1. Ethics in quality
improvement
Calle Lindén
Emily Moore
The Dinh Thi

2. Heart Failure
• Ethics of readmission for elderly patients
• 75-85 years
• heart failure NYHA Class II-IV
• telephone support and discharge education
• The cost-effectiveness in healthcare

3. To help interveners having
suitable decisions
Respect for
persons
Addressing
conflict of Justice
interest
patients
Beneficence
Diversity & non-
maleficence
Integrity

4. Values of medical ethics
• Autonomy - the patient has the right to refuse or choose their
treatment.
• Beneficence - a practitioner should act in the best interest of the
patient.
• Non-maleficence - "first, do no harm".
• Justice - concerns the distribution of scarce health resources, and
the decision of who gets what treatment (fairness and equality).
• Dignity - the patient (and the person treating the patient) have the
right to dignity.
• Truthfulness and honesty –

5. • To meet patient expectations
• To address the health needs of the community
• To enhance the quality care
• To foster professionalism
• To improve the organization s culture and practices

6. What components make up
cost in healthcare?
• Direct costs
Medical: drugs, staff-time, equipment.
Patient: transport, out-of
pocket expenses.
Cost in
Productivity costs Intangibilities: healthcare
Pain, suffering…

7. Ethics in healthcare
• Ethical standards promote the aim of medical care to alleviate
suffering.
• Medical care is built on the communication between medical
workers on one side and patients and/or patients’ families on
another side.
• Ethical standards will help to build public support for medical
care.
• Health and medical care typically involve different medical
workers from a variety of disciplines.

8. Ethical Problems for Heart
Failure Patients
• Costs
• Unnecessary medical services
• Fees for medical services
• Balancing practice economics with patient need
- improving health along with financial realities of running a
hospital or health service

9. References
• Morgan, L., (2006). Hasting center report on Ethics of Quality
Improvement.
• Anne Mart Oostheizen, Silvia Pera, Dirk van der Wal. (2011).
(3rd ed). Ethics in Healthcare.
• Sheila, M., (2006). First do no harm: Law, Ethics & Healthcare.
• Batter, K. (2001). Ethics issues in advanced nursing practice.
Edinburgh: Elsevier science limited.
• LAO. Providing Constitutional and Cost-Effective Inmate
Medical Care. Taylor, M. Legislative Analyst. April 19, 2012.
• Brent C. James, M.D. (1989). Quality Management for Health
care delivery.
• Aastha , D. (2012). Ethical Issues in Healthcare.
http://www.buzzle.com/articles/the-importance-of-health-
ethics.html

10. References
• AMA. (1994). Opinion 6.05 - Fees for medical services.
Retrieved from http://www.ama-assn.org/ama/pub/physician-
resources/medical-ethics/code-medical-
ethics/opinion605.page?
• WMA. (2006). WMA international code of medical ethics.
Retrieved from
http://www.wma.net/en/30publications/10policies/c8/
• AMA. (1994).AMA’s code of medical ethics. Retrieved from
http://www.ama-assn.org/ama/pub/physician-
resources/medical-ethics/code-medical-ethics.page?
• Medellin, G. (2011). Balancing practice economics with patient
need. Retrieved from http://virtualmentor.ama-
assn.org/2011/08/ccas1-1108.html

11. Search Process
• Established the common ethical values and principles in
healthcare
• Applied these values to our problem
• Used academic data bases and government websites to direct
our searches

12. Collaboration Process
• Divided up ethical problems to research among group
members
• Met up and combined powerpoint slides