Quality Health Care and Nursing

Odanga, Sheinlyn G. RN, MAN-c

Quality Standards for Health Provider Organizations

1. Patient Rights and Organizational Ethics. 2. Patient Care Standards 3. Leadership and Management 4. Human Resource Management 5. Information Management 6. Safe Practice and Environment 7. Improving Performance

Organizations
Are collections of individuals brought together in a defined environment to achieve a set of predetermined objectives. Health organizations provide two generally types of services: illness care (restorative) and wellness care (preventive). Illness care services help the sick and injured Wellness care services promote better health as well as illness and accident prevention.

 Nurses take a more active and independent role in providing services. Increase focus on continues performance improvement and benchmarking demands that organizations constantly consider their own practices and make appropriate changes.

Characteristics and Types of Organizations

1. 2. 3. 4. 5. Types of services provided Length of direct care services provided Ownership Teaching status Accreditation status

Types of Services Provided

General care General hospitals Special care limited scope of services; psychiatric hospital

Length of Direct care Services Provided

Short term care less than 30 days Long term care more that 30 days

Primary care first access care Secondary care disease and restorative care Tertiary care rehabilitative or long term care

Ownership
Public institutions Private non- profit organizations voluntary agencies For-profit organizations proprietary organizations

 Teaching status teaching institution Accreditation status

Standard of care
is a medical or psychological treatment guideline, and can be general or specific. It specifies appropriate treatment based on scientific evidence and collaboration between medical and/or psychological professionals involved in the treatment of a given condition.

Patients Rights and Organizational Ethics

the inherent dignity and the equal and unalienable rights of all members of the human family. the paternalistic model, the informative model, the interpretive model, and the deliberative mode

Paternalistic Model
The best interests of the patient as judged by the clinical expert are valued above the provision of comprehensive medical information and decision-making power to the patient Parental or priestly

Informative model
Scientific engineering or consumer model To provide relevant information, for the patient to select the medical interventions he or she wants Sees the patient as a consumer who is in the best position to judge what is in her own interest, and thus views the doctor as chiefly a provider of information.

Interpretative Model
The aim is to elucidate the patients values and what he or she actually wants, and to help the patient select the available medical interventions that realize these values

Deliberative Model
Aim is to help the patient determine and choose the best health-related values that can be realized in the clinical situation Moral self development

Organizational Ethics
ethics in an organization refers to rules (standards, principles & values) governing the conduct of organizational members and the consequences of organizational decisions

Approaches to Organizational Ethics

Individualistic approach Communal Approach

Individualistic Approach
Every person in an organization is morally responsible for his/her own behavior, and any efforts to change that behavior should focus on the individual.

Communal Approach
Individuals are viewed not in isolation, but as members of communities that are partially responsible for the behavior of their members. to understand and change an individual's behavior we need to understand and try to change the communities to which they belong.

Basic elements of an ethical organization

1) written code of ethics and standards; 2) ethics training to executives, managers, and employees; 3) availability for advice on ethical situations (i.e, advice lines or offices); and 4) systems for confidential reporting