Richard E. McDermott, Ph.D. - Weber State University

Code Blue

Health Science Edition Four

Richard E. McDermott, Ph.D.

Traemus Books 2481 West 1425 South Syracuse, Utah 84075 Phone (801) 525-9643 Fax (801) 773-7669 traemus- carol@

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CODE BLUE--Health Science, Fourth Edition. Copyright 2013 ? by Traemus Books. All rights reserved. Printed in the United States of America. No part of this book may be used or reproduced without written permission except for brief quotations embodied in critical articles or reviews. For questions or inquiries contact: Traemus Books, 2481 W 1425 South, Syracuse, UT 84075, phone (801) 525-9643, fax (801) 773-7669, email carol@. This novel is a work of fiction. Any reference to historical events; to real people, living or dead; or to real locales is intended only to give the fiction a sense of reality and authenticity. Names, characters, places and incidents are either products of the author's imagination or are used fictionally, and their likeness, if any, to real-life counterparts is coincidental. To order copies, see Order Information on last page. Instructors: To order instructors materials including test bank, answers to student questions, and PowerPoint lecture slides, e-mail author at carol@. Include name, title, institution, department, mailing address, e-mail address, phone, and the course for which materials will be used.

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Table of Contents

Major Characters.................................................................................... 10 Acknowledgments ................................................................................... 12 Preface...................................................................................................... 13

Chapter 1--Trip to McCall.................................................................... 18 Changes in managed care Discussion One--Communication........................................................ 22 Discussion Questions ............................................................................ 22 Writing Exercise ................................................................................... 23

Chapter 2--The Board ........................................................................... 24 Discussion One--Power and Politics ................................................... 27 Discussion Questions ............................................................................ 27

Chapter 3--A Change of Seasons.......................................................... 28 The importance of teams Quality assurance HIPAA and EMTALA Risk management A shabby termination--treating employees with respect The new healthcare environment Discussion One--Employability Skills ................................................ 39 Discussion Two--Terminology............................................................ 42 Discussion Questions ............................................................................ 44 Writing Exercise ................................................................................... 45 Role-playing Assignment...................................................................... 46

Chapter 4--Resolve and Regret ............................................................ 47 Should hospitals be run like businesses? Confidentiality in employee communication Operations and the role of the board of trustees Operational problems within the hospital Discussion One--Assuming the Reins ................................................. 54 Discussion Two--Teamwork ............................................................... 55 Discussion Questions ............................................................................ 59

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Chapter 5--Amy ..................................................................................... 63 How hospitals dehumanize patients Discussion One--Patients' Bill of Rights............................................. 65 Discussion Two--Healthcare Ethics .................................................... 66 Discussion Questions ............................................................................ 69 Guidelines for Answering Bioethical Questions................................... 71 Bioethical Case Studies......................................................................... 74

Chapter 6--Quality Assurance--The Plan .......................................... 79 Malpractice Peer review Total quality management (TQM) More on EMTALA and patient dumping Purpose of morbidity and mortality committee The 100k Lives Campaign The legal liability of the board for quality Purpose of the credentials committee Applying for medical staff membership Purpose of the infections committee Purpose of the quality assurance committee Discussion questions. ........................................................................... 84

Chapter 7--Implementing Quality Assurance..................................... 85 Strengthening the process of granting medical Staff privileges Economic ramifications of denying medical staff Membership Discussion One--Risk Management .................................................... 88 Discussion Two--Hospital Infections .................................................. 89 Discussion Three--Applying Principles of Body Mechanics and Ergonomics..................................................... 92 Discussion Questions ............................................................................ 93

Chapter 8--Cultural Diversity .............................................................. 94 Culture Ethnicity Race Cultural blindness Discussion One--Discrimination ......................................................... 99 Racial discrimination Sexual discrimination Age discrimination Disability Sexual preference

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Discussion Questions .......................................................................... 103

Chapter 9--High Noon......................................................................... 104 Financial problems caused by managed care Insolvency and bankruptcy Business plans Discussion One--Consequences of Bankruptcy................................. 109 Discussion Questions .......................................................................... 109

Chapter 10--Never Give Up ................................................................ 113 Developing personal character Non-responsive service departments Discussion One--Overcoming Discouragement ................................ 114 Discussion Two--Deciding Priorities ................................................ 114 Discussion Three--Participative Management................................... 115 Discussion Questions .......................................................................... 115 Writing Exercise ................................................................................. 115

Chapter 11--A Dynasty Falls .............................................................. 117

Chapter 12--Why Are Costs So High?............................................... 120 Health economics--the study of scarce resources Discussion One--The Impact of High Healthcare Costs on the Economy .................................................................... 122

Chapter 13--A Lesson in Medical Economics ................................... 123 Dramatic increases in healthcare costs The absence of price competition Characteristics necessary for a free market The absence of price elasticity Excess capacity Discussion One--Unreimbursed Care ................................................ 130 Discussion Questions .......................................................................... 131

Chapter 14--Gaming the System ........................................................ 132 The impact of cost reimbursement on healthcare costs Why nonprofit organizations have to earn a profit Discussion Questions .......................................................................... 134

Chapter 15--Adverse Incentives ......................................................... 135 Attempts to control costs through regulation Blue Cross and cost control The evolution of hospitals from poor houses Prospective payment and incentives for cost control Cost reimbursement and incentives for cost control

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