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The issues of standard of care in hospital management have not always been as big of an issue as they currently are.  In the past there were fewer regulations and government protocols having to do with these standards and therefore there were fewer overall problems and issues than there have been in recent times.

This means that due to the growing popularity of government regulations and agencies there are higher standards to which the hospital must be willing to place their standards.

The history of these changes has had a lot to do with law suits and problems that could have been avoided had the people who were in control been better at managing the health care system as a whole.  With new standards in regulations and continuous changes in the expectations on the part of hospitals there are no doubt that in the future there could be some problems with being able to manage the health care network and making sure that there is proper adherence to all of the standards and rules.

The joint commission or JCAHO (Joint Commission on Accreditation on Hospital Organizations) as it is known professionally sets the standards for health care in an effort to minimize the amount of error on the side of the hospital.  Each hospital must maintain certain standards in order to be certified by JCAHO.

The other problems with not following what is expected of them is that JCAHO can assess fines to the hospital and this can cost the hospital a lot of money in the end.  The goals that JCAHO sets forth are to “focus accreditation on the actual performance of important governance, managerial, clinical, and support functions within organizations.”  Some of these issues include the entire strict adherence to charting standards and standard of care as well as confidentiality.

  All of these things need to be managed by the hospital management and without these things management would be unable to properly assure the board of directors that things are following (Krasker and Balogun 1995).  Some other things that JCAHO requires are that charting standards be followed for nutritional information.  “Using charting by exception to document nutrition care can be a cost-effective method of meeting the 1996 JCAHO patient care standards” (Charles 1997).

Part of management in being able to help adhere to all of the standards and regulations that are involved with managing a hospital are to make sure and have a solid human resources department and solid programs for these issues.  Some of these include that there needs to be a standard in the hospital for making sure that the employees have proper credentials.

The hospital must also realize important it is to follow all JCAHO standards and to make sure that there is clear training for the employees on these guidelines and requirements.  This means really educating and utilizing the various things that were available.  Another thing to do is to encourage the competency tests and also work to be able to manage these issues.  Another thing is that management should be sure to encourage and work hard to protect is the number of employees that are working within the hospital from temp agencies or other places.

One way to avoid these types of issues is to hire employees on an as needed or PRN basis rather than always hiring employees as full time or part time.  Having these employees who could be on call could greatly reduce the amount of employees that could have to be utilized from these types of places.  All of these issues need to be taken into consideration and it is important for management to be in control of all areas of a hospital including those areas which are necessary in the human resources department.

When research has been done in the home health care setting that has been compared to the hospital setting on the prevalence of acquired infections it has shown that there is a definite connection between these infections and the patient being in the hospital.

Due to these types of problems there are now successful home health care services that promote keeping patients out of the hospital and are profiting as the patients prefer to not be in the hospital due to all of the risks that being in the hospital could be to them.  In the article Prevalence of hospital-acquired infections in the home care setting, the authors look at the facts that there are few hospital-acquired infections transmitted in the home care setting and therefore this is not an issue in this area.

In this study there were some infections that were prevalent when receiving home health care however it is unlikely that there is as large of a transmission in the hospital and for those who are in fear of these types of issues this could be an alternative for them if they feel that their hospital would not be able to provide them with the same protections (Patte, Drouvot, Quenon, Denic, Briand, and Patris 2005).

Through the organization and leadership in the hospital many things can be done to improve the hospital’s experience.  Requiring all of the hospital staff to read and discuss the book If Disney Ran Your Hospital as part of the orientation process can really help the staff to be in the right mindset to take care of the guests in the hospital.

Also requiring various types of trainings and education about the hospital, the standards, and the regulations for all areas to which an employee could be working in is a good idea as these are things that can make or break a hospital.  Making sure that there are appropriate trainings and education of the staff is very important to being able to move forward and improving overall hospital standards in the hospital environment.

These things can really improve the stay for the patient and there can be better patient interactions and relations to the staff if the staff is really aware of what the patient’s expectations are.

The main objectives for all hospitals should really be the same.  The objectives should include developing the highest quality of standards and care that are possible for the patients.  Having a higher quality of care and standards is one thing that will help to set a hospital aside and will encourage the guests to want to return to the hospital for further procedures and services.  Also word of mouth works great in the hospital environment as when someone hears about a bad experience at a hospital it is rare that they will choose this hospital if a choice is available to them.

There has been some debate of whether the typical hospital system is able to give the same standard of care and not show discrimination to those who have public health care or lack of insurance.  These issues were examined in the article Trends in the Quality of Care for Medicare Beneficiaries Admitted to the Hospital with Unstable Angina.

Within this study it was found that there have been improvements made within the health care environment in order to keep up with the trends and follow the acredication standards that were necessary for these services.  What was found was that there continue to be some concerns but that standards are improving.  In regards to managing the hospital it would be important to follow up with these regulations and standards (Krumholz, Philbin, Wang, Vaccarino, Murillo, Therrien, Williams and Radford 1998).

The policies and procedures can be written based on various key factors.  These include the area to which the hospitals demographic are and who they will be serving in their community.  Another issue is whether or not there is availability of the services offered at other local hospitals and what types of guests the hospital is wanting to cater to.

  The typical goal is to be able to make any guest feel as though they are the most important person at the hospital at that time and to treat them with both respect and dignity and to really listen to them and give them the power of choice over their care.  The power of choice will be effective in what is asked of the hospital and will help to eliminate feelings of dissatisfaction in the future.

The best way to implement research into the hospital to make sure that policies are satisfactory for all of the guests/patients is to make sure and follow through with standards and regulations and to ensure that all patients are receiving the same level of care no matter who they are or their socioeconomic status.

One other great resource that the hospital can use is the resource of an eHealth network or a national network that is connected through online and computer based medical records.  This is something that can simply be integrated into a hospital and can provide the guests of the hospital with better care as they will be able to access records immediately from any other health care provider who has been on the network that this guest has visited.  When this process would be the most affective would be when the guest was in the emergency department or if the guest was unable to communicate his/her medical history with staff.

Accurate medical history could prevent dangerous medication reactions or allergic reactions in the guest.  Being a part of the eHealth network could also be a cost effective solution to treatment in specific departments as there would be less chance for error with accurate records and with that there would be a lower occurrence of health care mistakes or lawsuits as there would be more information available to the staff about their patient (Hill and Powell 2009).

Some other studies that looked at the cost effectiveness of health care and health care treatment looked at the various types of treatment and how these types of treatment could affect the overall quality of care as well as the overall cost for the hospital.  In one study diabetes patients were looked at.  With this study the issues with proper foot care were looked at.  Proper foot care can help someone who is diabetic to be able to stay healthy where as having foot problems could drastically affect his/her health in a negative manner.

This study suggested that there be a program available to help diabetics with foot care problems and that this could greatly reduce and come close to eliminating the hospital stays and admissions of these patients in the hospital.  In the end this not only saves money for the hospital but also for the health care industry as a whole, making insurance payouts and patient payouts lower and over time this could help to reduce the cost of insurance and help to have more insured patients (Horswell, Birke, and Patout Jr. 2003).

In all of the studies that were looked at there were various types of research and research control groups.  All of the research control groups were stated clearly in the studies and all of them were done in the most professional way that was possible by those who were conducting the research.  The research was done in an ethical manner and it was appropriate for what was being researched in all groups.


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