Question

Case 2 - Changing Physician Credentialing

You are the Chairperson of the Department of Surgery and you attend the quality committee meetings. You do not have a vote on the quality committee because you need to carry out the recommendations of that committee. The committee is reviewing several cases of Dr. Monitor, one of the busiest surgeons on staff. These cases have had bad outcomes and the committee is concerned about Dr. Monitor’s surgical judgment. When each case is reviewed individually, it appears the issues are minor. However, upon detailed review of many of Dr. Monitor’s cases, a devastating pattern of events has emerged and the committee feels his practice patterns are not safe for the patients at this hospital. The committee has several choices; all choices are, however, only recommendations to you, the department Chairperson. The surgeon under scrutiny is not known to be arrogant or malicious and is, in fact, well liked. When you discuss these events with the partners in his practice, you find they are also concerned about Dr. Monitor’s practice patterns. You ask the committee to hold off on a recommendation giving you the opportunity to discuss the situation with the surgeon. After a very open discussion with Dr. Monitor and one of his partners, the Division Chief, you ask Dr. Monitor to voluntarily give up his privileges to perform the procedures that are in question. After being informed that he can only assist one of his partners in the procedures of concern, Dr. Monitor cordially agrees to comply with this recommendation. At the next quality committee meeting, you announce Dr. Monitor has volunteered to reduce his privileges.

CASE WRITE UP

1 - Write a background statement

2- What are the major problems and secondary issues?

3- Your Role

4- Organizational Strengths and Weaknesses

5- Alternatives and Recommended Solution

6- Evaluation

THEIR IS AN EXAMPLE BELOW OF HOW THIS SHOULD LOOK!!!!

Case Write-Up

Background Statement

A Wiccan patient who visited a nondenominational community hospital was discussing her religious beliefs with her primary care nurse, Penny Baker, when suddenly another nurse, Ruth Goose, walked into the conversation and rudely stated, “Thou shalt not suffer a witch amongst you.” The Wiccan nurse felt offended and complained that she was discriminated in the hospital because of her religious beliefs.

Major Problems and Secondary Issues

The major problem is that the two nurses, Penny Baker and Ruth Goose, made the patient feel unwelcomed in the nondenominational community hospital because of her Wiccan religious beliefs. The secondary issues that the nondenominational community hospital may face is that the Wiccan patient is threatening to go to the media. This means that there may be news coverage that your hospital engages in religious discrimination. This may make people, especially Wiccans, look down on your medical services.

Your Role

In this case, I am the Vice President of Nursing Services. As stated in the text, it writes, “You are the Vice President of Nursing Services in a nondenominational community hospital, and you receive a complaint from a patient, who is a Wiccan.” The advantages of this role are that I can sit down with Penny and Ruth to let them know that religious discrimination is not to be tolerated while we are caring for the patients. The disadvantages of this role are that I must decide how I am going to discuss this matter with Penny and Ruth because they’re passionate about being against the Wiccan patient. I need to let Penny and Ruth know that our patient’s care matters above everything else, not what religion they practice.

Organizational Strengths and Weaknesses

As the Vice President of Nursing Services, my strengths are that I can hold a training on racial, ethnic, and religious diversity. This training can supplement nurses with the information they need to work in a diverse environment. Nurses need to know that they must treat their patients justly despite their identity. The weaknesses I may face are that the two nurses are very religious themselves. They may not listen to what I have to say about religious discrimination because the two nurses try to justify their act by saying, “She did the right thing. We don’t have to pray with witches. They worship Satan. It’s blasphemy. What’s next? Human sacrifice?”

Alternatives and Recommended Solution

As a solution for this problem, I will make sure to provide all the nurses working in the hospital with diversity training. It is important that I sit down with the nurses and make it clear that discrimination will not be tolerated while they are working in our hospital. I can also offer every patient visiting the hospital with a survey. The patient can fill out the survey to let us know how they felt about their stay. Nurses who’ve been accused of any sort of discrimination, will have to speak with management. We would keep these incidences of discrimination in a file, and it the dilemma does not change, I would have to begin writing up the nurses. Discrimination would not be tolerated while the patient is in the hospital trying to recover from a medical condition. I would also recommend Penny and Ruth write an official letter of apology to the Wiccan patient before she decides to go to the media. Writing the official letter of apology would be my first recommended solution to Penny and Ruth, so that the patient does not feel unwelcomed to our hospital’s services in the future.

Evaluation

If there are enough surveys to prove that our medical treatment is getting better and there are less patients coming from the patients about discrimination, then I would know that the instances of discrimination have stopped. The goal is to aid in the medical recovery of patients. Patients must also feel welcomed to our hospital services despite their identity. By getting fewer, or even better, no discrimination complaints, I would know that my diversity trainings and meetings have worked.

Answer 1

BACK GROUND INFORMATION: Dr.Monitor is the busiest surgeon, has performed a procedure named knee amputation  along with his partners after getting consent from patient and patients relatives. after the completing procedure, pateint was shifted to ICU, patient had developed sudden bleeding, went to hypotension and measures were taken to reduce bleeding. again, he was taken for procedure to correct bleeding. he was shifted to ICU for 3 day observation.

major problems and secondary issues

Major problems is that the Primary surgeon Dr. Monitor who performed procedure, made patient life into threatening one. secondary issue is that the hospital is facing low quality care of patient and patients life is not safe in surgeon hands and patient will not come to hopital as a result of reduced surgery outcome.this decison has been taken by quality commitee.the Quality commitee has several choices like banning him to do surgery, termination of his job.

Your Role:

I am the chairperson of the department of surgery, as stated in the text you are chair person of the department of surgery and you receive a complaint from committee. i reviewed case performed by Dr. Monitor, the problem is minor. i went through thesurgical cases done by Dr. monitor. there are issues with his practice. i have open discussion with Dr. Monitor and one of his partner, Division chief and came to know that he is lacking skill in a orthopedic  procedure and independently doing particular procedure

Organizational Strength and Weakness

As a chair person of the department of the surgery, i have knowledge regarding different  surgery. i have performed different kinds of  surgeries during my practice period. therefor i can educate him about diffreent surgeries and its complication. the weakness that i may face, they are doctors and he is one of busiest surgeon in this hospital. he is well liked by every one.

Alternative solution and its recommendation

a as solution to this problem, i discussed  with surgeon in the hospital. i instructed them that patient's life is in our hands, so surgeron who lacked skill in a particular procedure, get helped and should do particular procedure under particular surgeon's supervision. i asked division chief to take charge of particular procedure.i asked Dr. monitor voluntarily give up rights to do the procedure. DR. monitor can only assist divison surgeon in the particular surgery. thereby, The surgical oucomes can be measured by going through the case sheets and feed back form can be given to the patient about their experiences in hospital.

Evaluation:

quality of care can be provided to patient who come to hospital with particular surgery. outcome of surgey can be improved. patient stay in hospital can be reduced and it improve satisfaction of patient.day by day, i came to know that outcome of surgery is good. complaints from quality commitee has been reduced. so i understood my diversity experience in surgical procedure and i have given a solution to this problem.