Laws concerning health care are key elements of in the organization and operation of the public health framework. In America, health laws are established by the federal system and other separate state legal systems. The federal and State constitution provides a basic framework for the establishment of health care laws by various branches of government.
Statutory laws are legislatively based and represent vast government policies such as authorization of government programmes and provision of resources for specific programmes. They are enacted by the Congress, states and legislative bodies at local levels. Local and states statute laws must be consistent with the state constitution. State laws also function to establish roles of various legislative subunits such as county commissions and city councils (Curtin, 2011). The state legislative subunits create laws concerning public health both at local and state level. These laws are designed to establish health departments and boards of health as well as to delineate their responsibilities. Enforcement of these rules is through governmental agencies.
They are regulatory laws promulgated by the executive branch via administrative agencies. The agencies develop specific regulations from the extensive policies enacted by either the Congress or state legislatures. Such a mechanism permits flexibility of the laws of design, operation and subsequent revision. Administrative agencies include commissions and cabinet-level departments. A unique aspect of regulatory laws is that they have the full executive and judicial powers (Curtin, 2011). They must, therefore, be consistent U.S. Constitution and all statutory authorities.
They include a collection of legal customs, traditions and judicial rulings of state and federal courts. Previous court decisions guide the judgment on related disputes to ensure consistency especially in areas where legislative bodies are yet to codify laws. For example, laws on public nuisance are determined by a review of previous court rulings (Curtin, 2011). The previous rulings determine specific conditions and circumstances that constitute public nuisance.
Establishing a Safety Culture
Curtins article, Quality Improvement, Patient Safety and Efficiency in Outpatient Practice provides an integrated approach to quality concepts that are useful in the improvement of healthcare services. In chapter four, Curtin describes the concept of establishing a safety culture in medical practice. According to her, many human errors are attributed to systematic biases that are largely beyond human consciousness. Systematic biases make humans fallible and prone to making errors. Inadequate sleep, being unhappy, overconfidence and being memory dependent also contribute to human errors (Curtin, 2011). According to Curtis, humans can minimize errors by understanding and avoid the leading causes of errors. In case of a medical error, the cause must be investigated to avoid a repeat of a similar error.
Local culture and safety culture are essential in improving patients safety. Local culture creates a predictable pattern of daily activities in a workplace. An organization can either adopt a local culture that fosters unsafe behaviors or one that improves appropriate behaviors in a workplace (Curtin, 2011). A culture of safety improves when an organization develops and adopts appropriate local culture. Assessment of a safety culture begins with an evaluation of the current culture of safety in practice. It is evaluated by seeking opinions from staff members about patients safety culture, quality of healthcare, working conditions, stress recognition among other factors. Participants respond to questionnaires which are reviewed by appropriate organizations. The organizations provide recommendations for assessment.
A just and fair culture promotes improvement opportunities through which staff members can learn from their mistakes. In case of an error, all factors such as human factors and system components contributing to that error are reviewed (Curtin, 2011). This practice encourages staff members to report errors and evaluate system flaws. It enables the management to dispense disciplinary actions in a just and fair manner.
According to me, the most essential practice in establishing a safety culture is an assessment. Assessment of a safety culture provides first-hand information on critical issues that influence the safety of patients in a particular organization. The information enables the management to establish improvement projects and to measure annual changes after intervention programmes.
Accountability is a major issue of concern in health care. At its most general, accountability is about individuals who are responsible for a set of activities and for explaining or answering for their actions (Shannon, 2017). As such, authority or a governing body such as healthcare board has the mandate to ensure that organizations meet a certain objective or set goals. One domain of accountability in health care is based on professional competence, legal and ethical conduct, public health promotion, and financial performance (Parker, Smith & Feek, 2010). Different models characterize the domain of accountability in various ways. The professional model illustrates the shared decision making among professional colleagues and the patient. In the economic model, the market is brought to bear in health care, and accountability is mediated through consumer choice of providers (Pekkinen & Aaltonen, 2015). In light of the economic model, the healthcare industry adopted risk management to mitigate malpractice crisis.
Healthcare risk management enables organizations to implement effective strategies that assist in minimizing or prevent undesirable practices. Currently, healthcare organizations utilize a centralized incident management and reporting system (Shannon, 2017). This system promotes accountability by improving communication across departments. For example, the reporting system can help determine the point of breakdown between a laboratory and a nursing department. Risk management also entails patients safety and provision of quality health care by promoting accountability of individual staffs (Bromiley, Michael, Anil & Elzotbek, 2015). It also collaborates with legal departments to investigate adverse cases and to ensure compliance with specific State laws. In promoting patients safety, risk management integrates with quality management programmes to reduce the occurrence of adverse effects due to medical errors.
Hindsight bias is a common cause of medical malpractice and amounts to medical negligence. It is induced by subconscious desires where an expert assumes to be highly knowledgeable, ambiguous and intelligent. Factors attributed to hindsight bias are easy to recognize an error but are inevitable before the error occurs.
Bromiley, Philip, et al. "Enterprise Risk Management: Review, Critique, and Research Directions." Long Range Planning 48.4 (2015).
Curtin, M.A. (2011) Quality Improvement, Patient Safety & Efficiency in Outpatient Practice. Chapter 4, pages 41 to 57. http://www.ashrm.org/pubs/files/Quality-Manual-Final-Links-Verified-updated-2012.pdf
Pekkinen, L. and Aaltonen, K. (2015) Risk Management in Project Networks: An Information Processing View. Technology and Investment, 6, 52-62.
Shannon, L., N., R., D., J., & N., B. (2017). The Purpose and Goals of Risk Management. Slideshare.net. Retrieved 9 November 2017, from https://www.slideshare.net/Msfent1/the-purpose-and-goals-of-risk-management-4159859
The Role of Risk Management in Healthcare Operations. Sharon Hall (October 2010) Parker, Smith & Feek. http://www.psfinc.com/press/the-role-of-risk-management-in-healthcare-operations
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