Health Care Decision-Making: A Qualitative Study

1. the robustness of the literature in this area, both in terms of assessing quality of care

The 25 participants were interviewed by a certified doctor and were asked questions regarding their

Individual ethics are important in decision-making within the health care industry. One of the main reasons for that is because often ethical dilemmas occur at lower decision-making levels, and this means that the decision is being made by one person, facing a difficult situation that must be resolved quickly. Another reason that individual ethics are important in health care is that often a manager is unaware that there is an ethical dilemma. Thus, by failing to recognize the ethical dilemma, the manager is resolving the dilemma by his or her actions without realizing that an ethical decision is being made (Mintz, 2011). This very much puts the individual's ethical compass at the center of the decision, because the default decision is the one that is being made, regardless of the ethical implications. If the person is generally ethical, the decision will probably be the right one; if the person lacks ethical standards, the decision could be very poor as result.

An emergency manager’s meeting was called this morning to announce the 2009 fiscal budget cut’s starting June 1, 2009. The North Carolina Department of Health and Hospitals has cut Medicaid payments for hospital services by 15 % to reduce the state 's budget deficit.These budget changes will directly affect private insurers with significant focus on the Medicaid recipients in the rural low income population located in Eastern North Carolina. During this called meeting a manager mentioned the Informed Decision Toolbox, she read about in an article for her graduate program. This article mentions steps or processes to help decide which services could be eliminated or introduced to continue to provide

Decision-making in the workforce is a process of responsibilities used by upper management to implement, enforce rules, regulations, and maintain a successful environment. Decision-making implemented more effectively by making a plan, thinking it through, accepting more than one opinion and determining what is best. However, decision-making often utilized more effectively by opening doors of opportunities for a suggestion, question, discussion, and feedback. Although, more involvement helps improve understanding, utilize behavior skills and present opportunities for better communication. Everyday life consists of decision-making, the right decision may not always be applied, but ensure room for improvement and opportunity. Individuals approached decision-making in many different ways. As stated by (Jones, Graham, & Bateman, 2006) decision making is a procedure used to recognize a problem, weigh the alternatives and evaluate a solution in which, certain situations will require different approaches to become effective.

Evidence-based practice includes the integration of best available research, clinical expertise, and patient/client values and circumstances related to patient/client management, practice management, and health care policy decision making (American Physical Therapy Association (APTA), 2015, para. 9). It is based upon the notion that clinicians will seek out and use scientific knowledge in the pursuit of best practice for their patient (Zidarov, Thomas, & Poissant, 2013, p. 1571). In our quest to further improve our practice and take our profession to the next level, it is our duty to serve our patients with the best available evidence. Evidence in physical therapy guides us to look at valid and reliable examination measures for precise diagnosis, evaluate prognostic and risk factors that influence and affect outcomes, assess treatment interventions’ credibility and effectiveness, and weigh its benefits versus harm, review predictive factors and analyze relevance to patient, clinical setting and available resources, and consider outcomes of episode of care.

The rational decision-making model describes a series of steps that decision makers should consider if their goal is to maximize the quality of their outcome. In other words, if you want to make sure that you make the best choice, going through the formal steps of the rational decision-making model may make sense. The following are the steps taken to come to a rational decision: 1. Identify the problem, 2. Establish decision criteria, 3. Weigh decision criteria, 4. Generate alternatives, 5. Evaluate the alternative, 6. Choose the best alternative, 7. Implement the decision, 8. Evaluate the decision.

Many times, time and perseverance is the key to the best result possible. But like Gary Collins said “We can try to avoid making choices by doing nothing, but even that is a decision. Therefore, decision making is in us relentlessly whether we want it or not.

Assess the value of healthcare professionals and decision makers understanding the discipline of health economics.

Professionals in all fields experience ethical problems especially in health care. In fact, ethical issues arise in government, industry, science, and academia (Steneck, 2004). Ethical issues can be see in every decision making process which often involves competing goals and motives (Werhane, 2002) Ethical decision making (EDM) requires a number of complex cognitive processes in which people must assess the effectiveness of alternative courses of action in the context of their understanding of the problem and the relevant rules and guidelines involved (Miner & Petocz, 2003). Occupational therapists (OT) have increased autonomy to meet the clients and provide unrestricted practice in today's healthcare

Healthcare is one of the fastest growing industries in the United States. With the new presidential administration and different changes in policies, people are putting more focus on hospitals and health insurance companies to make sure they give people the proper care that they need. I want to major in Health Administration because in a world with growing uncertainty and fear of the future, I want to make sure that people aren’t afraid and can afford to get medical care when they are sick or injured. The Bloustein School is the perfect place to help me achieve my goals and start my career in the professional world.

The data are collected from observation of over 100 patients’ visits, 50 of which were observed and audio taped. The research questions that are asked by Davidson are:

A focused clinical research question is comprised of four essential elements: the patient, population, or problem (P); the intervention of interest (I); the comparison of interest or the standard of care (C); and the outcome of interest (O). These four components represent the acronym PICO (Stone, 2002). As the elements of PICO become more precise, the review of the literature becomes more focused. For example, elements of PICO may translate into medical subject headings that can direct searches of the literature (Stone, 2002). Also, clinical questions for specific patient populations can be identified so that relevant information can be found on databases and Internet search engines easily (Adams, 2012). The facilitation of the data collection process is determined by how well the PICO components are articulated during the development of the focused clinical question (Stone, 2002).

The consumption of health care left to the market assumes certain conditions that are not reliably met in health care. For an ideal market, we seek both equity and efficiency. Efficiency in the sense of achieving optimal health benefits when allocating resources at minimal costs (1). Equity in a perfect market relates to the fair and just distribution of health care services (2). We will see that attempts to leave health care consumption to the market will achieve neither as certain conditions in health care result in extensive failure of the market. The key conditions that do not exist in health care are certainty, consumer sovereignty and symmetry of information between the provider and consumer (1). Externalities are also inherent in health which contributes to market failure in health care (1).

When thinking of health care I think it’s confusing because you have health care provided by employers, Obamacare, and Medical. It’s all around horrible, cost are crazy, insurance companies are out of control. At the end of the day it is a growing problem and will continue to be a problem due to that the fact that people are living longer. It’s a need that need to be met by the aging population and the complex health conditions. The cost cutting efforts of the 1990’s, however, often failed to make health care more affordable to the ordinary family because employers, hospitals, and other agencies shifted more of their costs to the recipients themselves (pg. 286). As of today everyone is required to have health care insurance rather it’s getting through an employer, buying private insurance, enrolling in Obamacare, or enrolling in public health care. And health care is not free, well it is free for the people that are living in poverty. Now that everyone is required to have insurance everyone needs to be educated on how to pick a plan that best suits their needs.