Healthcare Compliance

Subject: Health Care
Type: Evaluation Essay
Pages: 5
Word count: 1449
Topics: Medicine, Nursing, Public Policy, Work Ethic

Rules and regulations are fundamental in the day to day cohabitation in the different areas. There are key principles that are used during the formations of rules of different instances and institutions. Each institution or situation usually calls for a different approach during the formulation of the regulations. However, the basic core principles are frequently similar as the primary intention of rules and regulation is ensuring there is orders and protocols are followed. 

Without rules and regulation, frequently there is lawlessness where protocol is usually not adhered to by the individuals in that particular situation. It is important to note that the level of strictness of the rules and regulations is usually different depending on the situation the rules are being applied. One of the areas that have strict rules and regulations is the health sector. Due to the sensitive nature of the operations of healthcare practitioners, they have strict rules and regulations as they are involved in human life. Due to the sensitivity of their work, extra precaution is taken by provision of precise and strict rules and regulations. 

In order to sufficiently comprehend the rules and regulations instilled into the healthcare sector, it is necessary to address the regulatory compliance of different healthcare institutions.  Importantly, healthcare compliance is a progressive process of attaining or surpassing the ethical, professional and legal standards applicable to a particular healthcare institution. Healthcare compliance is one of the earliest forms of healthcare regulations where there were the minimum standards for the case of surgery facilities that was instituted by the American College of Surgeons in 1918 (Al-Tawfiq & Pittet, 2013). It is vital to note that for an operative healthcare compliance program mandatorily, has to address the following key areas. 

It has to address the development implementation and distribution of written standards of the proposed conduct of the written policies and the central procedures that describe the institutional commitment to achieving the ethical and legal standards applicable to the institution. Also, there is the description of a position of a chief compliance officer and other relevant committees and people that will be responsible for the working and monitoring the compliance program who will only report directly to the institution’s chief executive officer and the relevant governing body (Seddon & Currie, 2013). Additionally, the program must cover the development and delivery of current employee education and training courses. 

The compliance program has to have the development and maintenance of operational forms of communication that will permit individuals to report compliance issues without any forms of retaliation that includes the anonymity. Moreover, the compliance program needs to address the formulation and application of a process that responds to complaints that consist of the imposition of fitting corrective action including discipline of workers when necessary. It has also had to address use of internal monitoring and audits that measure compliance. Finally, the compliance program has to address responding appropriately and rapidly to detect offenses and quickly executing corrective action. 

There are various noncompliance incidences that occur in healthcare institutions that result in hefty fine and other stipulated punishments as per the healthcare compliance. One instance of noncompliance includes public discussion with patients about their health. This may result in their private medical condition being leaked to individuals who are not privileged to such information. Another instance of noncompliance is the release of medical records to financial institutions such as banks who if they learn that their client is seriously ill, it can prompt them to fasten their efforts in recovering current loan (Maningat, Gordon & Breslow, 2013). Moreover, gossiping about patients with ordinary people by healthcare practitioners is considered as an act of non-compliance by the physicians. Careless disposal of patient’s records that they can be accessed by unauthorized personnel. In all these instances, the patient’s confidentiality is not safeguarded making the patient vulnerable and susceptible exploitation. Medical records are personalized information that should only be accessible relevant medical practitioners and the patient.     

Instances of noncompliance in the healthcare institutions are usually quite expensive both the institutions and the doctors who practice in the various institutions. It is therefore vital to ensure that these instances are limited through the implementation of various key policies. It is the sole purpose of these policies to ensure that physicians carry themselves according to ensuring they do not violate any form of compliances as stipulated by the specific medical institution. Implementation of these policies sole purpose is to offer guidance to medical personnel have a definitive description of the manner they have to carry themselves (Al-Tawfiq & Pittet, 2013). Different measures to limit instances of noncompliance are usually used in different healthcare institutions depending on their criteria of operations. 

Ideally, there are five strategies that can be used in reducing instances of noncompliance. Diagnosing the problem is one great way of averting cases of noncompliance. Collection of data is done using specialized surveillance systems, hence analyze the core causes of compliance risk (Maningat, Gordon & Breslow, 2013). This ensures the various situations that may result in noncompliance are identified and create relative strategies that can combat occurrence of such situations. Another strategy used in combating occurrence of noncompliance in the healthcare organizations is definition of the goal clearly. Developing an action plan for transforming the portfolio, and policy changes should be done.

Patients in some occasion usually enter into contract with a healthcare institution. It is the responsibility of the health institution to adhere to the contract regardless of personal input towards the contract. There are different contracts that a patient can enter into a healthcare institution. There are instances that medical personnel habitually see it not fit to execute the requirements of a contract due to their personal views. One of the great controversial contracts is the Do Not Resuscitate contract also known as DNR, which is a contract which a patient who is terminally ill usually signs. Once signed, this contract typically prevents any medical officer from resuscitating a dying patient (Maningat, Gordon & Breslow, 2013). Regardless of the inhumane nature of the contract, it is the responsibility of all the physicians who are affected by the contract to abide by it.  

It is important to adhere to the rights of patients in regards to contracts. A contract is an agreement that ensures the contents of the contract adhere hence the best interests of the patient are safeguarded. It is hence vital to ensure the rights of the patients as per the signed contract is respected. Statistically, the patient safety has not improved over the past few decades where there is emphasis on improving it in the various hospitals (Maningat, Gordon & Breslow, 2013). However, efforts at improving the safety of the patient must be attuned to the changes in the organization and delivery of care that began about ten years ago with continues to accelerate. It is evident there is need for more implementation of policies in order to achieve the desired safety standards to meet the current patients’ needs. 

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There are different patient safety issues that are evident in American hospital. One major characteristic issue evident is the barrier to physician behavior change. This property results in physicians failing to follow the stipulated clinical practice guidelines. It is vital to comprehend that the provision of guideline is key to ensuring that the proper protocols are followed in ensuring the patient receives the best medical service from the physician. Another major issue that may threaten the patient’s safety, is the lack of familiarity by the physician (Flanders et al., 2009). A physician who is not familiar with the practice may endanger the life of the patient if there is misdiagnosis. 

Additionally, lack of agreement with guidelines may be a major issue that may affect the patient’s safety as the main role of the guideline is to safeguard the patient. Finally, lack of motivation can greatly affect patient’s safety. If the physician is not motivated by his, or her work in assisting the patient, the service rendered to the patient will not be satisfactory (Flanders et al., 2009). American patient safety as compared to similar nations, America is far ahead in addressing patients’ safety. With the increase of hospitalists and implementation of policies, America is making tremendous progress in ensuring patients are safe as compared to other nations.

The policy makers the various healthcare managers strived to improve the patients’ safety through the implementation of various crucial strategies.   One strategy executed by the managers is the dissemination of knowledge and best practices among members (Flanders et al., 2009). There were numerous meetings where participants from different health systems unveiled a quality improvement or a safety intervention that they would implement in different situations that they may face. 

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  1. Al-Tawfiq, J. A., & Pittet, D. (2013). Improving hand hygiene compliance in healthcare settings using behavior change theories: reflections. Teaching and learning in medicine25(4), 374-382.
  2. Flanders, S. A., Kaufman, S. R., Saint, S., & Parekh, V. I. (2009). Hospitalists as emerging leaders in patient safety: lessons learned and future directions. Journal of patient safety5(1), 3-8.
  3. Higgins, A., & Hannan, M. M. (2013). Improved hand hygiene technique and compliance in healthcare workers using gaming technology. Journal of Hospital Infection84(1), 32-37.
  4. Maningat, P., Gordon, B. R., & Breslow, J. L. (2013). How do we improve patient compliance and adherence to long-term statin therapy?. Current atherosclerosis reports15(1), 291.
  5. Seddon, J. J., & Currie, W. L. (2013). Cloud computing and trans-border health data: Unpacking US and EU healthcare regulation and compliance. Health policy and technology2(4), 229-241.
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