AN ETHICAL APPROACH TO ACCREDITATION STANDARDS FOR HOSPITALS IN ROMANIA. THE NEED FOR ETHICS AUDIT TO IMPROVE THE QUALITY OF CARE FOR PATIENTS

Daniela Tatiana Agheorghiesei(Corodeanu), Marius Dabija, Ion Copoeru

Abstract


In 2011, Romania joined other EU countries in making accreditation of hospital units. In the first quarter of 2012, five of 459 hospitals were accredited, while others were under evaluation.

Our research aims to analyse from an ethical perspective the hospital accreditation standards as they are applied by the National Commission on Accreditation of Hospitals (CoNAS).

The starting point of our inquiry is the relationship between quality (followed by accreditation) and ethics, supported by many authors and experts. The research consists, firstly, in a broad review of the literature and best practices and, secondly, in the ethical-philosophical analysis of the 11 referential categories employed in the evaluation of hospitals in Romania.

The qualitative analysis revealed that, by their nature and purpose, many of the accreditation standards are able to cover, to a certain extent, the moral obligations of the institution in accordance with its clinic mission, but in a formal way. Therefore, they do not provide a true picture of the concerns from the point of view of the ethics’ management. Consequently, the results of an ethical audit integrated into the accreditation process (or organized simultaneously) have to be taken into account. This approach, which introduces institutional ethics evaluation criteria, may be useful in the efforts to improve the performance of hospital facilities. Moreover, it can also provide a plausible argument for the classification of hospitals and a fairer allocation of resources, i.e. not only on grounds of cost effectiveness.


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References


. Agheorghiesei, Daniela-Tatiana, Iliescu, Liliana, Gavrilovici, Cristina, Oprea, Liviu, Why Is An Ethical And Integrated Audit Accreditation Process Required For Romanian Hospitals?, South African Journal of Economic and Management Sciences, Vol 17, No 3 (2014): 284-296.

. Agheorghiesei, Daniela-Tatiana, Iliescu, Liliana, Gavrilovici, Cristina, Oprea, Liviu, What Is To Be Expected from an Ethics Audit Integrated Within the Accreditation Process of Hospitals from Romania?, Iran J Public Health. 2013; 42(7): 737–747.

. Anonymous, Overview of hospital accreditation, The Journal of Nuclear Medicine; May 1997; 38, 5; ProQuest Central, p. 23

. Bialek, Ronald G., Duffy, Grace L., Moran, John W., The public health quality improvement handbook, Milwaukee, Wis. : ASQ Quality Press, 2009, pp. 414-415.

. Boyle, Douglas M;Hermanson, Dana R;Wilkins, Anne, Ethics audits: implications for internal auditors, Internal Auditing; Nov/Dec 2011; 26, 6; ProQuest Central, pp. 3; 114.

. Buchbinder, Sharon , Shanks, Nancy, Introduction to Health Care Management, Burlington, Mass. : Jones & Bartlett Learning, 2012, p. 344.

. The Governance Institute, Leadership in healthcare organizations. A guide to Joint Commission leadership standards. A governance institute white paper, winter 2009, http://www.jointcommission.org/assets/1/18/WP_leadership_standards.pdf

. Hall, Robert T., An introduction to healthcare organizational ethics, New York : Oxford University Press, 2000, p. 17.

. Harman, Laurinda B. , American Health Information Management Association, Ethical challenges in the management of health information, Sudbury, Mass. : Jones and Bartlett Publishers, 2006, p. 17.

. Hofmann, Paul B., Factors Complicate Ethical Resource Allocation Decisions, Healthcare Executive; May/Jun 2011; 26, 3; ProQuest Central, p. 62.

. Joint Commission Resources, Inc., The medical staff handbook: a guide to Joint Commission standards, Oakbrook Terrace, IL : Joint Commission Resources, 2011, pp. 1; 385-388; 390-391.

. Joint Commission on Accreditation of Healthcare Organizations, Ethical issues and patient rights: across the continuum of care, Oakbrook Terrace, Ill.: Joint Commission, 1998, pp. v-vii.

. Kapp, E. Andrew, Parboteeah, K. Praveen, Ethical Climate & Safety Performance.Design better programs, improve complianceand foster participation, Professional safety, July, 2008.

. Landman, Willem A., Mouton, Johann, Nevhutalu, Khanyisa H., Chris Hani Baragwanath Hospital Ethics’ Audit. Ethics Institute of South Africa. Research Report no. 2, http://ethicssa.intoweb.co.za/UserFiles/ ethicssaintoweb.co.za/CHBHFinalReport.pdf , 2001.

. Morrison, Eileen E. , Ethics in health administration: a practical approach for decision makers, Sudbury, Mass. : Jones and Bartlett Publishers, 2011, p. 230.

. Odegaard Turner, Susan, Aspen Reference Group (Aspen Publishers), Essential Readings in Nursing Managed Care, Gaithersburg, Mar. : Aspen, 1999, pp. 97-99.

. Scrivens, Ellie, ”Accreditation and the regulation of quality in health services” (chapter four) în Richard B. Saltman, Reinhard Busse, Elias Mossialos (editori), Regulating entrepreneurial behaviour in European health care systems, European Obsevatory on Health Care Systems Series, Open University Press, Buckingham, 2002, pp. 95-101; 103, http://www.euro.who.int/__data/assets/pdf_file/0006/98430/E74487.pdf, accesat august 2012.

. Swayne, Linda E., Duncan, W. Jack , Ginter, Peter M. , Strategic Management of Health Care Organizations, Malden, MA : Blackwell Pub., 2006, p. 231.

. Vinten, Gerald,Putting ethics into quality, The TQM Magazine, Vol. 10 Iss: 2, 1998, pp. 89 – 94.

. Wu, Min-Hua, Liao, Chih-Hsien, Chiu, Wen-Ta, Lin, Ching-Ying, Yang, Che-Ming (2011). Can we accredit hospital ethics? A tentative proposal, Journal of Medical Ethics, JME Online First

. Wurzbach, Mary Ellen, ”Improving Quality Care: An Ethical Imperative in a Time of Change”, în Claire Gavin Meisenheimer, Improving quality: a guide to effective programs, Rockville, Mar. : Aspen, 1997, p. 181.

Internet Addresses

• Budurca, Delia, Ambiţia noului preşedinte al CONAS, Lukács Vilmos: 50 de spitale acreditate până la sfârşitul anului, http://medicaacademica.ro/2012/04/17/ambitia-noului-presedinte-al-conas-lukacs-vilmos-50-de-spitale-acreditate-pana-la-sfarsitul-anului/, accessed August 12, 2014

• ***HCA’s Clinical Ethics Manual, 2008-2009, http://hcaethics.com/CPM/HCA Manual_2008-09.doc, accessed August 12, 2014

• DNV Healthcare, http://dnvaccreditation.com/pr/dnv/default.aspx, accessed August 12, 2014

• DNV Healthcare, http://dnvaccreditation.com/pr/dnv/document/DNVHC_Critical_Access_Hospital_Accreditation_Requirements_and_Interpretive_Guidelines-Rev_6.pdf, accessed August 12, 2014


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