discussion questions 547

This unit explores the issue of accountability, or who is responsible for defining, measuring, and reporting on quality measures. There is a formal process that expects accountability across the health care continuum. You will explore the current best practices and trends from an internal and external focus.

  • Use the Measuring Health Care text to read the following:
    • Chapter 5, “Promoting Accountability through Measurements,” pages 94–114. This chapter looks at who is accountable and how in measuring and reporting health care quality. While measuring of outcomes and processes is wonderful, someone or a department needs to be tasked with the responsibility for this ongoing effort.
    • Chapter 6, “The Rationale for External Drivers,” pages 115–134. There are many external drivers that also drive health care quality. Quality is not an internal method sitting in isolation. This chapter looks at who the external stakeholders are and the important role that these organizations provide to health care.

1. Determining Accountability-Read the information below and provide in a 250-300 word post, outline your plan of what needs to happen. Be sure to highlight who is accountable for each step of your plan. Your plan should have a minimum of five steps. What is your role in the PDCA plan designed by the CEO? Is the role appropriate? Who is most accountable – the CEO or the DON? How do you follow the PDCA model while moving swiftly on this issue?

You are the owner and CEO of group homes that serve those with mental impairments. Each group home services six to ten adult residents. Your group homes are located in neighborhoods throughout the community. The group homes are staffed with caregivers who have been trained as Certified Nurse Assistants (CNAs) or Home Health Aides (HHAs). You have a Director of Nursing (DON), an RN, who is responsible for writing the medical care plans and ensuring the needed medications and treatments are provided for each resident. The medications are given by the caregiver staff of each building.

The DON has come to meet with you. The DON reports that the medications at one facility are not being given on time, and some appear to be missing. The DON is particularly concerned about pain medications for one resident with rheumatoid arthritis. This client has been experiencing more pain symptoms and seems to be in tears often in the later day due to pain. The DON is concerned that this resident’s pills have actually been stolen.

2. Media Messages

The media carries messages rapidly across all areas of the nation. The media has been successful at uncovering fraud, discovering specific health issues, and disseminating helpful information. The media also may create challenges for health care managers faced with different crises and situations. Health care managers must be aware of the impact the media may have on their own organization.

You are the administrator of a local nursing home. During the evening shift, one of the cognitively impaired residents eloped (escaped from the facility). This resident was found several miles from the facility six hours later huddled in a ditch, cold, and dirty. You have spent most of the night dealing with the staff involved, the resident’s family, and local law enforcement. As you turn toward your office door at 8 a.m., a reporter is waiting for your statement.

In a 250- to 300-word response, develop your “media release” statement. Carefully word this piece recognizing that you want to continue to present your facility in a favorable light in the community and do not wish to pinpoint (in the media) who the accountable staff may be. Respond to the media release as a patient advocate. Does the media release provide a balanced response to the incident? Is the public’s right to know balanced by the rights of privacy for the patient? Is there a feeling that the facility responded correctly?

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