Ethical and Legal Implications in Healthcare: Case Study Essay

Introduction

Building an effective team is crucial for a healthcare organization’s functioning because most patient outcomes depend on multiple employees’ collaborative work. Doctors, medical assistants, and nurses build their careers by working at the same facilities for many years. Although the tendency is beneficial for efficient operations as people know each other well, the drawbacks are severe and disruptive conduct they develop and maintain (Gittell et al., 2020). Indeed, when the new employees arrive and identify these inter-team issues, they face unwillingness to change the inhabited behaviors. Conflicts and incidents inside a team can lead to a lower quality of healthcare delivery; thus, the risks of severe patient outcomes occur and can cause serious consequences (Gittell et al., 2020). This paper aims to explore the selected case study, and discuss ethical and legal implications for outpatient family practice employees, their influence on patient outcomes, and strategies to improve the collective’s culture.

Potential Implications for Medical Assistant

The medical assistant (MA) is responsible for registering and forwarding the information crucial for differential diagnosis and patient exam. Their failure to deliver the data can lead to severe patient outcomes and disciplinary penalties depending on the internal regulations and the missing mention of crucial details. In the selected case, MA did not notify a nurse practitioner (NP) about a patient’s low blood pressure because they were distracted by the confrontation between the two other employees. The situation signals the collective’s inability to cooperate correctly, and issues in the team can cause the worsening quality of healthcare services and severe patient outcomes (Brain et al., 2017). In the case of MA failing to deliver crucial information to NP, the result could be an incorrect differential diagnosis, prescribing the wrong medication, or making procedures prohibited with low blood pressure.

If harm is done to a patient, all healthcare workers who interacted with them would have to get through ethical and legislative implications. From the ethical perspective, MA’s actions increased the risks of the adverse impact of the services, could cause conflict between physical and patient and violated the moral principle of non-maleficence (Rosen et al., 2018). From the legislative perspective, MA’s implications would be faced if their mistake is proven as the cause of severe patient outcomes (Brain et al., 2017). Penalties depend on the local regulations and the jurisprudence between the healthcare system and the facility where the incident occurred.

Potential Implications for Nurse Practitioner

NP’s responsibility is significant because of their direct and complex interaction with the patient. Consequently, that representative would be the primary individual to be checked if bad outcomes occur. In the given study, NP is the newest employee, and, considering that the team experiences difficulties in cooperation, they might be blamed for an incident. The practitioner must know their rights and zones of responsibility to avoid irrelevant accusations (Farokhzadian et al., 2018). NP noticed that MA did not timely mention vital conditions, yet if the case were analyzed in retrospect, no evidence of the latter’s mistake would be proven. The case study’s scenario puts a practitioner in dangerous circumstances, and the unhealthy workplace environment, overall stress, and intense outpatient facility load might cause inadequate results.

NP’s work is based on communication with patients and gathering sufficient information for assisting a physician in further treatment. From the ethical perspective, their decision-making must be found on the principles of non-maleficence, efficiency, and beneficence (Farokhzadian et al., 2018). Conflicts among other employees that are risky for patient outcomes might force NPs to act unethically towards their colleagues or provoke challenging situations in their practice. The implications, such as more difficulties working in the team, would appear in the selected study and make a practitioner deal with ethical dilemmas. The legislative aspect of the severe patient outcomes would require clarification with the Board of Nursing and its local representatives (Peter, 2018). They would decide if the NP failed to fulfill their responsibilities in performing exams, recording the symptoms, providing urgent treatment, and delivering the necessary information to physicians. The implications a practitioner might face in the given study are tied to their healthcare system’s legislative departments and might include fines and suspension from working.

Potential Implications for Medical Doctor

Medical doctor (MD), or physician, has significant authority in an outpatient care facility due to their treatment and patient outcomes responsibilities. It is common for MDs to have leadership positions at departments, quality improvement boards, and employees’ unions, making them valuable decision-makers (Manzoor et al., 2019). In the case study’s scenario, MA’s failure to report vital signs could lead to physicians’ doubts or mistakes considering the treatment and the following serious patient outcomes. Consequently, a physician’s actions would be regarded as violating the ethical principles of non-maleficence and health maximization, resulting in inadequate healthcare costs, incorrect prescriptions, and the worsened relationships between them, NPs, and MAs (Manzoor et al., 2019). The implications depend on the severity of the outcomes, yet the primary concern of the selected study is patient safety, underdelivering which can lead to legal penalties.

From the legislative perspective, MDs have a considerable risk of receiving severe warnings and sentences. For instance, a physician’s legal duty is to perform with certain skills and have a specific scope of knowledge to operate (Peter, 2018). However, the missing information about a patient’s vital signs can lead to inappropriate mistakes for their level. Besides, complicated relationships and behaviors in their teams disrupt the working process causing unnecessary issues and worsening patient outcomes. If an MDs has been involved in a conflict with other employees that caused problems with patients,

Potential Ethical and Legal Implications for Practice

In the selected case study, outpatient family practice is part of an extensive healthcare system, and the implications depend on the department’s regulations. If tied to the security, patient outcomes worsening can be costly and challenging to handle (Peter, 2018). Indeed, in the given case, all involved individuals would not be able to deny their influence on the situation. If a patient sues the practice, physician and NP would be harmed the most, and the practice’s authority would be threatened. These implications are costly for an organization and require significant bureaucratic intervention from the local legislators’ perspective (Rosen et al., 2018). Furthermore, facilities that fail to work according to the fundamental ethical principles might become subjects of various interventions from the regulators, disrupting the normal working processes.

Strategies to Prevent Severe Patient Outcomes

The strategies to prevent the possible challenges must eliminate the root causes of many employees’ issues and include workable leadership tactics to maintain positive changes. As the study’s organization belongs to a large healthcare system, unions such as the quality improvement team can take action to decrease patient outcomes. Indeed, they can develop behavioral or practical interventions, set benchmarks and the apply their strategies through their authority (Peter, 2018). Ethical implications can be performed through penalties and educational events for the employees locally, while addressing the legal questions can require inviting legislators or expanding to the courts. Effective problem-solving is essential to decrease the frequency of patient security issues with the lowest firing rate possible to save an organization’s authority (Rosen et al., 2018). The strategies can include charges and temporary suspension; physicians and NPs can receive disciplinary rebukes and report their activities to the executives.

Leadership Qualities to Apply To Effect Positive Change

Strong leadership is the key to improving patient outcomes at outpatient family clinics because individuals in charge can simultaneously influence large groups of employees. In the selected case, change must be established on the behavioral level, and the leader is required to encourage the team to adapt the novel operational strategies (Gittell et al., 2020). The leadership qualities required for success are well-developed speaking skills, the ability to maintain motivation, and authority above the entire team.

Transformational leadership strategies are expected to be utilized to change the operations and improve patient outcomes effectively. The leader must know the measuring tactics for timely evaluation of the processes and address the challenges. In the case of issues or failures to change, practitioners, administrators, or physicians must know that they can reach the person in charge to explain the case and receive recommendations that align with the initial goals. Indeed, being open to communicating and adjusting the activities to increase their efficiency are the leadership qualities necessary for developing the culture of change in an organization (Gittell et al., 2020). Leaders also need to have the expertise in the unit’s specialization or knowledge of how their healthcare system works.

Conclusion

The case study revealed the importance of considering the legal and ethical implications of the personnel’s actions to maintain a practice’s efficiency. The strategies to prevent severe patient outcomes contain disciplinary measures, execution, and communicational approaches to encourage the employees to change their behaviors. Furthermore, strong leadership is necessary to maintain the culture of change until significant improvements are achieved. The leader’s qualities, such as open communication, encouragement, and authority, are required for effective execution.

References

Brain, M. M., Hackel, J., Stuart-Shor, E. M., & Dalton, J. (2017). Focusing on the role of a medical assistant in a team-based weight-counseling project in primary care. The Journal for Nurse Practitioners, 13(4), 185-190. Web.

Farokhzadian, J., Nayeri, N. D., & Borhani, F. (2018). The long way ahead to achieve an effective patient safety culture: challenges perceived by nurses. BMC Health Services Research, 18(1), 1-13. Web.

Gittell, J. H., Logan, C., Cronenwett, J., Foster, T. C., Freeman, R., Godfrey, M., & Vidal, D. C. (2020). Impact of relational coordination on staff and patient outcomes in outpatient surgical clinics. Health Care Management Review, 45(1), 12-20. Web.

Manzoor, F., Wei, L., Hussain, A., Asif, M., & Shah, S. I. A. (2019). Patient satisfaction with health care services; an application of physician’s behavior as a moderator. International Journal of Environmental Research and Public Health, 16(18), 3318. Web.

Peter, E. (2018). Overview and summary: Ethics in healthcare: Nurses respond. OJIN: The Online Journal of Issues in Nursing, 23(1). Web.

Rosen, M. A., DiazGranados, D., Dietz, A. S., Benishek, L. E., Thompson, D., Pronovost, P. J., & Weaver, S. J. (2018). Teamwork in healthcare: Key discoveries enabling safer, high-quality care. American Psychologist, 73(4), 433. Web.