Introduction
Patient safety is undoubtedly linked to health care quality; patient safety may even be considered as the cornerstone of health care quality. That statement alone, makes the ethical and legal concepts that are required of health care organizations in the delivery of high quality health care highly important when talking about patient safety. Quality health care is an umbrella term that encompasses many aspects. Moreover, many also consider patient safety as indistinguishable from quality health care. Nevertheless, a quality health care has indicators such as safety, effectiveness, patient centeredness, time, efficiency and equity. The focus of this paper will be on the safety of patients which translates to inflicting no harm to the patients in a broad sense (Mitchell, 2008).
Likewise, the issue that will be dealt with in this paper is the problem the society has in the delivery of high quality healthcare that ultimately protects patients. It is not a mere speculation, it is real. According to the Institute of Medicine, the health care system in the country does not provide every person with a consistent and high quality health or medical care (2001). This is unfortunate given that citizens of a given nation should be able to rely on the respective authorities or any governing bodies that are concerned with providing everyone the health care they truly deserve. The Institute of Medicine had also described the space between the health care system that the country has and the health care the country needs as a chasm, rather than a small gap that may have been filled with ease (2001).
Furthermore, to deal with the issue, it is only appropriate that one analyzes the various ethical and legal concepts that ensure the delivery of high quality health care that protects patients. As such, it is important to note the different stakeholders that are responsible for patient safety and quality health care. Among the stakeholders are the patients, the nurses, educators, researchers, administrators, physicians, the government, professional associations, and the society itself (Ballard, 2003). With that in mind, we may have an idea of how the health care system works and the factors, especially the ethical and legal concepts at play that play a significant role.
This particular issue regarding patient safety had been selected since most of people, if not all, had needed or will need a quality health care that may protect them. Everyone, at some point in their lives, needed a health care that not just passes basic standards but exceeds them. From one’s birth to one’s final years, the health care system had been responsible for one’s well-being. Moreover, according to Ballard, patient safety is essential and an important component to provide quality health care. Provided that patient safety is essential and vital, it is still evident that the health care system in many countries, including the United States, is not sufficient (2003).
Moreover, this paper will not have an exclusive perspective on the issue at hand. This paper will aim to look at the issue through the various stakeholders’ perspective so that a holistic and not blinded conclusion may be formed. In short, this paper will not evaluate the concepts in the health care system as a patient nor as a hospital administrator alone. This paper will try to find the balance by representing the concerns that the patients and the other stakeholders have in terms of the different health care concepts. This paper’s scope will likewise cover the ethical and legal concepts that are required by health care organizations to ensure the delivery of high quality health care that protects patient safety that include federal regulations.
Statement of the Issue to be investigated
Evidence tells us that many patients are harmed in the process of acquiring health care services. These harms are likewise expressed in terms of injury, the lengthened stay n respective health care facilities, or death at some instances (World Health Organization, n.d.). As a matter of fact, researchers had estimated that more than 400, 000 Americans die annually due to this preventable events (“Hospital Errors are the Third Leading Cause of Death in U.S., and New Hospital Safety Scores Show Improvements Are Too Slow,”2013). Medical errors is also likewise expensive, costing up to 19.5 million dollars. These preventable events are not the result of intended actions but of the flaws in the current and old health care system. The complexity of the health care system likewise makes it hard to pinpoint which aspect should be improved to achieve uniform and consistent success. Nevertheless, the statistics are alarming and patient safety continue to be an issue in many countries. Everyone should be comfortable going to their health care providers and confident that they will be provided with quality health care instead of being put to harm. Furthermore, patient safety had been closely linked to the quality of a health care that are directly influenced by the different concepts that are required of health organizations. Likewise, patient safety covers both operational protocols, such as the case for EMTALA and the latest technology (World Health Organization, n.d.).
Without the proper reform that aims to lessen the harm and improve patient safety, it is possible that the incidence that may lead to one’s death increase. As such legal actions may come in the way of health care organizations that may impede their growth in terms of delivering quality health care. The oath that many people in the health care service had promised to uphold will be rendered useless if they inflict harm, although unintentionally (Duffy, 2010).
Research Sources
EMTALA and HIPPA
A study analyzing the impact that federal regulations have on the operations of the health care system had been conducted in 2010 by Gasper. In the study, she provided examples of different federal regulations such as the Emergency Medical Treatment and Labor Act (EMTALA), and the Health Insurance Portability and Accountability Act (HIPAA). According to the study, a glance on many federal regulations concerning health care intend to prioritize patients. The two federal regulations, however, cause problems in operations. The study explore the impacts of these regulations (Gasper, 2010).
EMTALA sets guidelines on how and when patients may be refused in a health care facility or transferred to a more appropriate facility. HIPAA, on the other hand, standardizes the electronic data handling and insures health coverage when one loses his job. It also aims to protect patients by ensuring their privacy or their confidentiality by eliminating paper trails. (Gasper, 2010).
Among the many provisions of EMTALA is to prohibit health care facilities from refusing treatment regardless if the patients cannot pay nor their race, gender, age and such. EMTALA also prevents patient dumping by providing guidelines. EMTALA also requires a medical screening done by a medical person before any patient transfer. EMTALA, however, failed to define the parameters of these medical screening nor what qualifies as a medical person and leave the interpretation to the health care organizations. A health care organization may interpret this medical screening as a mere collection of basic insurance data or a full examination by a physician. Either way, complications are present. The medical screening delays treatment time, especially in emergency cases. Moreover, EMTALA also sorts patients according to acuity wherein if one’s condition is not considered an emergency, other patients with more pressing medical concerns may be prioritized (Gasper, 2010).
These findings may have been influenced by the experience of the researcher who happens to be a licensed attorney in hospital operations. The perspective is more of a legal perspective. Thus, the concerns were mainly focused on the liabilities that a health care organization may have in regards to the federal regulations. Patient safety was also a concern, but it is addressed as part of a legal responsibility rather than an ethical and moral obligation to the patients. Likewise, EMTALA and HIPAA, help in the instructional aspect of many health organizations. They set guidelines that may minimize any ethical and legal dilemmas such as being left untreated which equates to patient safety.
The Patient Protection and Affordable Care Act (PPACA)
One of the ethical concepts that had been promoted so that all may receive high quality health care without compromising their basic rights is the Patient Protection and Affordable Care Act or PPACA that was officially enacted in 2010. The act aims to provide guidelines as to what major stakeholders, such as the state and consumers, what they must do by 2014. Among these guidelines are guidelines on insurance coverage, and costs control (Sorrell, 2012).
The particular publication or study by Sorrell is more of a conceptual study rather than an empirical study. This study is basically a discussion of the ethical perspective in the health care system. As such, it was discussed that there are different priorities when the health care is talked about. It is never just about quality, there are many other fundamental goals that reforms wish to address such as affordability and freedom of choice. Moreover, the study also discussed the ethical considerations that are related to the act and the responsibilities that are expected to be fulfilled by health care professionals. The PPACA abolishes the perception by many that receiving quality health care is a privilege or an option. Instead, it had established that a quality health care that will ultimately help patients achieve patient safety is a right and that it is the moral responsibility of health care professionals to provide for them (Sorrell, 2012).
The interpretation of the ethical perspective have come from a senior nurse researcher. The view on this act is rather appropriate to come from one of the people that provides health care. If this is how all health care providers had interpreted the PPACA, then there is a high chance that patient safety may improve in the near future.
Making Health Care Safer: A Critical Analysis of Patient Safety Practices
A study was aimed on collecting relevant information for improving patient safety. Their search strategy and selection criteria were disclosed in their research paper. They had gathered their information through a thorough survey of literature, and consultation to many experts that are concerned with patient safety. Moreover, studies that are useful to the research were identified in many databases such as PsycINFO, INSPEC, and MEDLINE. In essence, their sources are a combination of Internet searches of published studies and facts from experts. As for the data collection, they had included data from clinical trials, and observational studies. They analyzed the data by sorting them based on the strength of their evidences (Shojania, Duncan, McDonald & Wachter, 2001).
The research study arrived at a highly variable result as their research had been a collection of many patient safety concepts. They reported 11 practices that were implemented in a wider scale. Among the 11 practices are the following: (a) prevention of venous thromboembolism by prophylaxis, (b) prevention of perioperative mortality and morbidity by perioperative beta blockers, and (c) prevention of infections when placing catheters by using sterile materials (Shojania, Duncan, McDonald & Wachter, 2001).
Furthermore, the study arrived at a conclusion that several practices may improve patient safety and that strict implementation in some practices may solve a variety of patient safety problems. The study also suggested that further research be done as there is a gap in the evidences that they had acquired (Shojania, Duncan, McDonald & Wachter, 2001).
The findings of the research may have been influenced by the volume of data that the researchers had tried to evaluate. They could have provided more critical evaluation of the different patient safety procedures if they limited their scope and focused their attention to specific areas. They covered a huge part of medical practices that concerns patient safety such as operations or surgeries up to consultation. Nevertheless, the study presents certain areas that need to be improved to attain patient safety that may be useful in future reforms.
Conclusion
The topic concerning patient safety was selected as it is the goal of health care providers to minimize any harm that may be inflicted to the patients. The health care sector will be rendered useless if they continue to inflict harm on the patients or disregard patient safety. As such, this paper had surveyed related literature that are concerned with the ethical and legal concepts that are required to deliver high quality health care that promotes patient safety. These survey of related literature had revealed that even though there may be efforts to improve patient safety in the form of federal regulations or safety practices, patient safety is not yet assured. These practices and acts had just merely provided the comfort that one should have as they walk in a health care facility. These are merely Band-Aid solution to a problem. What must be done is a comprehensive review of cases that compromised patient safety and from there formulate reforms with one goal in mind—high quality health care for patient safety.
References
Ballard, K. A. (2003). Patient Safety: A Shared Responsibility. Online Journal of Issues in Nursing, 8(3). Retrieved February 7, 2016, from http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Volume82003/No3Sept2003/PatientSafety.html
Duffy, B. (2010). First, Protect the Patient from Harm. Patient Safety and Quality Healthcare.
Gasper, P.M. (2010). The Impact of Federal Regulations on Health Care Operations. Annals of Health Law, 19(1). Retrieved February 7, 2016.
Hospital Errors are the Third Leading Cause of Death in U.S., and New Hospital Safety Scores Show Improvements Are Too Slow. (2013). Retrieved February 07, 2016, from http://www.hospitalsafetyscore.org/newsroom/display/hospitalerrors-thirdleading-causeofdeathinus-improvementstooslow Institute of Medicine. (2001). Crossing the Quality Chasm: A New Health System for the 21st Century. Washington, D.C.: National Academy Press.
Mitchell, P.H. (2008). Defining Patient Safety and Quality Care. National Center for Biotechnology Information. Retrieved February 7, 2016, from http://www.ncbi.nlm.nih.gov/books/NBK2681/
Shojania, K., Duncan, B., McDonald, K. & Wachter, R. (2001). Making Health Care Safer: A Critical Analysis of Patient Safety Practices.
Sorrell, J. (2012). Ethics: The Patient Protection and Affordable Care Act: Ethical Perspectives in 21st Century Health Care. OJIN, 18(1).
World Health Organization. (n.d.). What is Patient Safety? Retrieved February 7, 2016, from http://www.who.int/patientsafety/education/curriculum/who_mc_topic-1.pdf
