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The use of social media and the internet in the current world is vast and helpful when utilized appropriately. However, in the healthcare industry it may pose ethical issues; especially since it is a wide and sensitive industry in terms of ethics and procedures, and due to the kind of service delivered. For example, in 2017, two staff members of the Jacksonville Naval Hospital in Florida were relieved of their care delivery duties after a video they made while on duty made rounds on social media. The video showed them making a new-born baby dance to a rap song and referring to babies as “mini-satans” (Finley, 2017). Such cases bring into question, the existence or the need for policies on the use of mobile phones and related gadgets in hospitals. The policies ought to put utmost consideration to the ethical and professional standards required of the staff and privacy considerations.
While the American Medical Association (AMA) provides guidelines and policies on the use of social media and internet in healthcare organizations, individual institutions also should have such policies and standards in place. For example; all hospital staff should not use personal mobile phones and gadgets while attending to patients. They should instead use them in their offices or desks. Physicians should highly regard their patients’ privacy and identity and should not disclose them. Thirdly, physicians should not compromise on patients’ health for any reason including creating social media content. In the event that a physician requires to make social media content using the patient, consent should be sought. Hospital staff should not disclose a patient's identity on any social media platform for any reason without consent from patients or their families. Hospital staff should be respectful to everyone; they should not use vulgar language in reference to any patient or colleague.
The social media platform is a useful tool for healthcare institutions for various reasons; sharing news about the organization, communicating to the public and stakeholders, providing educative health information and also as a platform for interacting with customers. However, in the case of the Naval Hospital in Jacksonville Florida, social media was gravely misused as it posed ethical and legal issues, not only for the two staff members, but also the entire organization (Denecke, Bamidis, & Hansen, 2015).
To begin with, unprofessional social media conduct is one ethical liability that the two staff face. Their behaviour would jeopardize the hospital’s reputation as an ethical care-delivery institution. It goes against the core values of the organization; needless to say, their actions were a desecration of the pledges they took as professionals. Secondly, it is unethical to mishandle a patient, let alone a fragile newborn. Their publicly displayed action would threaten the customers’ trust for the hospital and the staff members. When ethical standards are put in the line, legal issues are also triggered. While it is unethical to mishandle and abuse patients, it is illegal and the hospital, as well as the staff involved, would face lawsuits from the concern patient’s parents or family. Revocation or suspension of the staff’s work permits or certificates is yet another legal liability they would encounter (Ventola, 2014).
The use of social media and the internet, in future times, will be inevitable. Therefore, healthcare organizations need to establish policies that protect patients from abuse or mistreatment while the staff members conduct themselves in high ethical standards in matters of using social media.
The use of social media today as a tool for communication is now used as a means of selection for jobs, promotions and even college admissions. The theory behind this trend is that the personal image of an individual reflects on the image and core values of the organization. While some institutions and organizations do not put keen interest in what their employees or students do on social media, some are ardent about this issue. For example, in 2017, Harvard university repealed the admission of ten students based on their activities on social media. As reported by the Harvard Crimson, the students’ content on Facebook were overtly sexual (including content on child abuse and sexual assault) while others were themed on racism against Mexicans and the Holocaust. One of the students whose admission was rescinded stated that they were asked to disclose the images they had sent to the groups, from which the Admissions Office was able to close in on the implicated students.
The case above brings about questions of one’s social media privacy and freedom of speech in the platform, yet, it also questions the jeopardy these contents may bring to the institutions. To what extent should employers and administrators have the right to access to employees or student’s social media content? Why is it necessary? Does it violate one’s freedom of speech or communication? Does it have a direct impact on the affiliated institution or organization? Should it be used as a tool to make employment or admission decisions?
To begin with, this trend is currently growing as employers regularly pry on their employees’ social media content, potential employers request to view applicants’ content and so do colleges. However, it still remains a privacy breach for the employees and students as it limits their freedom of expression and the organizations bear no right to these social media accounts or even private content. Nonetheless, while everyone has a right to privacy of their content, posting inappropriate content using an organization’s name in reference risks the institution’s reputation and core values while creating ethical and legal liabilities.
It is important to understand the implications of employees’ and students’ social media content on the organizations. One apparent reason is that one’s content reflects on an affiliated institution; therefore, a bad image also reflects negatively to the organization. Secondly, current employees may share information that compromises the activities of their organizations. Keeping tabs on these contents allows organizations to secure their reputation and core values. The institutions are also able to know who their employees or students are and what they are involved with away from work/ school based on their activities on the platform. Even so, there are legal and ethical issues related to the right to privacy of individuals. As such, people’s social media posts should not be used to determine their employment or college admissions especially if the job description does not relate to social media communication.
To begin with, the accuracy of the social media accounts of the students or employees may be biased with issues such as identity theft in existence; one simple example being the use of other users' profile pictures. Also, social media accounts are today subject to hacking. The involved employees and students may also conceal their activities such that they cannot be traced even by their affiliated organizations. Therefore, the future (with much more innovative internet technologies), is faced with more potential arguments about monitoring social media accounts of organization affiliates.
Various factors are associated with the quality of healthcare delivered in healthcare organizations. Quality of care delivered is directly or indirectly related to internal policies such as reimbursement and information management systems, and processes such as accreditation.
Accreditation is the process that involves assessments or evaluations to determine the performance of healthcare organizations based on their competences in complying with standards and requirements of established accreditation organizations. Examples of healthcare accreditation organizations in the United States include; Accreditation Commission for Health Care (ACHC), the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), and the American Medical Accreditation Program (AMAP) among others. The benefits of accreditation are related to quality improvement in healthcare organizations including; fortifies efforts made to enhance patient safety, help in risk management, and even ensures professional improvement (Benefits of Joint Commission Accreditation, 2017).
While accreditation standards help improve quality of health care, participating in accreditation processes does not have a significant relationship with the indicators of quality but with the quality of healthcare delivered; this according to research (Almoajel, 2012). The researcher supported his conclusion by highlighting that there are indicators that improve quality of care yet are not included in accreditation. Also, accreditation is identified as a tool for quality improvement especially when the analysis is done using the patient outcome as a performance indicator (El-Jardali, Jamal, Dimassi, Ammar, & Tchaghchaghian, 2008).
Health informatics involves the application of Information systems including information technology in planning, delivering and managing healthcare services (Kramer, 2014). The most common health information technology is the Electronic Health Record (EHR). A healthcare facility that utilizes an efficient information system with good EHR is few steps towards quality care (in addition to other quality indicators). Research done on the relationship between EHR and patient outcome (in terms of length of stay in hospital) showed positive results; fewer patients stayed longer in the hospital (Hessels, Flynn, & Gershon, 2015). Patient outcome, as a quality indicator, implies that with effective health informatics, the quality of care is improved. Quality of care can also be indicated by the speed at which out-patients are attended to in a day which in turn reflects on the patients’ satisfaction. With proper EHR, data can be effectively collected and the information passed on to relevant physician or department without taking too much time with bulky paperwork. The information is also stored securely and can be retrieved when needed even for making follow-ups on patients.
Reimbursement of staff is an important step in indirect quality of care improvement. It is a motivating factor to staff members especially nurses who are mostly in contact with the patients than any other staff. Research shows a direct relation between reimbursement, motivation and low turnover of staff especially nurses. There is a dire need for healthcare staff in the United States today as more nurses leave their jobs and get to other professions (Mazurenko, 2015); this means that with a high turnover rate, the quality of care delivered is also negatively affected. Needless to say, for any profession, a satisfied employee means morale and hence better performance.
About Accreditation. (2018). Retrieved from ACHC: https://www.achc.org/about-accrediatation.html
Almoajel, A. M. (2012). Relationship Between Accreditation and Quality Indicators in Hospital Care: A Review of the Literature. World Applied Sciences Journal, 17(5): 598-606.
Benefits of Joint Commission Accreditation. (2017, October 9). Retrieved from The Joint Commission: https://www.jointcommission.org/benefits_of_joint_commission_accreditation
Denecke, K., Bamidis, P., & Hansen, M. (2015). Ethical Issues of Social Media Usage in Healthcare. Yearbook of Medical Informatics, 10(1): 137-147.
El-Jardali, F., Jamal, D., Dimassi, H., Ammar, W., & Tchaghchaghian, V. (2008). The Impact of Hospital Accreditation on Quality of Care: Perception of Lebanese Nurses. international Journal for Quality in Health Care, 20(5): 363-371.
Finley, T. (2017, September 22). Navy Hospital Removes Staffers For Calling Babies 'Mini Satans' On Social Media. Retrieved from PARENTS: https://www.huffpost.com/entry/hospital-staff-post-images-of-black-newborns-dancing-to-rap-refer-to-them-as-satans_n_59c2cfede4b06f93538c2c03
Hebda, T., Hunter, K., & Czar, P. (2019). Handbook of Informatics for Nurses and Healthcare Professionals. New York: NY: Pearson.
Hessels, A., Flynn, L., & Gershon, R. (2015). Impact of Health Information Technology on the Quality of Patient Care. Online Journal of Nursing Informatics.
Kramer, A. (2014). Medical Informatics Defined. Physician Informatics Community.
Mazurenko, O. (2015). Analyzing U.S. nurse turnover: Are nurses leaving their jobs or the profession itself? Journal of Hospital Administration, 4(4): 48-56.
Ventola, C. L. (2014). Social Media and Health Care Professionals: Benefits, Risks and Best Practices. Pharmacy and Therapeutics, 39(7): 491-499.
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