Question

Complexities in Leadership

At your hospital, the Committee on Medical Ethics is a medical staff committee. It answers to the Medical Executive Committee and the medical staff president, and its members are jointly appointed by the president of the Medical Staff and committee chair.

Although it is a Medical Staff Committee, its membership is multidisciplinary, including physicians, nurses, social workers, lawyers, and members of the lay public (for community representation).

Most members of the committee have received training in clinical ethics consultation, and were chosen because of their interest in resolution of ethical issues and their interpersonal qualities with patients and staff.

The hospital administration has engaged a consulting firm to “modernize” its structure. The consultants have advised converting the “old” social worker approach to the contemporary position of case manager. The consultants note that three social workers sit on the Ethics Committee.

The social worker members of the Ethics Committee were advised that they will no longer serve on said committee, and that their place will be taken by the manager of case management, who has no experience in ethics consultation, nor does she know anything about the history of Ethics Committee activities at your hospital.

The chair of the Ethics Committee is informed that three of his committee members are “out.” The chair is livid, and there is also an immediate reaction from all the rest of the committee members, most especially the medical staff members of the committee— something about separation of powers is mentioned.

You have been assigned by the hospital administrator to “handle this mess.” How would you go about doing so? If you had been told to handle the proposed committee reconfiguration from the very beginning, what would you have done differently from what was done? What change management practices would you have implemented to have these adjustments be handled better?

Describe your answer in detail, write in a response to each case scenario. Your Journal entry should be at least 500 words.

Answer 1

The functions and responsibilities of social workers have got changed. The majority of the hospitals removed social workers during the 1990s so that non-beneficial overtime can get prevented. At present several of the medical committees have to work hard with the substitution of the work of social workers with the case managers. The situation can be handled by looking at the corresponding abilities of every disciple.

The case managers and social workers possess distinct skills sets and knowledge. The members of the committee have to look for the specific differences between the two so that modernization of the structure can be done. The social workers generally perform the roles in the cases of social dysfunction and life-threatening medical cases and are also involved in counseling and discharge planning.

However, at present, the hospitals are reducing the length of stay as it is turning cost-effective, which is making discharge planning more important in comparison to psychological counseling. Thus, the activities of social workers are changing completely, and the involvement of case managers is becoming more important.

In this condition, one can utilize the finest skillset of the case manager and the social worker. There is a need to divide the work of social workers and case managers, that is, by adapting the skills of both case managers and social workers based on the patients and their requirements. Thus, creating novel structure groundwork as the collective work of social workers and case managers.

The provision of work is to be decided by the members of the committee and the assessment has to be done to get desired outcomes. There is a need to create and maintain a modern method, imparting appropriate training regarding committee ethics, and the committee has to ensure that they are fulfilling the requirements of the present and coming future needs.