Outcome 6 - DA's professional obligation Flashcards
Ethics defined
Ethics can be defined as “a notion of character permeated with values that determine the identity and good or bad of an individual or group. Ethics is not a mtter of right or wrong as it is a process by which an organization evaluates its decisions”
-principles of right and wrong that humans feel obligated to do whether because of benefit to society, fairness or standards of virtue
What is a Code of Ethics?
Is the most comprehensive and consists of general statements, sometimes altruistic or inspirational, that serve as principles and the basis for rules of conduct. A code of ethics specifies methods of reporting violations, disciplinary action for violations, and a structure of due process.
Several principles which will assist in making ethical decisions and which underlie the rules found in most professional codes of ethics:
- Autonomy
- Veracity
- Beneficence
- Nonmaleficence
- Confidentiality
- Justice
- Role Fidelity
What is Autonomy?
Can be seen as “personal liberty” in that the individual has the freedom to choose how to deal with ethical dilemmas and put their decision into action. Underlying this principle are 3 basic elements:
- the ability to decide
-the power to act on a decision
-respect for the individual autonomy of others - foundation of “informed consent” - the patient, given adequate information, can choose between treatment plans.
What is Veracity?
refers to telling the truth. In terms of the professional and the patient, truth flows both ways. The patient must provide truthful information and the healthcare professional needs to share factual information in order for the patient to have the autonomy to make a decision.
What is Beneficence?
Relates to mercy and charity as well as actions that beneift another. Most professions have, in one way or another included a statement in their code of ethics similar to the Hipoocratic Oath, wherby they pledge their duty to promote the best interests of their patients in providing for their health and wellness.
What is Nonmaleficence?
is the pledge to “do no harm”. It is related to the Hippocratic oath, which states “I will never use treatment to injur or wrong the sick”. It is essentially beneficence stated in reverse” the pledge to refrain from inflicting harm.
What is Confidentiality?
Refers to the patient’s right of privacy and is a critical part of the trust they place in healthcare professionals.
How health information is controlled is detailed in Alberta’s Health Information Act.
What is Justice?
Relates to the concepts of fairness and entitlements - what is more specifically referred to as distributive justice. Healthcare services, according to this principle, should be distributed in a manner that ensures individuals receive an equal and fair share.
What is Role Fidelity?
Requires
that professionals act within the constraints of their role. In the province of Alberta, the Health Professions Act describes restricted activities rather than the scopes of practice as in previous acts. These restricted activities are detailed within the Gov’t Organizations Act.
4 Main generations:
Baby Boomers (49-67)
Generation X (30-48)
Generation Y (19-30)
Millennials (born after 2000)
Basic Character Traits related to ethical and moral behaviour
honesty
integrity
keeping promises
loyalty
responsibility
kindness and caring
respectfulness
fairness
being a good citizen
confidentiality
Who are DAs accountable to?
They are accountable to both themselves and the public to provide safe, competent and ethical dental care
What does Accountability involve?
Involves taking responsibility for one’s actions, behaviours, decisions and omissions. DAs should have knowledge of and comply with the relevant laws and standards of practice that govern the field of dental assisting
What is just culture?
Culture is a set of shared attitudes, values, goals and practices that characterize an organization. A Just culture is a small part of a larger healthcare organizational culture - “the way we do things around here “ - that strives to make care as safe as it can be.
In a just culture…
-HCWs are treated with respect and feel support when something goes wrong or nearly goes wrong with patient care
-the actions of people involved when something goes wrong are assessed fairly.
-HCWs - are only held accountable for THEIR actions
-Healthcare organizations and health professional regulators should reach an agreement and communicate proactively about the definition of accountability for one’s actions in the event of a patient safety incident.
-HCWs and patients should feel comfortable rasing concerns and reporting errors and threats to patients safety
-shared values, beliefs and attitudes about safety guard against naming, shaming, and blaming people if something goes wrong with care delivery
Just culture beliefs and attitudes
- Fairness and transparency are essential for building trust
-in a just healthcare culture, the focus is on identifying system factors that lead to errors and making changes to improve safety
-HCWs who trust the process to assess their actions when something goes wrong are more likely to report system factors that create unsafe situations and threats to patient’s safety
-when a patient is harmed by care delivery, the actions of those involved are assessed without consideration of the patient outcome
Just culture behaviours
-support HCWs with respect, dignity, and compassion during patient-related incidents
-avoid blame and quick judgements about the actions of an individual
-proactively informing HCWs about the appropriate accountability for ones actions
-hold individuals accountable for their actions by considering the situation and contributing factors
- follow a systemic approach to understanding why people took the actions they did in the context of the situation
-be aware and take steps to minimize hindsight bias or outcome bias when assessing a person’s actions
-actively seek out systemic factors that led to patient harm or near harm and implement changes to minimize the risk of recurrence
What is hindsight bias?
“If i knew then what I know now”
What is outcome bias?
The greater the harm, the greater the consequence
healthcare students have a moral responsibility to:
-Express serious doubts about your qualifications to your supervisor if you have been given the authority by that person to act independently and you feel ill equipped to do so.
-Share what you know about the patient and other aspects of the situation with the healthcare team in an attempt to identify any ethical problems.
-Refrain from acts that would be wrong for anyone to commit.
-Be ready to help identify the best alternatives possible for patients, or clients, and others who are faced with difficult situations.
-Remain faithful to your own convictions and exercise the will and courage to act on them.
-Give yourself the opportunity to reflect on your action.
When deciding what to do, how to act, and making the best decision based on ethical and moral grounds, there are a number of principles to consider:
-What do I know and understand will be the best course of action for myself and others?
-When I make a decision that will impact my peers, is it made in their best interests as well as mine?
-What do my peers expect of me?
-What do I expect of my peers?
Quality assurance can be defined as:
All activities that contribute to defining, designing, assessing, monitoring, and improving the quality of healthcare. These activities can be performed as part of the accreditation of facilities, supervision of health workers, or other efforts to improve the performance of health workers and the quality of health services.
Quality Assurance is a method of..
measuring quality healthcare as
determined by the achievement of the best possible outcomes given the resources available.
The measurement of quality involves..
detertmining the degree to which clinical standards are met
What plays a strong role in Quality Assurance?
Decision making - poor decision making skills can lead to a decline in quality, which in turn can lead to a loss of accredidation and a generally poorer patient experience.
Quality Assurance for Patients
Services should be designed so as to meet hte needs and expectations of patients and communities.
Quality Assurance for System and processes
Providers must understand the service delivery system and its key service processes in order to improve them.
Quality Assurance Measurement
Data is needed to analyze processes, identify problems, and measure performance.
Quality Assurance for Teamwork
Quality is best acheived through a team approach to problem-solving and decision making.
several dimensions of quality care must be assessed through data collection
Technical performance
Access to services
Effectiveness of care
Efficiency of service delivery
Interpersonal relations
Continuity of services
Physical infrastructure and comfort
Choice
The data for the quality assessments can be gathered through a number of methods:
Observation of service delivery
Mystery client method
Audit of individual patient records
Review of data from automated information system
Testing (written tests, simulation with standardized patients, computer-based testing)
Health worker interview
Patient exit interview
The Health Profession Act governs..
governs the practice of regulated health professions. It sets out standard processes for colleges for registration, continuing competence, complaints, and discipline.
What are Standards of Practice and Codes of Ethics
Health profession colleges establish policies and procedures to serve as a standard of practice. This helps healthcare providers understand what behaviour is considered acceptable and what is not.
they set the expectations for members to adhere to. Regardless of personal beliefs, background, or ideas, the regulatory body communicates how they expect a healthcare provider to behave.
Ask yourself the following questions when a problematic decision or action arises that could be an ethical dilemma:
What are my core values and beliefs?
What are the core values and beliefs of my organization?
Whose values, beliefs and interests may be at risk in this decision? Why?
Who will be harmed or helped by my decision or by the decision of my organization?
How will my own values and beliefs and those of my organization be affected or changed by this decision?
How will I and my organization be affected by the decision?
What is CADA’s Mission?
The College of Alberta Dental Assistants regulates its members in the public interest, promoting the delivery of safe, quality oral health care.
What is CADA’s Mission?
We champion regulatory excellence, innovation, and trust among our communities.
What are CADA’s Values?
Accountable [taking responsibility for the work we do]
We deliver an effective regulatory framework and answer to Albertans.
Ethical [acting with personal and professional integrity]
We do the right things for the right reasons.
Inclusive [honouring human diversity]
We embrace equality in the delivery of our mandate and encourage differing perspectives in decision-making.
Innovative [leading by learning]
We pursue opportunities to collaborate, grow, and improve our systems and processes
HPA establishes a regulatory college for each profession and set outs common requirements for each profession. The common requirements include:
mandatory registration
mandatory continuing competency
restricted activities
investigation and discipline
What are Restricted Activities?
Restricted activities are high risk activities performed as part of providing a health service that require specific competencies and skills to be carried out safely. Restricted activities are not linked to any particular health profession and a number of regulated health practitioners may perform a particular restricted activity.
What does the Dental Assistants Profession Regulation set out for regulated members?
registration requirements
practice permit requirements
continuing competency programs
authority to provide restricted activities
