Background Statement
The organization under review, the Sleepy Hollow General Hospital, experiences an issue in the incoherency in hip and knee implant supply. The investigation has shown that orthopedic surgeons in the facility purchase their equipment from different suppliers that vary significantly in price, quality, and use. The financial executive initiated the discussion about the possibility of switching to a single inventory supplier to reduce costs and increase efficiency. The staff agreed but insisted that they will only use the implants that they prefer due to the familiarity of working with the products and the tested quality.
Upon closer inspection, it became apparent that all the medical professionals have some affiliation with the preferred supplier, either financial or non-financial. For example, some surgeons are listed on the manufacturers’ websites as professionals who recommend their products, indicating that they have been paid for the featured advertisement. Some orthopedic surgeons appeared to be the owners or creators of the patents of the equipment, signifying their financial incentive to use a specific implant manufacturer. The current paper will examine how the case study relates to the conflict of interest and how the issue can be solved by the change agent of chief executive.
Issues
One of the significant issues apparent from the analysis of the case study mentioned above is the breach in the preservation of trust. Every surgeon had a financial or non-financial interest in using a particular implant, which yielded costs for the Sleepy Hollow General Hospital and its patients. This is an overarching problem in the organization since, as Fineberg (2017) notes, conflict of interest “influences medical education, research, and clinical practice, and therefore has profound implications for the integrity of medicine” (p. 1717). These consequences that might appear as a result of the ethical misconduct can be regarded as minor issues in the case study that can become more influential as the conflict of interest progresses. Potentially, the current problem can also have legal repercussions since it is forbidden by the provisions of the Stark Law (Wiersma et al., 2018). Therefore, the potential effects of the conflict of interest, such as legal responsibility and ethicality, should be acknowledged.
The second major issue in the presented organization is financial losses. Unethical treatment of patients by not disclosing financial incentivizing not only violates the law but also leads to economic consequences for the hospital. As the case study shows, the surgeons are unwilling to facilitate the critical decision-making out of personal profit, which can be identified as imposing direct harm to the organization. Lack of self-reporting, which is a driving motive behind the conflict of interest, can also potentially lead to a reduction of employee loyalty, morale, corporate culture, and ethicality (Fineberg, 2017). If the behavior persists, the hospital will suffer major losses, unable to optimize due to uncompliant staff.
Role of the Change Agent
My role in tackling the issue of conflict of interest in Sleepy Hollow Hospital surgeons’ supply decisions is the chief administrator of the organization. This change agent is beneficial in resolving the problem since the person in that position has the knowledge of employees, financial records, and the hospital’s operations, as well as the freedom to execute organizational changes. However, the perspective of chief administrator also has its disadvantages in terms of lack of objectivity.
Strengths and Weaknesses
As a part of the analysis of the issue, it is essential to address the organization’s strengths and weaknesses that can either facilitate or disrupt the resolution of the situation. As per the vulnerabilities, the case study depicts a lack of understanding of the legal and ethical context of the conflict of interest, which is a pitfall of the organization’s managers. Consequently, inadequate communication between the doctors and an HR department and organizational incoherency in supply chains are the shortcomings that can be potential barriers to change. The aforementioned weaknesses ultimately lead to a lack of self-reporting and disclosure.
On the other hand, the present electronic human resource management system (e-HRIS) can be regarded as a strength due to its potential use in tackling unethical treatment. E-HRIS can include an elaborate definition of the conflict of interest and serve as a tool for reporting, self-reporting, identification, and management of ethical misconduct (Nichols-Casebolt & Macrina, 2015). However, the utilization of that opportunity requires funding and can be met with human resistance.
Recommendations
First Solution: Standardization Procedure
The first solution proposed to solve the issue is identifying and implementing the standardized use of one implant company by the chief administrator. This measure would require the involvement of the outside professional or a consultant to evaluate the available options that are already in use by the operation room’s surgeons. That way, the executive decision will rely on objective research. This approach will also ensure that the change will be useful in lowering the expenses for the organization and increasing the surgeons’ effectiveness (Robbins, 2018). Although there is a possibility of human resistance to change, this decision will be guided by the end goal of standardization instead of surgeons’ financial incentive (Robbins, 2018). This objective can be measured by quantitative evaluation of financial cost reduction in the six months following implementation.
Second Solution: Ensuring Preservation of Trust
The second chief executive strategy that can be implemented is an educational program on the conflict of interest’s legal, professional, and interpersonal contexts conducted by the HR managers. As Fineberg (2017) highlights, conflict of interest, especially non-financial, can be unacknowledged by a medical professional and still have detrimental effects on patient trust. However, it is essential to acknowledge that while “full disclosure is an important step toward mitigating COI, it does not redress subconscious accompanying biases” (Robbins, 2018, p. 589). Furthermore, the consequences of misconduct are often unaddressed by medical institutions.
Therefore, to eliminate the issue of unethical supply chain among operation room employees and normalize the standardization procedures, complementary educational training should be conducted. This will facilitate the creation of a need to preserve the trust that Sleepy Hollow’s surgeons disrupt by their practice. Fineberg (2017) states that “when trust in physician judgment is impaired, the role of physicians is diminished,” and the hospital and patients need to be aware of the incentives that the doctor has (p. 1717). When this level of awareness is achieved, the patient outcomes and medical staff corporate culture will improve. To evaluate this solution’s success, the organization will monitor the surgeons’ self-reporting activity and compare the results with previous years. The expected outcome is the increase in self-disclosure and acknowledgment of the conflict of interest.
Third Solution: E-HRIS Management
The third solution involves the previously discussed potential of e-HRIS to identify, report, self-report, and manage the conflict of interest within an organization. The HR department will implement an additional function to the existing e-HRIS that will enable patients and the medical staff to submit their concerns about potential ethical misconduct. This strategy will allow for easier traction of the conflicts and will make surgeons more aware of the consequences of their actions (Nichols-Casebolt & Macrina, 2015). The pitfalls of this method are the challenges in developing the framework since it requires significant funding. Its success can be measured by regular external assessment of the conflict of interest claims and ethical misconduct investigations.
References
Fineberg, H. V. (2017). Conflict of interest. The Journal of the American Medical Association, 317(17), 1717-1721. Web.
Nichols-Casebolt, A., & Macrina, F. (2015). Current perspectives regarding institutional conflict of interest. Science and Engineering Ethics, 25(6), 1671-1677. Web.
Robbins, N. (2018). Ethical issues pertaining to conflicts of interest between neurologists and the pharmaceutical and medical device industries. Seminars in Neurology, 38(5), 589-598. Web.
Wiersma, M., Kerridge, I., & Lipworth, W. (2018). Dangers of neglecting non-financial conflicts of interest in health and medicine. Journal of Medical Ethics, 44(1), 319-322. Web.