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Regulation and Performance Improvement 1
Published in Rui Nunes, Healthcare as a Universal Human Right, 2022
The complexity of the healthcare system necessitates that healthcare providers are held accountable. Doing so effectively ensures that the two essential objectives of the healthcare sector regulation are achieved, namely, to promote healthy competition among providers and to uphold important social values such as the right to information and the freedom of choice. Public accountability is essential to combat the threat posed by encrypted data and to publicize performance indicators for each healthcare organization. Evidence-based performance indicators (i.e., social, economic, and quality) are necessary to accomplish these objectives. For instance, a repercussion of a bad score may be growing waiting lists for surgery that can be more properly managed with accountability procedures. The term accountability within this context refers to the need to make the decision-making process in all stages of the healthcare system visible and transparent, as well as the method for achieving transparency. At all levels of the healthcare system, important decisions are made concerning the amount of and way that resources are used.
Is criminal law the answer to individual healthcare negligence?
Published in Mélinée Kazarian, Criminalising Medical Malpractice, 2020
It was shown that between 2005 and 2009 at the Mid-Staffordshire NHS Foundation Trust, in what has been labelled one of England’s worst healthcare scandals, hospital staff had treated 400 to 1200 patients with the most appalling care.70 It appeared that health officials and regulators claimed that concerns had not been raised by staff members in the hospital, although it was later shown that concerns had actually been raised.71 Health officials and regulators had failed to prevent the neglect of these patients, and severe failures had occurred in several areas of the decision-making process.72 This scandal reflected the lack of accountability of decision-makers when something goes wrong in the healthcare setting. The offences of wilful neglect/ill-treatment in s. 20 of the CJCA 2015 can be used against an individual care provider and could therefore be used to penalise decision-makers who have recklessly or wilfully put patients at risk of harm, without having to prove causation. The new offences in fact aim to ‘incentivise providers to take further action to put in place systems to monitor and ensure that service users are not subject to ill-treatment or wilful neglect in order to avoid a potential prosecution’.73
Professional ethics
Published in Gerard Magill, Lawrence Prybil, Governance Ethics in Healthcare Organizations, 2020
Gerard Magill, Lawrence Prybil
Second, the concept of accountability that highlights how we function in the ethics paradigm is evident in this book on Public Value and Public Administration. The book underscores the contribution of dialogue to develop pathways for mutual efforts of persuasion, thereby building deliberative capacity to create public value. In addition, the concept of accountability is evident in the decision-making model that is adopted in Ethics for Health Care Professionals, and in the deliberative processes for making ethical decisions in The Elements of Ethics that requires prudence for sound judgement. Also, the concept of accountability is evident in Ethical Dimensions in the Health Professions. Here, a multi-step process of ethical decision-making is explained in section one and applied in sections two and three to elucidate deliberative processes on professional roles (e.g., student scenarios, organizational dilemmas, team decisions). Furthermore, the concept of accountability is evident in The Helping Professional’s Guide to Ethics where the majority of chapters engage the importance of ethical decision-making for patient care.
Underreporting of Adverse Drug Events: a Look into the Extent, Causes, and Potential Solutions
Published in Expert Opinion on Drug Safety, 2023
Fear-based factors or potential negative repercussions of reporting an error or adverse event (ADE), include potential retribution, litigation costs, reputational harm, or career prospects [12]. Fear can create an atmosphere of silence among healthcare providers, leading them to underreport adverse drug events (ADEs) with potentially negative outcomes for patients. Knowledge-based factors may impede reporting, including a lack of awareness or comprehension about how ADE reporting should occur; poor knowledge regarding clinical outcomes related to adverse drug events (ADEs); or misconceptions and myths surrounding reporting [20]. Unavailable training or education on reporting Adverse Event Disclosures can obstruct effective reporting. System-related factors involve tools and processes in place for reporting ADEs, including ineffective reporting tools or systems, difficulties using electronic systems, and lack of standard criteria/definitions [20]. Failing to provide proper feedback or follow-up can discourage healthcare professionals from reporting any adverse drug events (ADEs). Organization-related factors that hinder effective reporting include lack of leadership support, insufficient resources, prioritization of other metrics over ADE reporting and creating an atmosphere of blame or punishment. Poor collaboration or communication within healthcare teams, as well as lacking accountability or transparency regarding reporting processes and outcomes also interfere with effective reporting.
Moving beyond teamwork in the operating room to facilitating mutual professional respect
Published in Baylor University Medical Center Proceedings, 2023
Melody W. Lin, Harry T. Papaconstantinou, Bobbie Ann Adair White
Communication is especially important in a psychologically safe OR team. All team members reported a professional responsibility and accountability to safe patient care, which may motivate speaking up.13–15 However, fear of retribution, not wanting to cause trouble, or feeling ignored remain top concerns.16,17 In our study, team familiarity was identified as a contributor to psychological safety; consistent teams also facilitated trust, camaraderie, and openness.18 In contrast, most team members who rotate on to ad hoc teams reported decreased psychological safety stemming in part from communication problems, which can be exacerbated due to a lack of team identity, familiarity, and trust.19 In all teams, communication problems may arise due to differences in perception and values.20 Team communication may benefit from incorporating standardized processes that share information efficiently and predictably (i.e., the SBAR technique, situation-background-assessment-recommendation).19,21,22 At an organizational level, maintaining a culture of safety that values team members’ concerns and validates their contributions can further motivate team members to speak up.23
Ethical Challenges in the Commercialization of Neurotechnology: Contending with Competing Priorities
Published in AJOB Neuroscience, 2022
Tristan McIntosh, James M. DuBois, Joel S. Perlmutter
Accountability involves justifying decisions (e.g., related to clinical trial design or how and what data inform the development of new technology) and demonstrating the validity of these decisions to relevant stakeholders. As accountability relates to industry’s development of neurotechnologies, entities within the neurotechnology enterprise should be able to trust that technology is scientifically robust. Information about a particular neurotechnology and its functionality should be accurate and verifiable. The neurotechnology industry may be wary of sharing proprietary information about neurotechnology and its development. This makes it challenging for the larger neurotechnology community to hold the involved organization accountable and assess the reliability of research supporting the development of neurotechnologies.