Purpose

The purpose of this discussion is to discuss organizational changes and ethical-legal influences in a clinical scenario at an out-patient family practice. Students will explore potential effects on patient outcomes and ethical and legal implications for members of the heath care team as a result of illegal behaviors.  Students will develop strategies that result in prevention of untoward outcomes that result in a positive practice culture.

Activity Learning Outcomes

Through this discussion, the student will demonstrate the ability to:

1. Demonstrate effective leadership styles in the management of organizational change (CO3)
2. Interpret various forms of ethical theories and application into practice (CO4)
3. Discuss practice guidelines and malpractice prevention (CO2)

 Due Date: Wednesday by 11:59PM MST of Week 2

Students must post a minimum of two times in each graded discussion. The two posts in each individual discussion must be on separate days. Posting twice on two different days meets the minimum requirement however for full credit, the student must post at least three substantive posts on three different days. The student must provide an initial post to each graded discussion topic posted by the course instructor, by Wednesday, 11:59 p.m. MT of Week 2. Subsequent posts, including essential responses to peers, must occur no later than the Sunday, 11:59 p.m. MT at the end of Week 2. Students are expected to submit assignments by the time they are due. Threaded discussions are not considered assignments and are not part of the late assignment policy.

 A 10% late penalty will be imposed for discussions posted after the deadline on Wednesday of week 2, regardless of the number of days late. NOTHING will be accepted after 11:59pm MT on Sunday (i.e. student will receive an automatic 0).

Total Points Possible: 100

Requirements:

You are a family nurse practitioner employed in a busy primary care office. The providers in the group include one physician and three nurse practitioners. The back office staff includes eight medical assistants who assist with patient care as well as filing, answering calls from patients, processing laboratory results and taking prescription renewal requests from patients and pharmacies. Stephanie, a medical assistant, has worked in the practice for 10 years and is very proficient at her job. She knows almost every patient in the practice, and has an excellent rapport with all of the providers.

Mrs. Smith was seen today in the office for an annual physical. Her last appointment was a year ago for the same reason. During this visit, Mrs. Smith brought an empty bottle of amoxicillin with her and asked if she could have a refill. You noted the patient’s name on the label, and the date on the bottle was 1 week ago. You also noted your name printed on the label as the prescriber. The patient admitted that she called last week concerned about her cough and spoke to Stephanie. You do not recall having discussed this patient with Stephanie nor do the other providers in the practice.

Case Study Questions:

1. What are the potential ethical and legal implications for each of the following practice members?
   • Medical assistant
   • Nurse Practitioner
   • Medical Director
   • Practice
2. What strategies would you implement to prevent further episodes of potentially illegal behavior?
3. What leadership qualities would you apply to effect a positive change in the practice?  Be thinking about the culture of the practice.
4. A scholarly resource must be used for EACH discussion question each week.

Solution:

What are the potential ethical and legal implications for each of the following practice members?

 Healthcare providers are expected to practice within their scope of practice. Performing beyond the scope of practice is a ground for disciplinary actions.  For the medical assistant, Stephanie, potential ethical implications include disciplinary actions by the facility or being reported to the board that regulates medical assistants. acting beyond the scope of practice. Legal implications include legal litigation. However, this is only possible if Stephanie’s action resulted in patient harm. For nurse practitioners, possible disciplinary action such as revoking licensure from the nursing board if patient harm could have occurred. The NP can also bear the liability for Stephanie’s action as MA is required to be supervised by the NP hence it may be an indication of negligence. A medical director is responsible for supervision as well as regulation and medical aspect that may affect the healthcare system in the healthcare organization ..