Examine the role of leaders in ethical decision-making and problem solving strategies in the U.S. health system.

Examine the role of leaders in ethical decision-making and problem solving strategies in the U.S. health system.

HS450-5: Evaluate the impact of ethical decision-making on healthcare leadership to maximize strategic planning

Unit Outcomes

 Discuss the principles of ethics and medical professionalism in strategic planning.

 Examine the role of leaders in ethical decision-making and problem solving strategies in the U.S. health system.

GEL-7.7: Analyze the effects of ethical decision making on the field of study.

Unit 8 Assignment

Case Study: Problems at the VA Health System

In 2009, President Barack Obama appointed Eric Sinseki as the secretary of Veterans Affairs (VA), the U.S. department responsible for providing healthcare and federal benefits to U.S. veterans and dependents. Secretary Shinseki was charged with 16 initiatives to bring the VA into the 21st Century. One of the 16 initiatives was to enhance veterans’ experience with and access to healthcare.

In 2013, CNN was among the news outlets reporting that veterans were experiencing delayed care at the Williams Jennings Bryan Dorn Veterans Medical Center in Columbia SC. In fact, the delays were so serious that six veterans died while waiting for months to receive necessary diagnostic procedures. The VA launched an investigation into the GO clinic at Dorn and found several issues, including low staff census; leadership turnover that resulted in a lack of understanding of roles, responsibilities and system processes; and program coordination. Allegations of long wait times also emerged about VA facilities in Arizona, Pittsburgh, and Phoenix VA Health Care Systems. Delays, however, were not the only issues in the VA facilities. In the Phoenix VA Health Care System, for instance, there were claims of manipulated patient wait times, bad scheduling practices, and patient deaths.

In 2014, the Office of Inspector General (OIG) launched an investigation into these allegations.

Two questions were addressed in this review:

1. Did the facility’s electronic wait list (EWL purposely omit the names of veterans waiting for

care and, if so, at whose direction?

2. Were the deaths of any of these veterans related to delays in care?

The investigators confirmed “inappropriate scheduling issues throughout the VA and health care system.

The OIG report concluded as follows (VA 2014, iii).

In Phoenix VA, specifically, investigators found that 1,400 veterans did not have a primary care appointment

but were listed on the EWL and that 1,700 vete


 

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