A hospital is not just an institution where one can get professional examination and treatment, this type of medical organization is also to provide excellence in medical research, patient case and medical education services. Some hospitals serve as outstanding examples of high-quality and well-planned health system management within a wide clinical network and are consistently expanding the range of multispecialty services. This paper reviews the policy and principal daily operations that relate to the area of ethical and fiscal responsibility of health care assistants (HCAs). Management system of any medical institution presupposes that HCAs are competent stewards of resources who are to be aware of basic ethical and moral issues performing these responsibilities. Although this particular position does not presuppose any direct dealing with finance, HCAs still are responsible for rational use of resources.
The focus of this paper is narrowed down to the hospitals, which provide ophthalmological, otolaryngological and reconstructive surgery services. Physicians in such medical institutions do not only evaluate and treat diseases in their departments, but also are competent in questions of allergy, immunology, medical imaging services, pain management, pathology and treatment of sleeping disorders. HCAs are supplement their complex work and make sure physicians and patients are satisfied with their working conditions. Such a wide range of medical services requires an efficient management mechanism, which aims to constructively and wisely organize daily activities and operation in the hospital. According to the Rules and Regulations lists on the companies’ websites, regular meetings of the staff are held annually to monitor clinical practice patterns, discuss individual and collective work within the institution, consult physicians, assistants and also administrative personnel. Health care executives do not provide medical services directly, but are responsible for budgeting, information management, daily scheduling, internal communication and marketing. Therefore, they need to manage human and financial resources of the company and connect all daily operations and activities to this central to their specialization responsibility.
Crew Source Management has become one of the main responsibilities within the medical sphere, because teamwork training is an essential task for any health care organization due to various instances of communication breakdowns, medical errors, failure to provide a high level of patient security. Although, health care administrators seem only to indirectly influence medical treatment and perform such daily tasks as patient admission, general order in the hospital, hygiene questions, waste management, staff scheduling, they are still directly responsible for patient well-being and prevention from adverse events. Concerning these ethical aspects, patient safety equates to economic ramification and budget planning. “If health care managers do not address ways to increase the level of care, they are adversely impacting their financial situation on several fronts” (Dean, Marshall, Maynard, 2012, p.61). Therefore, medical errors should be reduced and one of the best ways to achieve this objective, is to encourage an efficient teamwork, improve dynamics in communication and organize specialized training programs for each health care worker. Instructional sessions, meetings and seminars are traditional instruments to discuss major problems and issues within the medical team. Different educational activities for current or future workers must be frequently organized and include such types of instruction as meetings, conferences, seminars, grand rounds, live webcasts and symposia. This option enables the medical institution to present the most important perspectives of the company, inform newcomers about its policy, ethical principles and general rules. Although this process is rather time- and finance-consuming, it raises one’s sense of team leadership, situational awareness and finally, conflict resolution. Besides, effective communication models are usually provided to deal with the foreigners, people with mental disorders, children or elderly people. These groups of patients require additional attention and individual approach, because when addressed in a usual way, a number of miscomprehension situations might occur.
Recent studies of health care management and administration show that costs in health care sector are very often used inappropriately and unwisely. Labro (2015) in his brief analysis of health care management systems in different countries states that the main reason for financial planning problems is managers’ inability to accurately measure costs, balance between outer and inner spending, correctly diagnose income, profit and outcomes. He lists the following reasons for this matter: “a lack of incentives to control costs under a reimbursement system that is predominantly based on fee-for-service, a blurred distinction between the costing methods used for both for external purposes and for internal cost management decisions, or an unwillingness to think in terms of costs when patient health is the main concern” (Labro, 2015, p. 568). Policy of separate payment for each service is not a right and consequential decision and is quite inefficient in its nature and a move away from this methodology towards the so-called bundled payments or capitation might be a significant step for improvement of cost measurement within the health care organization.
Directly addressing the question how HCAs being good stewards of resources can improve their level of social responsibility, one should admit that their basic duties include feeding, dressing, washing, bed making, toileting and helping their patients to move. Besides, they need to take overall control over the patients’ comfort and consistently monitor their health conditions taking temperatures, measuring pulse, blood pressure and weight. While fulfilling these and other tasks HCAs should always keep in mind some ethical principles and remember that medical care is not a business venture, but a moral enterprise and private money must not help people to jump the queue or receive a certain special service. “The ongoing problem of recruiting appropriately qualified nurses has affected staffing levels in many units and continues to be a national problem” (The British Association of Critical Care Nurses, 2003: 141). Feeling of moral obligation and responsibility are as significant as the main professional skills and qualification. All patients are equal in their rights and should be able to use necessary facilities, resources any possible time. It is important to consider the coexistence of private and public services and HCAs’ main purpose must be optimization of the use of resources and services.
Detailed overlook and analysis of additional aspects in health care system management may significantly improve financial state of an institution. Although medical services and facilities are of the primary administrative concern, such questions as team training, efficient cost management and division of responsibilities remain important issues in medical research field. Even the best hospitals leading in the U.S. and abroad and managing the largest networks of affiliations, must reconsider and develop their management systems. Poor working conditions, negative health outcomes, unmet health needs, delays in receiving certain services and high costs of medical treatment are those barriers that block one’s access to a certain health care organization or provide negative patient’s experience and therefore, reduces the institution’s credibility, authority and overall reputation.
References
Dean, M.; Marshall, D.; Maynard, T. (2012). Crew Resource Management and Teamwork
Training in Health Care: A Review of the Literature and Recommendations for How to Leverage Such Interventions to Enhance Patient Safety. In Goes, J.; Savage, G.; Friedman, L. (eds.). Annual Review of Health Care Management: Strategy and Policy Perspectives in Reforming Health Systems, 59-90.
Labro, E. (2015). Health-Care Costs: Discussion of “The Impact of Changes in Regulation
on Cost Behavior. Contemporary Accounting Research 32(2), 567-574.
The British Association of Critical Care Nurses. (2003). Health care assistants’ role, function
and development: results of a national survey. Nursing in Critical Care 8(4), 141-149.
