Healthcare Ethics: Tackling ED Overutilization

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Table of Contents

Introduction
Case Study Overview
Ethical Issue Analysis
Possible Solutions
Communication Approaches
Conclusion
References

Introduction

Each day, many patients require urgent medical treatment provided in the Emergency Departments (ED). This structure’s functioning is an essential instrument in ensuring timely medical treatment for acute illnesses. The maintenance of such a huge system requires significant funding. Even though Medicaid usually covers most expenditures, ED requires governmental material support to be developed further. The research case and Loshinski’s examination showed that there is such a problem as ED overuse which is associated with substantial medical costs. This ethical issue should be elaborated on to empower medical innovations and reduce ED expenditures. Possible solutions for this problem are to increase the patient’s medical awareness and improve the high-speed diagnostic instruments.

Case Study Overview

The case study addresses the issue of ED overuse in Texas. According to the provided data, the patients often visit the ED wrongfully when they need no urgent help. Such a situation involves significant funding and Medicaid money wasted. This ethical problem is a considerable obstacle to applying innovations in medical treatment. The author of the case study believes that if the expenditures are reduced, the medicine and ED urgent treatment may have more significant developmental potential. Generally, this ethical problem affects both the patients and the medical providers.

The patients are concerned that they are experiencing dangerous health conditions when they need regular medical help. The medical providers lose the possible opportunities to help in urgent situations because they spend resources on treating common cases. Factors contributing to this ethical problem are the patient’s lack of medical education and awareness and the insufficient diagnostic instruments in the medical organizations.

Ethical Issue Analysis

The current problem can be analyzed from the perspective of the ethical decision-making model, which includes three components: moral awareness, moral judgment, and ethical behavior. The first factor can be associated with insufficient patients’ understanding of the health issues. The lack of knowledge and behavioral patterns of what should be done in particular situations causes significant problems for patients and medical providers.

Patients should estimate their health state adequately and seek a suitable type of treatment: urgent or regular. Moral judgment is connected with the patients’ ability to compare their health needs with other people’s ones. Considering the ethical implications, they should prioritize their healthcare need only in extreme cases. This is also related to ethical behavior when patients estimate their health condition as a typical case but strive to get more rapid health and go to the ED. Thus, they should be taught how to assess their health state and which treatment they should get in different cases.

Possible Solutions

There are two problem solutions to the problem mentioned in the study. The first one is implementing large-scale educational programs for the patients to increase their medical literacy (Hinson et al., 2018). It can be implemented through a mobile application that navigates the patients when choosing the medical department. Another solution is ensuring the technological advancement for the surveillance of the patient’s cases and the diagnosis systems.

According to the practical attempts to implement the cooperative approach, a total decrease in the wrong ED appeals was noted (Adams, 2013). Besides the most productive analytical technologies, it would be rational to apply the patient-oriented communication approaches. The ethical problem will be solved if the clinicians consult the patient who has wrongfully visited the ED on the diagnosis step (Adams, 2013). Thus, implementing new technologies and the interaction of the patient-oriented communication approaches will help decrease the costs and wrongful ED visits.

Both of these two solutions comply with four fundamental principles of ethics, which include the principle of respect for autonomy, the principle of beneficence, the principle of nonmaleficence, and the principle of justice. However, the first solution may interfere with personal rights and freedoms if implemented improperly. It may be essential not to oblige citizens to participate in proposed educational programs. Instead, the potential benefits of such medical literacy improvements should be explained, and the necessary data should be available from various types of sources.

The principle of beneficence is also followed as medical literacy improvements may prevent ED overuse, mitigate professional burnout of healthcare workers, increase the quality of medical services, and improve patient outcomes. The decision does not contain any intentions to harm and hence adheres to the principle of non-maleficence. The provision of equal opportunities for all citizens to learn more in the field of medicine complies with the principle of justice.

The second solution may also face several problems related to the principle of autonomy, as it involves surveillance and personal data processing. Moreover, the efficiency of the second measure may depend on the level of surveillance. Hence, it may be important to introduce a balanced approach to maximize efficiency while minimizing privacy interference. The initiative is highly beneficial as it not only solves the ethical dilemma but also may provide valuable practical data regarding the use of electronic health records. It also respects the principle of non-maleficence, as no malicious intent is involved. The solution treats people fairly and equally and hence corresponds with the principle of justice.

Communication Approaches

As was mentioned earlier, the lack of awareness and collaboration among the patients and clinicians is a fundamental problem of the study. While solving this ethical problem, the non-assertive communicational approach can be helpful. This choice is logical because it contributes to better cooperation and complies with the patient-oriented focus of healthcare. Thus, the non-assertive communicational approach is effective for solving the discussed ethical problem.

On the contrary, the assertive communicational approach is irrelevant for this case. The main aim of the collaboration with patients and increasing their awareness is mutual understanding. For example, when executing the rapid diagnostic, the clinicians should be calm and understanding to persuade the anxious patients to consult the ordinary medical department. The consequences of using non-assertive communication are the growth of the medical awareness of patients and the reduction of ED expenses. For the assertive approach, only the aggravating of the current situation is expected.

Considering the communication effectiveness within the case study, it is necessary to mention that the health care professionals academically discussed the problem. There were conferences, the data collection procedure, and scientific publications on the topic mentioned. Such an approach is relevant for the ethical issue of such a scale that touches upon the whole healthcare system. This moral issue requires scientific data gathering and analysis, which can provoke discussion to solve the main problem. Thus, mentioned in the case study, medical professionals’ activities are efficient for developing ED overuse.

The professionals in the case study chose the structured and rational approach to deal with the ethical problem. Before making conclusions and finding the problem solutions, Losinski double-checked the information and collected the practical data. After that, the researcher summarized the moral issue in the article, which he presented to his executive committee to provoke discussion. Then he asked the management team to find possible solutions. Generally, the researcher took all the necessary actions to state the problem and highlight the additional research necessity. Even though there were no practical issue solutions presented in the study, all the activities were efficient.

Conclusion

The key lesson that health care professionals can apply in their practice based on the case study is that any issue requires detailed analysis and collaboration. Such an approach helps to build effective relationships across disciplines within the medical organization. The precise data collection, the exploration of the ethical contributions, and the task distribution will help find the problem solution more quickly. The other studies mentioned in this work provided more practical ways to solve this ethical problem. The lessons learned from them are efficient communication with patients and technological innovations.

These factors are the core aspects of decreasing the ED wrongful visits. The mentioned problem solutions are ethically and medically correct, helping to save clinicians’ resources and patients’ time. Moreover, the implementation of the mentioned in the ways of the article can appeal to other professionals to develop cross-organizational collaboration because of the high-quality treatment opportunities.

Therefore, the case study provides a practical, ethical problem exploration approach, which provokes the discussion and contributes to its solving. The ED overuse is a significant problem undermining the quality of health care. The researchers’ framework addresses all the essential moral and theoretical aspects of the discussed issue. The approaches used in the articles provide practical solutions for ethical problem-solving. Thus, this solution is rational and can be applied in practice more widely in medical practice.

References

Adams, J. (2013). Emergency department overuse. JAMA, 309(11), 1173–1174. Web.

Hinson, J., Nothelle, S., Pannikottu, J., Segal, J., Sharma, R., & Tung, M. (2018). Factors associated with imaging overuse in the emergency department: A systematic review. The American Journal of Emergency Medicine, 1, 1-12. Web.

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