Hospital Consumer Assessment of Healthcare Providers and Systems: An Ethical Leadership Dilemma to Satisfy Patients.

This article examines the parameters and the dynamics of Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) that create an ethical leadership dilemma to satisfy patients in the hospital setting while still ensuring appropriate care for quality clinical outcomes. Under the Affordable Care Act, hospitals and health care systems are in a high-stakes struggle of winners and losers based on HCAHPS scores. This high-stakes struggle creates unintended consequences of an ethical dilemma of doing what is right for the patient versus doing whatever it takes to please the patient in order to achieve high scores of satisfaction that are tied to better reimbursements. This article also reports the results of a national survey of 500 chief executive officers by the authors about the attitudes and frustrations of chief executive officers confronting the wild unrest caused by HCAHPS.

The ethical leadership challenge for effective resolution of patient and family complaints and grievances: proven methods and models.

Health care leaders and managers face the ethical leadership challenge in ensuring effective resolution of patient and family complaints and grievances. In today's society of increasing discontent about safety, quality, cost, and satisfaction, patient complaints and grievances are becoming more prevalent. Under the mandates of the Patient Protection and Affordable Care Act for transparency of quality and patient satisfaction scores and to be compliant with the standards from the Centers for Medicare & Medicaid Services and The Joint Commission, it is imperative that leadership ensure an ethical culture for effective resolution of patient and family complaints and grievances. This article addresses this ethical leadership challenge by providing a systematic approach with proven methods and models for effective resolution of complaints and grievances and thereby improving satisfaction, quality, safety, and cost.

The Affordable Care Act: the ethical call to transform the organizational culture.

The Patient Protection and Affordable Care Act will require health care leaders and managers to develop strategies and implement organizational tactics for their organization to survive and thrive under the federal mandates of this new health care law. Successful health care organizations and health care systems will be defined by their adaptability in the new value-based marketplace created by the Affordable Care Act. The most critical underlining challenge for this success will be the effective transformation of the organizational culture. Transformational value-based leadership is now needed to answer the ethical call for transforming the organizational culture. This article provides a model and recommendations to influence change in the most difficult leadership duty-transforming the organizational culture.

Patient service navigator: improving quality and services and reducing cost under the Affordable Care Act.

This article proposes the implementation of a Patient Service Navigator to improve quality, service, and the patient and family experience and to reduce costs in caring for patients in a hospital setting. Under the Affordable Care Act, the Patient Service Navigator is a means to address value-based purchasing whereby hospitals will be reimbursed based on quality and Hospital Consumer Assessment of Healthcare Providers and System scores for Medicare patients. In this article, the reader will learn the history, background, purpose, and role of the Patient Service Navigator as a critical component of a multidisciplinary health care team in supporting inpatient care with a human touch. Navigating for the patient and family in a confusing and complex health care delivery environment is critical today in order to survive the mandates of the Affordable Care Act.

The Affordable Care Act: the ethical call for value-based leadership to transform quality.

Hospitals in America face a daunting and historical challenge starting in 2013 as leadership navigates their organizations toward a new port of call-the Patient Protection and Affordable Care Act. Known as the Affordable Care Act (ACA) was signed into law in March 2010 and held in abeyance waiting on 2 pivotal points-the Supreme Court's June 2012 ruling upholding the constitutionality of the ACA and the 2012 presidential election of Barack Obama bringing to reality to health care organizations that leadership now must implement the mandates of health care delivery under the ACA. This article addresses the need for value-based leadership to transform the culture of health care organizations in order to be successful in navigating uncharted waters under the unprecedented challenges for change in the delivery of quality health care.

Generation Y in healthcare: leading millennials in an era of reform.

The healthcare workforce has grown with the addition of a new group of physicians, nurses, allied health professionals, administrators, and support staff who belong to America's youngest generation now in the workforce-generation Y, or the millennials. This generation consists of more than 70 million people, the oldest of whom are now in their late 20s and early 30s. With traits and workplace expectations that differ from those observed in other generations, and with a size that threatens to overtake the total number of baby boomers, generation Yers are positioned to influence (if not drastically change) current leadership approaches. The common traits that define or are associated with generation Y workers are often regarded as barriers yet provide healthcare leaders with a clear guide to understanding these employees and drawing out their best qualities and performance. For the organization to fulfill its social contract to provide high-quality, cost-effective, and safe healthcare, it must satisfy the needs and manage the expectations of those who directly deliver these services. This is especially important in today's environment, which is marked by the still-fluid stipulations of the Affordable Care Act (ACA), changed consumer expectations, and public demands for transparency and accountability.

The ethical leadership challenge to do no harm: the cognitive imperative.

In hospitals across the United States, there is a growing epidemic of unprecedented proportions. This epidemic is the rising number of deaths caused by medical errors. Deaths due to medical errors are a leading cause of deaths in the hospital setting. These errors are attributable to human error. Health care managers and leaders must gain knowledge of how cognition is related to human error. With this knowledge, health care managers and leaders will have a better understanding of how cognition is the primary cause of human error in the hospital setting. This article addresses and evaluates the different components of cognition and provides recommendations to reduce human error and thereby deaths in hospitals.

The ethical leadership challenge: creating a culture of patient- and family-centered care in the hospital setting.

The growing number of medical errors and resulting preventable deaths in hospitals presents an ethical dilemma that must be addressed by health care leaders and managers. These medical errors and deaths raise questions about safety and quality issues resulting in rising public mistrust and patient dissatisfaction. Many of these medical errors and deaths could have been avoided by including the patient and family in the care. The ethical challenge for leadership is creating a culture of patient- and family-centered care as a means to improve quality, safety, patient satisfaction, and public trust. This article addresses ways to improve safety, quality, patient satisfaction, and cost and thereby reduce medical errors and deaths by implementing a patient- and family-centered care culture. The first critical step for improvement is for hospital leaders and managers to answer the ethical call to create a culture centered on patient- and family-centered care in the hospital setting.

Trust: the sublime duty in health care leadership.

Trust is the essence of human social existence. From the moment of birth, trust is the basic component in any human relationship and interaction. Trust is the Holy Grail for human confidence in others. From human survival to organizational survival, trust is the primordial bond. No organization is more dependent on trust than health care. This article views trust as the most basic fundamental quality for leadership. Trust is a sublime duty of a leader and the leadership of an organization. Leadership sets the culture of trust. Trust is the one quality that is essential for guiding an organization toward serving others. This article addresses trust from many perspectives. Trust is viewed from our subordinates, our peers, our superiors, and the public we serve. This article postulates how trust in an organization is the sublime duty of leadership that unites all human understanding and without it destroys all human relationships.

The Generation-Y workforce in health care: the new challenge for leadership.

The new generation of workforce entering health care today is the new challenge for leadership. This young workforce, known as the "Generation-Y," is demanding a different organizational culture to meet its needs. These new spoilers, once the babies of the baby boomers, will once again test the creativity and patience of their parents, who are now the leaders in health care. The baby boomer leaders of today face a delicate balance to meet the new demands of the Generation-Y workforce, along with the patients' demands. At stake in this balance is the viability of health care as we know it today. If the leadership of health care fails to grab hold of this new generation of employees, the ability to provide safe and quality health care and the survivability of the organization will be compromised. This article identifies the problem and provides guidelines to journey through this new wave of spoilers.

Ethics: the evidence of leadership.

Today's leaders in health care are being challenged by many demands and issues. To confront these many demands, health care leaders must have the ability to make decisions based on ethics. To ensure the survivability of an organization, the leadership must have values grounded on ethical principles. The problem in today's health care organizations is that not enough emphasis is being placed on a culture of ethics within the organization and within the behavior of the leadership. This article addresses the ethical issues facing today's health care leaders. In this article, an overview of the history and philosophy of ethics is provided along with definitions, guidelines, and a model to assist the leadership in health care organization to pursue and to adhere to a more ethical course.

A theoretical model to address organizational human conflict and disruptive behavior in health care organizations.

This article proposes a theoretical model for leaders to use to address organizational human conflict and disruptive behavior in health care organizations. Leadership is needed to improve interpersonal relationships within the workforce. A workforce with a culture of internal conflict will be unable to achieve its full potential to delivery quality patient care.

Passion in today's health care leaders.

Passion in today's health care leaders is essential as health care organizations face increasing demands for survival. Leaders in health care have been educated, selected, promoted, and retained based on their analytical and creativity skills. Today's health care leaders must also have emotional intelligence. Emotional intelligence is primal for passion. Emotional intelligence, which leads to passion, is crucial to the survivability of today's health care organizations. In order for health care organizations to go from good to great, the leader must inspire followers through passion. This article encourages health care leaders to gain awareness of emotional intelligence and to use emotional intelligence as part of their leadership to inspire passion. Through passion, leaders and followers become more motivated to accomplish the health care mission of serving others.

Addressing the phenomenon of disruptive physician behavior.

This timely article provides current information on an age-old issue of disruptive physician behavior within the hospital setting. Documented in medical literature over 100 years ago, disruptive physician behavior has been an ongoing challenge to the hospital staff and the quality of patient care in the hospital. Covered in this article are the negative consequences of disruptive physician behavior and the call to respond. If allowed to go unchecked, a physician exhibiting disruptive behavior may threaten a hospital's image, staff morale, finance, and quality of care. Failure to respond undermines the leadership of the hospital and the trust of the community in the hospital's mission. Included in this article are suggestions obtained from the literature and from the author's experience in responding to disruptive physician behavior. Of emphasis is a methodology that includes supporting bylaws and policies to manage disruptive physician behavior.