A not-for-profit hospital in Nebraska paid its patients $100 to render positive remarks on the Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey concerning the health care services received during their visit. High consumer ratings on quality of care and patient safety meant the hospital would be eligible to receive increased financing (from the state of Nebraska) for the upcoming year. Ethical?
A regulatory compliance and quality assurance agency gave a Managed Behavioral Health Organization (MBHO) in Florida a “one-time point allowance” to retain their accreditation status during their most recent audit. The compliance agency understood and empathized with the fact that the MBHO had recently acquired a new leadership team within the last year that negatively impacted the MBHO’s operations. Accreditation results are publicly reported. Ethical?
Would you agree that neither of the aforementioned scenarios are ethical? Ethics are described as the moral principles and values that govern a person’s (or entity’s) behavior or the conducting of an activity.1 Over the past decade, quality of healthcare has been an increasingly prominent area of focus; aside from the long-standing issues of cost, finance, and access. Ethics serve as the foundation of quality and extend well beyond an organization’s mission and values statement and code of ethics manual given during new-hire orientation. Healthcare ethics should be a culture, a patient’s expectation, and a clinician and healthcare executive’s mantra.
When healthcare is void of ethics, it strips transparency, trust, patient safety, and certainly has a direct impact on quality. How can an organization implement a quality improvement activity if their CAHPS results have been skewed and compromised? Furthermore, what is there to say about the integrity of the survey results that were publicly reported? The healthcare community has consumed erroneous information and are at risk due to misinformation and a lack of ethical practice. The fundamental ethical principles that drive the goal of providing high-quality healthcare are: autonomy (do not deprive freedom); beneficence (act to benefit the patient, avoiding clinician or executive self-interest); non-maleficence (do not harm); justice (fairness and equitable care); and duty & due-diligence (adhering to one’s professional and organizational responsibility).2
How does your healthcare organization ensure the fundamental ethical principles are practiced?