At your hospital, the Committee on Medical Ethics is a medical staff committee.
ID: 123407 • Letter: A
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At your hospital, the Committee on Medical Ethics is a medical staff committee. It answers to the Medical Executive Committee and the medical staff president, and its members are jointly appointed by the president of the Medical Staff and committee chair. Although it is a Medical Staff Committee, its membership is multidisciplinary, including physicians, nurses, social workers, lawyers, and members of the lay public (for community representation). Most members of the committee have received training in clinical ethics consultation, and were chosen because of their interest in resolution of ethical issues and their interpersonal qualities with patients and staff. The hospital administration has engaged a consulting firm to “modernize” its structure. The consultants have advised converting the “old” social worker approach to the contemporary position of case manager. The consultants note that three social workers sit on the Ethics Committee. The social worker members of the Ethics Committee were advised that they will no longer serve on said committee, and that their place will be taken by the manager of case management, who has no experience in ethics consultation, nor does she know anything about the history of Ethics Committee activities at your hospital. The chair of the Ethics Committee is informed that three of his committee members are “out.” The chair is livid, and there is also an immediate reaction from all the rest of the committee members, most especially the medical staff members of the committee— something about separation of powers is mentioned. You have been assigned by the hospital administrator to “handle this mess.” How would you go about doing so? If you had been told to handle the proposed committee reconfiguration from the very beginning, what would you have done differently from what was done? What change management practices would you have implemented to have these adjustments be handled better? Describe your answer in detail, write in a response to each case scenario. Your Journal entry should be at least 500 words. At your hospital, the Committee on Medical Ethics is a medical staff committee. It answers to the Medical Executive Committee and the medical staff president, and its members are jointly appointed by the president of the Medical Staff and committee chair. Although it is a Medical Staff Committee, its membership is multidisciplinary, including physicians, nurses, social workers, lawyers, and members of the lay public (for community representation). Most members of the committee have received training in clinical ethics consultation, and were chosen because of their interest in resolution of ethical issues and their interpersonal qualities with patients and staff. The hospital administration has engaged a consulting firm to “modernize” its structure. The consultants have advised converting the “old” social worker approach to the contemporary position of case manager. The consultants note that three social workers sit on the Ethics Committee. The social worker members of the Ethics Committee were advised that they will no longer serve on said committee, and that their place will be taken by the manager of case management, who has no experience in ethics consultation, nor does she know anything about the history of Ethics Committee activities at your hospital. The chair of the Ethics Committee is informed that three of his committee members are “out.” The chair is livid, and there is also an immediate reaction from all the rest of the committee members, most especially the medical staff members of the committee— something about separation of powers is mentioned. You have been assigned by the hospital administrator to “handle this mess.” How would you go about doing so? If you had been told to handle the proposed committee reconfiguration from the very beginning, what would you have done differently from what was done? What change management practices would you have implemented to have these adjustments be handled better? Describe your answer in detail, write in a response to each case scenario. Your Journal entry should be at least 500 words. At your hospital, the Committee on Medical Ethics is a medical staff committee. It answers to the Medical Executive Committee and the medical staff president, and its members are jointly appointed by the president of the Medical Staff and committee chair. Although it is a Medical Staff Committee, its membership is multidisciplinary, including physicians, nurses, social workers, lawyers, and members of the lay public (for community representation). Most members of the committee have received training in clinical ethics consultation, and were chosen because of their interest in resolution of ethical issues and their interpersonal qualities with patients and staff. The hospital administration has engaged a consulting firm to “modernize” its structure. The consultants have advised converting the “old” social worker approach to the contemporary position of case manager. The consultants note that three social workers sit on the Ethics Committee. The social worker members of the Ethics Committee were advised that they will no longer serve on said committee, and that their place will be taken by the manager of case management, who has no experience in ethics consultation, nor does she know anything about the history of Ethics Committee activities at your hospital. The chair of the Ethics Committee is informed that three of his committee members are “out.” The chair is livid, and there is also an immediate reaction from all the rest of the committee members, most especially the medical staff members of the committee— something about separation of powers is mentioned. You have been assigned by the hospital administrator to “handle this mess.” How would you go about doing so? If you had been told to handle the proposed committee reconfiguration from the very beginning, what would you have done differently from what was done? What change management practices would you have implemented to have these adjustments be handled better? Describe your answer in detail, write in a response to each case scenario. Your Journal entry should be at least 500 words.Explanation / Answer
The roles and functions of social workers have changed and modified.In the 1990s most of the hospital eliminated social workers in order to avoid non-beneficial overtime. Today many of the medical committees are struggling with the replacement of responsibilities of social workers with case managers. I will handle this situation by look at the complementary skills of each disciple.
Social workers and case managers have different skill sets and knowledge. The committee members have to consider the unique differences between the two disciples in order to modernize its structure.Social workers typically focused on social dysfunction and life-threatening medical events cases as to find independently. They also involved with discharge planning and counseling
Now, the Hospital environment has changed to minimize the length of stay as it becomes cost-effective. This makes to give more importance to discharge planning and less focus on psychological counseling. So, the role of social workers is totally changed, and the utilization of case managers became more clinical.
In this, challengeable situation, I will use the optimum skill set of the social worker and case manager. The committee should split the work of case managers versus social workers. Adapting both social workers and case managers based on the patient population and its needs. By the way, the new structure framework as collaborative work of case managers and social workers.
The allocation of work is determined by the committee members and evaluation has to be done to obtain optimum results. The committee has to develop and maintain a contemparory practice. Provide proper training on committee ethics. The committee makes sure that they are meeting the demands of current and future healthcare needs.
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