Medical Law and Ethics Report: Analysis of Hospital Cases

This report delves into various aspects of medical law and ethics within a healthcare setting, analyzing four distinct case studies. The first case examines the challenges faced by a hospital in ensuring employee health and well-being, including discussions among key committee members regarding issues like long working hours, stress, and the need for subsidized medical services and counseling. It includes an IS/SHOULD comparison table. The second case focuses on the allocation of refrigerators across different hospital departments, evaluating the cost-effectiveness and convenience of different options. The third case assesses patient satisfaction, highlighting areas of concern such as facility cleanliness and food services using a Pareto histogram. The final case outlines a Plan-Do-Check-Act (PDCA) cycle for reducing blood sample contamination through improved phlebotomy techniques. The report references several sources to support its findings and recommendations.

1Running head: MEDICAL LAW AND ETHICS
Medical Law and Ethics
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Case 1
The present issues faced by the hospital are multifaceted and for improving the health
and wellbeing of all the employees it is imperitive to set up a committe. The members of the
committe for this purpose are as follows-
Harry Thomas - Director of the health care setting
Mark Clinton - Chief Medical Officer
Martha Harris- Chief Nursing Officer
The opinion of the three committe members was directed towards the same goal;
bringing changes in the manner health and wellbeing of the employees are addressed. While
Harry belived that much improvement have been made in the recent past, Mark and Martha
argued that there is much left to be done that is potentially of more concern. The chief
concern of Martha was that the nurses are subjected to more adverse conditions, the most
important being increased risk of patient harm. Nurses work with patients who have physical
and mental instability. Under such conditions, the safety of the nurses is a chief concern.
Mark had the viewpoint that the pathologists and radiologists are being continually exposed
to hazards and infectious agents that are to be addresse immediately. Mark and Martha agreed
that apart from creating a better and safe working environment, it would be beneficial
approach to provide medical services to the employees at a subsidised rate.
Martha- High rate of absenteeism of nurses is the reflection that this employee population is
more subjected to poor health conditions.
Mark- Agreeing to this fact, I would like to add in that the probable cause of such high rate of
abseetiesm is increased stress and burnout in comparison to the phsycial exhaustion
experienced by other employees of the organisation.

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Harry- Well, then I think we should be looking forward to implement strategies through
which nursing burnout and stress can be reduced.
Mark- I have accumulated reports from pathologists who have mentioned that their working
hours are of long duration, leading to phsycial burnout.
Martha- Strategies for addressing concerns of nurses can be applied for the radiologists too.
Harry- This would require proper allocation of resources. Funding would be the focus under
such circumstances.
Martha- Increased recruitment of professionals might solve the issue to some extent.
Mark- Reduction in the working hours of the professionals would be the best suited strategy
at present,
Harry- An accurate cost benefit analysis would be imperitive therefore. Support and
sugeestions from all speheres are welcomed.
Table 1. IS/SHOULD comparison
Is Should
Longer duration of working hours of nurses Shorter duration of working hours
Longer duration of working hours of pathologists Shorter duration of working hours
Abscence of health checkup for professionals at
subsidised rate
Regular health checkups conducted for
employees
Abscence of provision for counselling for
employees
A conselling cell for employees to combat
emotional stress
The team came to the consenus that mental stress and physical exhaustion are to be
addressed immediately for promoting health and wellbeing of the employees. As stated by

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Singh and Lillrank (2015) productivity can be increased if employees are in good health. The
healthcare setting was recoomended to carry out a regualt monitoring for understanding the
benefits achieved. Though there might be opposition to the idea that the suggested steps
would be economically disadvantegous for the system, it can be stated that absenteeism and
turnover due to health conditions of the employees is more of an economic burden for the
organisation.
Case 2
Laboratory- It would be advisable to have provision for five different refrigerators for each of
the five departments for eliminating chances of conflict. The cost for each would be 150 US
dollars.
Pharmacy- Two large cold-room refrigerators would serve the purpose. One refrigerator
would not suffice.
Rehabilitation- One refrigerator of approximate 600 US dolloars would be advantageous.
This needs to have the best available facilities though.
Labor & delivery- Refrigeration plants installed in a permanent manner would be beneficial.
The initial cost, though seem high, would be less than that of regular maintainence of
multiple refrigerators.
Post-partum- Five different refrigerators would be needed for each department since the
number of employees from each department is high.
Table 2. Evaluation grid of refrigerators
Refrigerator Points of evaluation
5 refrigerators at 150 dollars each Higher cost of purchase

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Convinience of employees
1 refrigerator of 600 dollars Low cost of purchase
Inconvenience of employees
1 Refrigerator plant High initial cost
More flexible
2 large cold-room refrigerators Low cost of purchase
Inconvenience of employees
The team decided to purchase 5 refrigerators keeping in mind the convenience of the
employees. Though the cost of purchase was higher than one single refrigerator, the
difference in the cost was not much. The initial capital would be less as compared to
establishing a permanent refrigerator plant. Each refrigerator would be allocated for each of
the five departments. All the refrigerators woud be of the same feature and from the same
manufacturing company. The basic features for a refrigerator would be present so as to serve
the basic functions. The maintainence cost for these refrigerators would thereby be of not
much concern.
Case 3
Table 3. Satisfaction score
CATEGORY SATISFACTION SCORE
Parking 7
Customer Service 6
Registration 2
Food services 1
Facility Cleanliness 0

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Figure 1. Pareto histogram showing satisfaction score
The Pareto and Histogram was an indication that the satisfaction score with regards to
facility cleanliness and food services were extremely poor, at near about zero percentage.
These two areas contributed to 80% of dissatisfaction score. The area that was prominent for
satisfying the patients was the parking area. This was the only area where near about 80%
satisfaction was achieved. Registration and customer services also have areas needing
improvement for increasing the obtained score. According to Denton (2013), customer
satisfaction is the key area where patient satisfaction score needs to be highest. The
registration process also needs to be swift and efficient enough to handle a large number of
patient population at a time.
The health care setting must address the concerns related to food services and
cleanliness at the earliest. Cleanliness is essential in a healthcare setting as prevention of
infectious and contagious diseases is pivotal. The setting must allot workers who would be
entrusted with the responsibility of maintaining a clean and healthy environment. In addition,
the healthcare professionals are to be educated about the importance of the same and must be

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encouraged and motivated to adhere to cleanliness practices. For better food services, the
setting can consider giving the tender to a different food service agency that is better capable
of handling the patient demand (Roberts et al., 2016).
Case 4
Plan-Do-Check-Act Cycle (PDCA)
Plan- The chief approach to reduce the rate of contamination of blood samples would be to
carry out efficient and safe phlebotomy techniques. Such practices would mainly pertain to
collection of blood from the puncture site after cleaning has been done adequately to
eliminate chances of infection. Sterilisation of the skin with the help of antiseptic would be
beneficial in this regard. The latest guidelines of safe phlebotomy techniques are to be
researched on for this purpose.
Do- The plan is to be executed for each patient from whom blood would be collected. The
aim would be to reduce the chances of contamination of external flora into the puncture site.
It would be desirable to carry out an examination of the contamination presented to the blood
sample if any (Nelson & Hood, 2016).
Check- Data is to be recorded for each of the samples, and a comparison analysis between
the samples would be beneficial to understand the maximum extent to which contamination
can be prevented.
Act- Depending on the results achieved, it would be advisable to refer to more detailed and
advanced techniques that are available. After deciding onto the best available methods, they
are to be adopted and implemented on a regular basis (Talaro & Chess, 2017).

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References
Denton, B. T. (2013). Handbook of healthcare operations management. New York: Springer.
Nelson, D. E., & Hood, M. (2016). Phlebotomy Training Programs: An Investment in
Laboratory Quality and Improved Patient Services. Laboratory Medicine, 11(10),
669-672.
Roberts, J. P., Fisher, T. R., Trowbridge, M. J., & Bent, C. (2016, March). A design thinking
framework for healthcare management and innovation. In Healthcare (Vol. 4, No. 1,
pp. 11-14). Elsevier.
Singh, V. K., & Lillrank, P. (Eds.). (2015). Innovations in Healthcare Management: Cost-
Effective and Sustainable Solutions. CRC Press.
Talaro, K. P., & Chess, B. (2017). Foundations in microbiology. McGraw-Hill.