Research Paper on "Ethical Analysis Looking Into Palliative Care Strategy"

Research Paper 10 pages (3295 words) Sources: 10

[EXCERPT] . . . .

According to the publication, authentic leadership denotes the adhesive required for holding a positive workplace environment together. Authentic leaders' relationships and roles in a good workplace setting are well-defined. A more comprehensive definition of the authentic style of leadership covers the attributes of kindness, authenticity, honesty, consistency, and credibility. One tactic authentic healthcare leaders can employ for fostering a healthy clinical atmosphere is engaging staff in the workplace environment for promoting positive behaviors. Healthcare organizations need to advance a practical guidebook that details how one can become an effective authentic leader. A research plan for further research into the leadership style termed as authentic nursing leadership via collaboration between business and nursing needs to be developed (Shirey, 2006). This would aid in sustaining a better workplace atmosphere for palliative care workers.

Clarity in code of conduct

The nursing ethical code appears to have scant value in the resource allocation context. Therefore, well-defined guidelines must be formulated for palliative care nursing leaders, and must function as a tool in making ethical decisions concerning resource allocation matters and, further, to integrate economically efficient activities, and superior care quality. Leaders have to ascertain that all employees are familiar with the organization's ethical code (Aitamaa et al., 2010).

Proper Education

Education marks a key element. The aspiration to perform more efficiently, be ethically competent, and create a common, powerful foundation for thinking ethically in overall nursing management and practice is of utmost import. Extensive discourse in connection with healthcare-related values is also required, which has to be held at the organizational as well as societal level. Nurse leader participation in this discourse is imperative. They should be allowed to voice their opinions for solutions that serve themselves, organizational stakeholders, the nurses working under their wing, and society. This is very vital, particularly in scenarios wherein healthcare resources and structures are reassessed owing to societal transformations (Aitamaa et al., 2010).

Communication to move strategy forward

Strategy development is necessitated in case of change, introduction of a novel service, or improvements to any existing service; it can entail both minor and major changes. However, any change requires the presence of certain elements. Even trivial modifications may have an impact on care quality (Rowe, 2008). Communication of strategy implies communication of change. Vital to strategy communication is the ability to bring into line the scope and extent of change, and implementation approaches with principles and values described in the relevant policy record (Jones, 2008). As an executive nursing leader, my preferred mode of communication is via letter.

December 9, 2015

Dear Dr. Stanley,

The purpose of this letter is to voice my frustration over the team from palliative care organized for formulating strategies to perform ethical measurements in EOL care. A number of strategies were formulated, which team members agreed to. Yet, numerous ethical issues continue to be a source of concern for staff members, which adversely influence hospital performance. In this letter, I wish to outline some factual details, which will explicitly prove the fact that adoption of clear-cut guidelines and ethical code, education, and authentic leadership, in the palliative care context is positive and beneficial.

Primarily, delivering care to patients asking for euthanasia would prove challenging if it is not permitted. Hospital departments would prevent admission of patients and subsequent care delivery, which could really help change the patient's decision. Such patients would continually be shifted between departments, which is, in fact, akin to abandonment. Patients and their families may feel desperate (Bigler, Jean-Michel, et al., 2006). Hence, this approach must be allowed, since it is sensible, and does not amount to or causal to shorten patients' life.

In addition, I wish, as a nurse leader, to convey my opinion that critical patient decisions (e.g., decisions pertaining to life support) mustn't be taken independently by nursing staff. Leaders' and doctors' involvement is absolutely compulsory. Thus, hospital management must prove all personnel with clear-cut guidelines in this regard.

Furthermore, authentic leadership is a vital requirement, for an enriched workplace atmosphere for staff members, as it fosters an orderly working structure and reduces palliative care-related complexities and stress. Moreover, the ethical code instituted by hospital management is not being properly adhered to; this also negatively affects hospital performance. Thus, all hospital personnel must abide by them, and management should establish strict regulations for penalizing those who fail to adhere to them properly. This will serve to reduce hospital death rate, and to organize patient progress in a holistic manner.

Finally, an essential requirement for each healthcare worker is education. Adequate recruitment must be done, without any compromises on training, educational qualifications, and experience. Also, the palliative care division must arrange routine training sessions to ensure that staff is well informed and up-to-date about recent medications and technology.

Effective networking and communication is required for efficient, proper team functioning, as it will have greater benefit. Furthermore, serious issues require a powerful team. The information I have presented explicitly reveal the need to make some significant changes. But for resolving the disagreement among team members, I would, being a team leader, like for you to aid in negotiations between Dr. Blank and members of the palliative team, for swift resolution of conflicts and immediate implementation of strategies. Additionally, it is imperative for all personnel to adhere to new rules, and therefore, I request you to delegate the authority of levying strict rules for improving overall performance.

Awaiting your kind response

Yours sincerely,

Minnie L. Davis, ARNP

Conclusion

Most of the work carried out by my coworkers, collaborators, and me, revolves around reforms to healthcare policy and private sector, as well as private-public collaborations for supporting patients and healthcare providers in improved care delivery. As a senior palliative-care nurse leader, I head numerous endeavors connected with bettering healthcare value and innovation. My focus is surmounting the practical barriers encountered in the implementation of quality measures, followed by applying them for care improvement. Formerly, I supervised the application of several reforms concerned with quality, including providers' quality reporting and experience of patient for reducing general realty rate (McClellan, 2013).

In recent times, however, tremendous progress has been made in regards to supporting superior quality care. Medicare has built on Congressional support and bipartisan rules, and instituted systems for care quality reporting for healthcare providers. Never-before-seen activity surrounds quality measure development, owing to public support, private agencies such as the National Committee for Quality Assurance, the Physician Consortium for Performance Improvement of the American Medical Association, and AHRQ (Agency for Healthcare Research and Quality) and CMS (Centers for Medicare and Medicaid Services) initiatives. Significant steps have been taken by the NQF (National Quality Forum), including facilitating prioritization of implementation and development measures and, in particular, ratifying quality measures for supporting consistent application of well-understood, significant measures (McClellan, 2013).

Currently, several different quality improvement programs are underway at local, state, regional, and federal levels of America's healthcare structure, as well as within hospitals and other healthcare facilities, which are applying quality measures. Quality improvement programs across and within healthcare facilities are central in this regard. They necessitate measurement for identifying opportunities to improve, usually by means of registries enabling providers to track and evaluate how patients fare concerning core care components and likely complications for identifying areas to improve. Further, quality measures are being employed in the context of payment reforms as well, which may help healthcare professionals receive more resources for taking steps in the form of establishing registries and putting other changes into practice in patient care delivery, for avoiding needless expenses and improving care. As an example, fee-for-service Medicaid, Medicare, and private sector payments have, in the past, offered little financial assistance for a number of activities that may possibly lower costs and enhance patient care. Examples include: answering patient emails or phone calls for avoiding the time and cost associated with a visit to the office; devoting time to implement care coordination systems for avoiding inappropriate or duplication of services; and devoting more time to complex patients (or establishing a patient care team comprising of non-physician healthcare workers, nurse practitioner, and pharmacist) for improving adherence to medication, lifestyle modifications, or other steps in care management that may allow disease prevention or progressing of patients' health risks. Medicaid, Medicare, private payers, and employers, all agree to a series of reforms in payment for offering enhanced support for these types of activities, often in combination with quality measure application. Lastly, an increasing adoption of quality measures is witnessed in the area of public reporting, because of national Medicare-supported efforts and remarkable regional efforts, like Minnesota Community Measurement, Puget Sound Health Alliance, Pittsburgh Regional Health Initiative, Wisconsin Collaborative for Healthcare Quality, etc. (McClellan, 2013).

USA's healthcare structure still needs to do a lot of work in the area of quality measurement. A number of key, current quality measures have not been implemented… READ MORE

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