The Veterans Health Administration's failure and caregiving problem
The Veterans Health Administration's failure and caregiving problem may not be managed by raising the quantity of resources or by hiring more nurses and doctors. (Powell-Young, Baker & Hogan, 2006). Even though more resources might seem essential and crucial, they cannot provide comprehensive or adequate long-term solutions to the problems that the majority of cultures and basic ethical observers have recognized. The leadership style of the VA is defined by a lack of responsiveness, a failure to effectively communicate with and manage both employees and veterans. The culture has inculcated the problems of outdated and cumbersome technology, history of employee retaliation as well as a shortage of nurses, doctors and physical space for patient treatment.
An integrated ethics initiative
Taking ethics severe especially, about decision-making has been observed to be a difficult task for the VA. As such, an integrated ethics initiative came into play to assist in preventing the ethical lapse as well as integrating ethics into the healthcare management's mainstream. In the year 2008, over one hundred medical centers, as well as 21 regional networks, were launched. They come handy to facilitate the replacement of the traditional ethics committees which were considered not only to be obsolete but also but could also not manage larger systematic, environmental and cultural challenges (Cheung, 2005).
The standardized process and structure
A standardized process and structure was therefore introduced for doing ethics at three levels namely: decisions and actions, which involved daily administrators and clinician practices; processes and systems, that constituted of the factors that drive decisions and actions but are not visible in the short-run and finally, environment and culture, which involved the value of the systems that informs on financial and administrative policies and procedures in the VA structure (Cheung, 2005). The integrated ethics attempted changing the culture and systems for purposes of preventing unethical conduct within VA.
The challenges of implementing ethics in healthcare
Practicing the right thing, which is taking ethics critically in this case, indeed has come out not to be an easy task for VA just the way it has always been for most institutions, to some extent worse, immaterial to quality nature. The latter has evident from the first-hand experience as described by Cheung (2005) that the former Hospital of ethics of the Philadelphia (PVAMC) and the creator of PVAMC organization ethics committee claimed that ethics quality is not measurable with authenticated measurement instruments. Thus, ethics could not be established to be an esteemed portion of health care quality. Ethics itself in a wider view with regards to high-quality care affordability seems to be having an unclear institutional payoff. However, not validated even up to date that the VA's struggle to institute ethics in the organizational mainstream has become so creditable it is so clear that ethic an integral part of any professionalism. Certainly, the program was commended by many researchers due to its broad goals relating systematic actions to ethical practices and its all-inclusive goals for humanizing ethics in healthcare. Therefore, to infuse ethical practices in healthcare the management and stakeholders have to understand significant challenges involved and manners n which they can be resolved.
The overwhelming of the ethical program
The standardized processes and structures which were designed to facilitate the implementation of the new ethical program got overwhelmed by an extensive and rigid organization which preferred documentation to actions and minimized ethics to risk management and compliance. The decision-making process is as such marred with unethical issues which could otherwise be solved by the implementation program (Ward, Stearmer& Cope, 2017). For instance, before decisions are made, performance evaluations and measurements are performed to guide the decision process. They, however, don't matter since they are not ethical excellence proxies.
The importance of leadership commitment and perseverance
The VA's efforts to introduce ethics into the organizational mainstream is however laudable. Transforming the culture of ethics in any large organization, especially when it influences the decision-making process is extraordinarily challenging. Corporate values at VA are work in progress (Cheung 122-126). Whether it succeeds or fails depends on the leadership commitment and perseverance of the corporate members as well as the moral courage of all the employees at the VA levels who assisted in improving the procedures and policies that influence the process of decision-making in the organization. It is recommendable that the VA performs a total review of the ethics program to recognize its weaknesses and strengths to make decisions on whether to discontinue or to do a replacement of programs that are not beneficial to the ethics and decision-making issues in the organization.
References
Cheung, P. (2005). Validity of Ethics Decisions in Palliative Care Research.Research Ethics, 1(4), 122-126. http://dx.doi.org/10.1177/174701610500100403
Powell-Young,, Y., Baker, J., & Hogan, J. (2006). Disaster Ethics and Healthcare Personnel: A Model Case Study to Facilitate the Decision Making Process. Online Journal Of Health Ethics, 3. http://dx.doi.org/10.18785/ojhe.0302.03
Ward, C., Stearmer, M., & Cope, M. (2017). Intersecting Contexts: Understanding Rural Utah Veterans' Experiences with Accessing VA Health Care. Rural Sociology. http://dx.doi.org/10.1111/ruso.12155
