Balancing Profit and Patient Safety Discussion

Balancing Profit and Patient Safety Discussion

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For-profit private organizations are frequently questioned for their dedication to patient outcomes and safety, especially in the healthcare industry. The experiences of a nurse working in the emergency department of HCA, the biggest healthcare system in the country, will be examined in this conversation, along with an examination of the organizational structure, culture, and difficulties encountered in maintaining patient safety.

According to the nurse, HCA is a varied organization with a centralized decision-making structure at the top that places a major focus on maximizing investor returns. According to the organization’s mission statement, patient happiness, safety, and inclusivity are given first priority (“Above all else, we are committed to the care and improvement of human life” – HCA Health Care, 2020, Code of Conduct, Mission & Value Statement). The nurse’s personal observation, however, highlights a contradiction between the language of the organization and the actual situation in the emergency department. Balancing Profit and Patient Safety Discussion

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The nurse draws attention to the difficulties in promoting patient safety in a business model that is for profit. Problems including insufficient staffing, low supplies, and operating with outdated equipment have a direct effect on patient care. Because of the hierarchical structure’s communication barriers, frontline employees find it challenging to be heard by decision-makers who are not directly involved in patient care. Additionally, despite the hospital being full, patient transfers are accepted, placing additional burden on the emergency room and highlighting the conflict between business and patient safety.

The nurse suggests a possible remedy to these problems, drawing on Han et al. (2021) studies on legally required nurse-to-patient ratios. The study asserts that the application of such ratios has a favorable effect on nurse satisfaction, patient care, and safety. The nurse makes the argument that if nurse-to-patient ratios are required, then it is feasible to keep the for-profit organizational structure. This strategy seeks to strike a compromise between the institution’s need to deliver the best possible patient care and its financial interests.

Follow-up Response 1

I find both parallels and discrepancies between the organizational structure and culture that the HCA nurse described and my personal experiences in a different healthcare setting. Similar to HCA, my company has a hierarchical organizational structure with a central decision-making body. But in contrast to the nurse’s experience at HCA, collaborative decision-making involving input from different staff levels is highly valued at my business. Balancing Profit and Patient Safety Discussion

The apparent conflict between business and patient safety that the HCA nurse mentioned is one obvious distinction. Within my organization, there is a deliberate attempt to strike a balance between a dedication to patient well-being and financial viability. Profit is obviously a factor in decision-making, but choices are made knowing full well that jeopardizing patient safety would eventually hurt the institution’s chances of long-term success.

I like the nurse’s recommendation to try federally mandated nurse-to-patient ratios as a possible remedy (Jaqua, 2021). This supports my personal opinion that standardized staffing ratios make a big difference in patient safety. This is a really good idea, and I would support a similar project in my company to make sure that workload sharing is equitable and consistent. Balancing Profit and Patient Safety Discussion

Follow-up Response 2

The nurse’s HCA experience offers insightful information about the difficulties of promoting patient safety in a private, for-profit facility (Lightman, 2022). I see similarities in my own business, where there are situations where decisions are made with financial reasons in mind, even though there is a strong dedication to patient care. I understand the nurse’s frustration and can relate to her fight to be heard by those in positions of authority.

It’s an interesting idea to impose legally regulated nurse-to-patient ratios. It makes me think about how my organization’s staff happiness and patient results might be affected. Even though every institution is different, it’s critical to look into cutting-edge for-profit solutions that put patient safety first. I would be open to having additional conversations inside my company to assess the viability and advantages of this kind of approach, drawing on the experiences that the HCA nurse has shared. Balancing Profit and Patient Safety Discussion

References

Han, X., Pittman, P., & Barnow, B. (2021). Alternative approaches to ensuring adequate nurse staffing: the effect of state legislation on hospital nurse staffing. Medical Care, 59(10 Suppl 5), S463. https://annamaria.edu/wp-content/uploads/2020/09/Elizabeth-Rondeau-Spring-2020.pdf

Jaqua, T. L. M. (2021). A Comparison Between Nurse-to-Patient Ratio Mandates and 2018 Patient Satisfaction Scores (HCAHPS) in Select California and Texas Hospitals (Doctoral dissertation, Trident University International). https://search.proquest.com/openview/5a7c72736712e4c8a2397bde20c73ed2/1?pq-origsite=gscholar&cbl=18750&diss=y

Lightman, N. (2022). Caring during the COVID‐19 crisis: Intersectional exclusion of immigrant women health care aides in Canadian long‐term care. Health & Social Care in the Community, 30(4), e1343-e1351.  Balancing Profit and Patient Safety Discussion

In your follow-up peer responses, you should do the following:

Compare your peers†organizational structure and culture with your own, noting any similarities and differences.
Comment on any parts of their organization that you would like your organization to adopt.

Instructions
Post your original response.
Use sources that are within 5 years of publication
Post a minimum of 2 follow-up responses.
Check your syllabus for specific due dates.
See the rubric for graded content description.
In order to easily meet the minimum curiosity points, please use the Bloom’s verbs when posing your initial question. See image attached. Balancing Profit and Patient Safety Discussion

Peer post:
Unit 1 Week 1: Do you think for-profit private institutions value patient safety and outcomes?
I work for the nation’s largest healthcare system, HCA. My organization’s structure is a for-profit private institution with a diverse hierarchy-based structure. This means that all choices are made at the top of the hierarchy, “CEO,” and made to benefit the investors, with minimal input from staff that work with patients. HCA prides itself on having a culture of safety, inclusion, and patient satisfaction. With a mission statement of “Above all else, we are committed to the care and improvement of human life.”(HCA Health Care, 2020, code of conduct, Mission & Value Statement). As a staff nurse in the emergency room, I see the culture of “profit over patients.” I see how my patients suffer when staff is cut short, supplies are not ordered, and they have to run with minimal equipment, beds, and medical staff. I see my charge nurses trying to escalate dangerous patient-to-nurse ratios up the chain of command with minimal changes being made. I see my manager and director trying to keep the nursing staff safe and appease the profit standards from the “higher-ups”. I see people who work for the division accepting patient transfers from other facilities when our hospital is already at capacity and hundreds of people are waiting for a bed in the emergency room. Balancing Profit and Patient Safety Discussion

The difficulties I experience with this type of organizational structure are advocating for patient safety, better patient ratios, and more ancillary staff support. It is difficult to be heard with a hierarchy-based structure when the chain of command is complex, and the decision-makers are far from direct patient care. With this organization being for-profit, it is hard to receive more staff, better equipment, and more supplies, to stop accepting patient transfers, and to postpone elective surgeries when the hospital is at capacity.

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While I understand that our hospital cannot function without a profit, I still have hopes of change. The organizational structure can stay if there are mandated nurse-to-patient ratios in the emergency room and in-patient. Robert L. Anders writes about the positive effects on patient care, safety, and nurse satisfaction when there are laws in place to mandate nurse-to-patient ratios (Anders RL. Patient safety time for federally mandated registered nurse to patient ratios. Nurs Forum. 2021; 56: 1038-1043. https: //doi.org/10.1111/nuf.12625). With patient safety as an actual goal of my facility the patient will receive the best care, and the hospital can still profit. Balancing Profit and Patient Safety Discussion

Source: (Anders RL. Patient safety time for federally mandated registered nurse to patient ratios. Nurs Forum. 2021; 56: 1038-1043. https://doi.org/10.1111/nuf.12625 ) https://hcahealthcare.com/util/forms/ethics/Code-of-Conduct-Booklet-a.pdf

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