72. Case: My Way

You are part of team preparing for an upcoming accreditation visit. In meeting the listed standards, there has been much discussion among the team about the expectations for smaller rural facilities in relation to these standards. When there are fewer resources (people, equipment, budget) for meeting some of the standards as compared to larger urban facilities, is this taken into account? Many on the team have argued that the focus should be on demonstrating that the spirit and intention of a given standard has been met, and may be done so through adaptive, innovative ways as well as the standard approaches. Recognizing that the standards are there to help ensure quality, good health care for all patients, there is still some concern about whether the standards were written primarily from an urban perspective and whether there will be some flexibility in their application in a rural setting…

What do you identify as the ethics issues in this case?

What values are involved in this case (e.g., equity, fairness, trust, good care…)? Do we all mean the same thing when we talk about, for example, “good care”?

What is your perspective on standards for health care and how these may apply (or not) across different practice settings?

What are some of the innovative and/or adaptive approaches that you are aware of that your health facility has undertaken?

Resources:

Niemara, D. 2008 Ethical Dimensions of the Quality of Rural Health Care.  In Klugman C, and Dalinis P eds. Ethical Issues in Rural Health Care Johns Hopkins University Press Baltimore Maryland 119-131.

Rural Health Services Review Committee. 2015. Rural health services review: final report. Edmonton: Government of Alberta. http://www.health.alberta.ca/documents/Rural-Health-Services-Review-2015.pdf

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