A moral compass for management decision making: a healthcare CEO's reflections.

Ethical behavior is good for business in any organization. In healthcare, it results in better patient care, a more committed and satisfied staff, more efficient care delivery, and increased market share. But it requires leaders who have a broad view of the role that ethics programs--and an effective, sustained ethical culture--play. Ethical organizations have integrated and shared ethical values and practices, an effective ethics infrastructure, ongoing ethics education for staff at every level, ethical and morally courageous leaders, and a culture that is consistent with the organization's values. The mission, vision, and values statements of these organizations have been successfully translated into a set of shared values--a moral compass that guides behavior and decision making.

New Hampshire critical access hospitals: CEOs' report on ethical challenges.

Research into the importance of organizational healthcare ethics has increasingly appeared in healthcare publications. However, to date, few published studies have examined ethical issues from the perspective of healthcare executives, and no empirical study has addressed organizational ethics with an explicit focus on rural hospitals. For our study, we sought to identify the frequency of ethical conflicts occurring within 12 general categories (domains) of administrative activities. Also, we wanted to determine what ethics resources are currently available and whether additional resources would be helpful. We conducted a structured telephone interview of all 13 chief executive officers (CEOs) of critical access hospitals in New Hampshire. All the CEOs in the study indicated that they encountered ethical conflicts. On average, the three most frequently noted domains were organizational-professional staff relations, reimbursement, and clinical care. All CEOs indicated they would like to have additional ethics resources to address these conflicts. This study verified that CEOs encounter a broad spectrum of ethical conflicts and need additional ethics resources to address them. Because this study used a small sample of CEOs and represented only one New England state, further ethics-related research in rural healthcare facilities is warranted. Follow-up study would allow for (1) a higher level of generalization of the findings, (2) clarity regarding specific ethical dilemmas that rural healthcare executives encounter, and (3) an assessment of ethics resources and training that healthcare executives need to address the ethical conflicts.

Honesty in leadership. Interview by Mary Grayson.

The AHA's chair-elect Thomas Priselac talks with Health Forum Publisher and Editorial Director Mary Grayson about health care reform, the role of IT in health care, workforce relations and what it means to be a leader.

Guilty in Rhode Island. Conviction of hospital executives in Roger Williams case strengthens the argument that stronger oversight needed.

The conviction of two former Roger Williams Medical Center executives in Rhode Island is sure to keep up the heat for more vigorous oversight of hospitals. Robert Urciuoli and Frances Driscoll were both convicted of fraud. "It's not to say that directors should be running these organizations," says attorney Patrick Coffey, left. "But it is their function to hire qualified people (who) won't ever tarnish the reputation of their institution".

States turn up the heat. As self-regulation sputters, state legislatures are leading charge for more accountability in governance of not-for-profit hospitals.

Recent scandals have pushed some states to tackle transparency and governance issues at healthcare not-for-profits, which the federal government has been reluctant to touch. Rhode Island Lt. Gov. Charles Fogarty, left, supports a bill in his state that would establish a code of ethics for hospital boards. Fogarty sees leaders as getting too comfortable in their jobs and working without accountability.

Expanding the scope of fiduciary duties to fill a gap in the law: the role of nonprofit hospital directors to ensure patient safety.

In the wake of the patient safety movement, there is a glaring disconnect between the increasing responsibilities placed on hospital board members and the limited accountability for those board members if they fail to meet their responsibilities. This Article discusses how the effectiveness of new patient safety laws is diminished by the lack of accountability of nonprofit board members. The Article suggests that an expanded notion of corporatefiduciary duties, enhanced by shifts in social norms, would contribute to patient safety reform.