HS450 Strategic Panning and organizational development for health are

H S450 - Un it 8 Assign me nt Et hics and D ec isio n-M ak ing in t he VA H ea lthca re System Cour se Outcome HS 45 0-5: Evaluate the impa ct of ethical decis ion-ma king on hea lthcare l eade rship to ma xim ize strat egic plann ing Unit Outcom es  Disc uss th e principl es of ethics and medical prof essio nalism in strat eg ic plann ing.  Exam ine the ro le of leade rs in ethical de cis ion-ma king and problem solving strat egies in the U.S. hea lth system . GEL-7.7: Ana lyze th e effects of ethical de cis ion ma king on the field of study. Unit 8 Ass ignm ent Ca se St udy: Probl ems at the VA Hea lth System In 200 9, Presi den t Barack Obam a appointed retired Army Chief of Staff, General Er ic Shins eki, to the position of s ecret ary of Vetera ns Affairs (VA), t he f ede ra l de partm en t re sponsible for p rovidi ng hea lthcare and fede ral benefits to U.S. vetera ns and de pen den ts. As part of its strategic plan, Secret ary Sh ins eki was tasked with implementing 16 major initiatives to bring th e VA i nto the 21st century. One of the 16 initi atives was the en ha nce ment of the vetera n’s expe rience with an d acc ess to hea lthcare. In 201 3, CNN was amon g th e ne ws ou tlets repo rting that veterans were expe rien cing de layed care at the W illiam s J enn ings Bryan Dorn Vetera ns M edical C en ter in Columb ia, SC. In fact, the de lays were so serious tha t six vetera ns died while waiting for m on ths to rec eive necess ary diagno stic pro cedu res. The VA l aunched an investi gation into the GI clinic at Dorn and foun d several issu es, inclu ding low staff cen sus; leade rship turn over t hat res ulted in a lack of unde rst and ing of roles, responsibil ities and system proc esses; and ineffective pro gram c oo rdin ation . Allegations of lon g wait time s also eme rged from VA facilities in Ar izona , Pi ttsbu rgh, and the Pho enix VA H ea lth Care System . De lays, ho wever, were no t the only shortcomings alleged . In the P ho enix VA H ea lth Care System , for instan ce, the re were cl aim s of man ipu lated pa tient wait tim es, bad sc he duling practices, and patient dea ths. In 201 4, the Office of the Inspe ctor G ene ral (OI G) laun ched an investi gation into the se allegation s. Two que sti on s were add ress ed in this re view: 1. Did th e facility’s elec tro nic wait list ( EW L) purposely om it the name s of vetera ns waiting for care and, if so, at whose directi on? 2. W ere the deaths of any of the se vetera ns re lated to de lays in care? The investi gators co nfirme d “inapp ropriate sche duling iss ue s th roughou t the VA and hea lth care s ystem ” (VA 20 14, iii). In the Phoenix VA, spe cifically, investigators f oun d that 1,400 vetera ns did no t ha ve a prima ry care appo intme nt bu t were list ed on the EW L. It was also determined that 1,700 vetera ns were waiting for a prim ary care ap point ment bu t were not listed on the EW L. Becau se vetera ns were no t on the EW L system , the Phoen ix lea dership si gnifica ntly unde rsta ted the ti m e ne w pa tients waited for t he appo intme nts. The investi gators foun d that the avera ge wait tim e was 11 5 da ys fo r t he first prim ary care appo intme nt and abou t 84 pe rcent of the se pa tients waited m ore than 14 da ys. The Office of Inspector General (O IG) identified mu ltiple type s of sc he duling practices tha t we re not in com pliance with Veteran s Health A dmin istratio n po licy. Since the mu ltip le lists found were some thing othe r tha n the official EW L, the add itiona l lists m ay be the ba sis for allegation s of “secret” wait lists. Secret ary Shins eki called the findings “rep rehensibl e” a nd resi gne d from his po st on May 30 , 2014 . Ca se Study Que stions 1. From a leadership persp ecti ve, analyze th e pro blem s at the VA re lative to ethical decis ion making practices. 2. Disc uss the ethical iss ue of having 1,700 vetera ns, who were no t listed on the EW L, wait fo r a prima ry care appo intment at the Pho enix VA. Crea te at lea st two (2) policies /stan dards to en sure ethical leadership practices with respect to improving coordination of the EW L and primary care appointments . 3. Explain why Se cret ary Eric Sh ins eki resi gne d his po siti on. Ide ntify at least two (2) alt ernative op tion s that Secretary Shins eki could have taken to re solve the une thical de cis ion-ma king pra ctic es in this c ase stud y. 4. Apply th e Ame rican Colle ge of Hea lthcare Executives (ACHE) Co de of Ethics to the VA He alth System case stud y. Requir em ents : ● Plea se c omple te Ass ign men t in a Microsoft W ord do cument. ● The bo dy of you r do cumen t shoul d be at lea st 150 0 words in length. ● Quo ting s hou ld be less tha n 10 % of the en tire pape r. Paraph rasing is necess ary. ● Stu den ts must cite an d r eferen ce at lea st 4 cr edibl e s ources. ● APA form at is re quired. ● For su pport access Kaplan W riting Cen ter or Res ou rces Do cum en ts fo und in Doc Sha ring. Submit Ass ignm ent Subm it as: Microsoft® W ord® do cum en t to the appro priate Dro pbox.