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Ethics in quality
improvement
Calle Lindén
Emily Moore
The Dinh Thi
Heart Failure
•   Ethics of readmission for elderly patients
•   75-85 years
•   heart failure NYHA Class II-IV
•   telephone support and discharge education
•   The cost-effectiveness in healthcare
To help interveners having
suitable decisions
                       Respect for
                        persons


         Addressing
         conflict of                   Justice
          interest



                       patients

                                     Beneficence
          Diversity                    & non-
                                     maleficence



                        Integrity
Values of medical ethics
• Autonomy - the patient has the right to refuse or choose their
  treatment.

• Beneficence - a practitioner should act in the best interest of the
  patient.

• Non-maleficence - "first, do no harm".

• Justice - concerns the distribution of scarce health resources, and
  the decision of who gets what treatment (fairness and equality).

• Dignity - the patient (and the person treating the patient) have the
  right to dignity.

• Truthfulness and honesty –
•   To meet patient expectations
•   To address the health needs of the community
•   To enhance the quality care
•   To foster professionalism
•   To improve the organization s culture and practices
What components make up
cost in healthcare?
• Direct costs

                            Medical: drugs, staff-time, equipment.
   Patient: transport, out-of
   pocket expenses.


                                                                 Cost in
      Productivity costs        Intangibilities:                 healthcare
                                Pain, suffering…
Ethics in healthcare
• Ethical standards promote the aim of medical care to alleviate
  suffering.
• Medical care is built on the communication between medical
  workers on one side and patients and/or patients’ families on
  another side.
• Ethical standards will help to build public support for medical
  care.
• Health and medical care typically involve different medical
  workers from a variety of disciplines.
Ethical Problems for Heart
Failure Patients
 • Costs
 • Unnecessary medical services
 • Fees for medical services
 • Balancing practice economics with patient need
- improving health along with financial realities of running a
hospital or health service
References
• Morgan, L., (2006). Hasting center report on Ethics of Quality
  Improvement.
• Anne Mart Oostheizen, Silvia Pera, Dirk van der Wal. (2011).
  (3rd ed). Ethics in Healthcare.
• Sheila, M., (2006). First do no harm: Law, Ethics & Healthcare.
• Batter, K. (2001). Ethics issues in advanced nursing practice.
  Edinburgh: Elsevier science limited.
• LAO. Providing Constitutional and Cost-Effective Inmate
  Medical Care. Taylor, M. Legislative Analyst. April 19, 2012.
• Brent C. James, M.D. (1989). Quality Management for Health
  care delivery.
• Aastha , D. (2012). Ethical Issues in Healthcare.
  http://www.buzzle.com/articles/the-importance-of-health-
  ethics.html
References
• AMA. (1994). Opinion 6.05 - Fees for medical services.
  Retrieved from http://www.ama-assn.org/ama/pub/physician-
  resources/medical-ethics/code-medical-
  ethics/opinion605.page?
• WMA. (2006). WMA international code of medical ethics.
  Retrieved from
  http://www.wma.net/en/30publications/10policies/c8/
• AMA. (1994).AMA’s code of medical ethics. Retrieved from
  http://www.ama-assn.org/ama/pub/physician-
  resources/medical-ethics/code-medical-ethics.page?
• Medellin, G. (2011). Balancing practice economics with patient
  need. Retrieved from http://virtualmentor.ama-
  assn.org/2011/08/ccas1-1108.html
Search Process
• Established the common ethical values and principles in
  healthcare
• Applied these values to our problem
• Used academic data bases and government websites to direct
  our searches
Collaboration Process
• Divided up ethical problems to research among group
  members
• Met up and combined powerpoint slides

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Ethics

  • 1. Ethics in quality improvement Calle Lindén Emily Moore The Dinh Thi
  • 2. Heart Failure • Ethics of readmission for elderly patients • 75-85 years • heart failure NYHA Class II-IV • telephone support and discharge education • The cost-effectiveness in healthcare
  • 3. To help interveners having suitable decisions Respect for persons Addressing conflict of Justice interest patients Beneficence Diversity & non- maleficence Integrity
  • 4. Values of medical ethics • Autonomy - the patient has the right to refuse or choose their treatment. • Beneficence - a practitioner should act in the best interest of the patient. • Non-maleficence - "first, do no harm". • Justice - concerns the distribution of scarce health resources, and the decision of who gets what treatment (fairness and equality). • Dignity - the patient (and the person treating the patient) have the right to dignity. • Truthfulness and honesty –
  • 5. To meet patient expectations • To address the health needs of the community • To enhance the quality care • To foster professionalism • To improve the organization s culture and practices
  • 6. What components make up cost in healthcare? • Direct costs Medical: drugs, staff-time, equipment. Patient: transport, out-of pocket expenses. Cost in Productivity costs Intangibilities: healthcare Pain, suffering…
  • 7. Ethics in healthcare • Ethical standards promote the aim of medical care to alleviate suffering. • Medical care is built on the communication between medical workers on one side and patients and/or patients’ families on another side. • Ethical standards will help to build public support for medical care. • Health and medical care typically involve different medical workers from a variety of disciplines.
  • 8. Ethical Problems for Heart Failure Patients • Costs • Unnecessary medical services • Fees for medical services • Balancing practice economics with patient need - improving health along with financial realities of running a hospital or health service
  • 9. References • Morgan, L., (2006). Hasting center report on Ethics of Quality Improvement. • Anne Mart Oostheizen, Silvia Pera, Dirk van der Wal. (2011). (3rd ed). Ethics in Healthcare. • Sheila, M., (2006). First do no harm: Law, Ethics & Healthcare. • Batter, K. (2001). Ethics issues in advanced nursing practice. Edinburgh: Elsevier science limited. • LAO. Providing Constitutional and Cost-Effective Inmate Medical Care. Taylor, M. Legislative Analyst. April 19, 2012. • Brent C. James, M.D. (1989). Quality Management for Health care delivery. • Aastha , D. (2012). Ethical Issues in Healthcare. http://www.buzzle.com/articles/the-importance-of-health- ethics.html
  • 10. References • AMA. (1994). Opinion 6.05 - Fees for medical services. Retrieved from http://www.ama-assn.org/ama/pub/physician- resources/medical-ethics/code-medical- ethics/opinion605.page? • WMA. (2006). WMA international code of medical ethics. Retrieved from http://www.wma.net/en/30publications/10policies/c8/ • AMA. (1994).AMA’s code of medical ethics. Retrieved from http://www.ama-assn.org/ama/pub/physician- resources/medical-ethics/code-medical-ethics.page? • Medellin, G. (2011). Balancing practice economics with patient need. Retrieved from http://virtualmentor.ama- assn.org/2011/08/ccas1-1108.html
  • 11. Search Process • Established the common ethical values and principles in healthcare • Applied these values to our problem • Used academic data bases and government websites to direct our searches
  • 12. Collaboration Process • Divided up ethical problems to research among group members • Met up and combined powerpoint slides

Notas do Editor

  1. https://docs.google.com/viewer?a=v&q=cache:vVVR2R6RkD8J:www.neac.health.govt.nz/moh.nsf/pagescm/7654/%24File/ethical-guidelines-intervention-studies-nov09.pdf+ethics+in+the+invervention+in+taking+care+patients&hl=vi&gl=vn&pid=bl&srcid=ADGEEShZ4_M-3TOAmYfl_Xd-m25z3wUboSJGNBcK7n8TQbAPVDfUpqiSchsvTM3gVQwqkJfHikDDwcrMdl4Yx0XWC8kHUegS9UiSEazy4ezFbcwQHtXqLndEQPbeX_bfmp9ezwl6A5wD&sig=AHIEtbSK17In_9ECLSC7KLRWAtyDo6cISA
  2. Principles that when followed, promote values such as trust, good behavior, fairness, and/or kindness.There is not one consistent set of standards that all companies follow, but each company has the right to develop the standards that are meaningful for their organization. Ethical standards are not always easily enforceable, as they are frequently vaguely defined and somewhat open to interpretation ("Men and women should be treated equally, " or "Treat the customer with respect and kindness."). Others can be more specific, such as "Do not share the customer's private information with anyone outside of the company."Read more: http://www.businessdictionary.com/definition/ethical-standards.html#ixzz1tgTjPe55