. (2017). Evaluation  of health care quality in for DNPs (2nd  ed.). New York, NY: Springer Publishing Company.
Chapter 1, “Evaluation and DNPs: The Mandate for Evaluation” (pp. 3-36)
Chapter 3, “Conceptual Models for Evaluation in Advanced Nursing Practice” (pp. 61-86)
Chapter 6, “Evaluating Organizations and Systems” (pp. 127-142)Chapter 1 defines microsystem, mesosystem, and macrosystem and notes that evaluation can focus on one of these levels or all three. Chapter 5 examines the evaluation of organizations and systems.

Sadeghi, S., Barzi, A., Mikhail, O., & Shabot, M. M. (2013). Integrating quality and strategy in health care organizations, Burlington, MA: Jones & Bartlett Publishers.
Chapter 2, “Understanding the Healthcare Organization” (pp. 31–43)Although this chapter focuses on hospitals, the authors provide information about strategic planning and organizational structure that is applicable in many health care settings. The authors examine financial and quality issues as key aspects of performance measurement.

Elkin, G., Zhang, H., & Cone, M. (2011). The acceptance of Senge’s learning organisation model among managers in China: An interview study. International Journal of Management, 28(4), 354–364.
Retrieved from the Walden Library databases.

This article outlines the five disciplines that Senge argued could be found in a learning organization. The authors also discuss the worldview that is inherent in business organizations in China and explain how this relates to Senge’s theory.

Geller, E. S. (2006). From good to great in safety: What does it take to be world class? Professional Safety, 51(6), 35–40.
Retrieved from the Walden Library databases.

Geller reviews and applies Collin’s foundational Good to Great theory from its focus on financial success to safety.

Nesse, R. E., Kutcher, G., Wood, D., & Rummans, T. (2010). Framing change for high-value healthcare systems. Journal for Healthcare Quality, 32(1), 23–28.
Retrieved from the Walden Library databases.

This article explores how to implement change in complex adaptive systems (CAS) such as health care. The authors purport that an understanding of the principles of change management in CAS is critical for success.

Sabino, J. N., Friel, T., Deitrick, L. M., & Salas-Lopez, D. (2009). Striving for cultural competence in an HIV program: The transformative impact of a microsystem in a larger health network. Health & Social Work, 34(4), 309–313.
Retrieved from the Walden Library databases.

The authors discuss cultural competence as part of a patient-centered perspective on health care delivery. They examine an approach to creating innovation that originates at the unit (microsystem) level and can be diffused to the larger health care environment (macrosystem).