Module 8 lecture, part 5

Question 1

What is the tripartite structure of hospital governance?

Answer 1

Board of trustees
CEO
Medical staff

Question 2

Responsibility of board of trustees for hospital

Answer 2

A governing body
Legally responsible for operations
Evaluate medical decisions and approve plans and budgets
Appoint and evaluate the CEO
Approve appointment of medical staff

Question 3

Responsibility of CEO for hospital

Answer 3

Administrator/president
Carry out the mission and objectives
Responsible for day-to-day operations
Receives delegated authority from the board

Question 4

Responsibility of medical staff of hospital

Answer 4

Chief of staff heads the medical staff
Physicians are formally granted admitting privileges
Chiefs of service (for specialties) in major hospitals
Committees: executive, credentials, medical records, utilization review, infection control, quality improvement

Question 5

What was the shift in power for hospitals?

Answer 5

From the trustees, to physicians, to senior managers

Question 6

What does parallel operational structure in hospitals lead to?

Answer 6

Opportunities for conflict

Question 7

Details about hospital licensure

Answer 7

A hospital must be licensed to operate
State gov’t overseas with own set of standards

Question 8

Details about hospital certification

Answer 8

Not mandatory: required only if a hospital wants to participate in Medicare and Medicaid- most do
A federal function
Hospitals must comply with the “conditions of participation”, federal standards for health, safety, and quality
Currently focus on quality of care delivered and the outcomes of that care

Question 9

Details about hospital accreditation

Answer 9

By the Joint Commission of American Osteopathic Association
A private undertaking
Voluntary
It confers deemed status on hospitals: met certification standards

Question 10

What is magnet recognition program for hospitals?

Answer 10

A special designation conferred by the American Nursing Credentialing Center
Recognizes quality of care, nursing excellence, and innovations in professional nursing practice

Question 11

What helps attract and retain well-qualified nurses in hospitals?

Answer 11

Organizational environment

Question 12

What creates healthy work environments, attracts qualified nurses, and improves pt care?

Answer 12

Visionary leadership, empowerment and collaboration

Question 13

What are the 4 main principles of ethics?

Answer 13

Respect for others
Beneficence
Nonmaleficence
Justice

Question 14

What are some legal mechanisms to deal with pts’ rights?

Answer 14

Pts’ bill of rights
Informed consent
Advance directives

Question 15

In what areas does the pts’ bill of rights reflect the law?

Answer 15

Confidentiality
Consent re: medical care
Info on dx and tx
Right to refuse tx
Formulation of advance directives

Question 16

What is informed consent?

Answer 16

The pt’s right to make an informed choice regarding medical tx

Question 17

Types of advanced directives

Answer 17

DNR order
Living will
Durable power of attorney for HC

Question 18

To what do advanced directives refer?

Answer 18

Pt’s wishes regarding continuation or withdrawal of tx when the pt lacks the capacity to make end-of-life decisions

Question 19

What is a DNR?

Answer 19

Directs medical caregivers not to administer any artificial means to resuscitate the person when his or her heart or breathing stops

Question 20

What does a living will do?

Answer 20

Communicates a pt’s wishes regarding medical tx when he or she is unable to make decisions due to terminal illness or incapacitation in advance

Question 21

What is the main drawback of a living will?

Answer 21

It does not cover all possible situations

Question 22

What is a durable power of attorney for HC?

Answer 22

A written legal document in which the pt appoints someone else to make decisions in the event that the person is unable to make such decisions

Question 23

What is the main drawback of a durable power of attorney for HC?

Answer 23

The appointed person may not act in the same manner in which the pt would have acted

Question 24

Responsibility of ethics committees

Answer 24

Develop guidelines and standards
Address ethics issues
Multidisciplinary, including various members of the institution and outsiders

Question 25

Who must assume the role of a moral agent?

Answer 25

The healthcare executive

Question 26

Responsibilities of the moral agent?

Answer 26

Moral responsibility to put pt needs above those of the org
Ethics transcends compliance with the law