Need your help, Litizens

[impressive]

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[matriarch]

So, as I read it, you're going to produce a legally binding 'Code of Practice'??

Have you tried web-searching for similar documents, from other authorities, states, counties????

 

[impressive]

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[hugo_sam]

BESides not accepting thing Imp, Theft of money or good or possesions should be covered.
Also doing anything to cause physical harm or injury
Doing anything to isolate them further. or something like that

 

[Salvor-Hardon]

3. Staff shall, to the best of their abilities, strive to uphold and encourage the dignity, health and quality of life of the clients.

(The clients are people, and those three areas of self esteem are central proper care. Even teh politicians should embrce this concept as laws and funding are debated.)

4. Staff shall extend all due respect, including respect to privacy, respect to preferences and respect to confidence, to the clients at all times unless and only if treatments demand otherwise and to the greatest extent that it enhances their
health, well being and sense of pride.

(In caring for others, we see them at their most vulnerable and most potentially embarassing. Guard their pride by not spreading stories of how Mister so and so dumped a bowl of oatmeal on his head or Missus Such and such talked about her buried treasure in a moment of dementia).

That's teh two off the top of my head I could come up with.

 

[Guest]

i think im a bit confused
is this agency work? every hospital i ever worked for had a Code of Ethics. They even had orientation with a section on acceptable behavior.
lemme see if i can dig some of that schtuff up.

 

[Pure]

I am not sure I understand. You want some 'commandments' on record that will tend to make the staff, if not legally vulnerable, administratively so. In effect, the list is going to look like 'commandments' or directions to prison guards or prison administrators, or maybe even the police. You might also look at existing directives of famous hotels for their hotel staff, and directives or objectives for staff in 'retirement communities.'

Carrying this thought forward you are looking for a kind of catalog of the most common forms of abuse and neglect.

Physical Abuse (Physical violence and intimidation)
Mental and Emotional Abuse (Humiliating, Instilling Fear; Measures which take away dignity [Indignities])
Financial Abuse (thefts, frauds, coercion of 'loans', manipulations for financial gain; exploitation [e.g. in 'borrowing'])
Sexual Abuse (touching, exploitation, assault)

Active measures to limit 'freedom of choice'
(Making threats connected to legal acts to further legal rights; deterring or punishing petitions or the making of complaint in writing or by phone, etc.)

Failure to provide:
information as to rights, choices,
access to advocates

necessities of life
adequate medical service, etc.

Failures and acts of neglect which limit freedom of choice.

Probably you want also some broader language, possibly in an intro, to cover some loopholes of any list. Possibly put these as positive duties, rather than 'do not' s.
Within demonstrably reasonably limitations and limitiations of contract*, provide for the physical, mental and emotional well being of those supervised or directed or generally 'under care.'

*(Obviously someone in charge of an independent home (where people can leave for trips, go shopping, etc.) has fewer responsibilities that someone in charge of a nursing facility providing 24-7 comprehensive care)

Respect the human, constitutional, and legal rights of the persons supervised or 'under care.

If there is not general enumeration of patient rights (violations of which are forbidden in the commandments) then piggy back the thing on 'human rights' and constitutional and legal rights (security of person and possessions). The rights in the Bill of Rights are an obvious starting point; speech, association, due process, no cruel punishments, etc. The European Union has some nice general statements about human rights of the 'positive sort', e.g to food and shelter, etc. rights to organize.

As you have done, use of the criminal code, is a logical way of specifying what is serious misbehavior. Look at laws related to spousal or child abuse.

These are some ideas. Incidentally, it would be good to have in the document something about fair treatment and due process for those alleged to commit infractions or acts of abuse-- (I.e. administrators and staff have rights, also). This makes the document more 'saleable.'

 

[Guest]

Code of Conduct (LONG) *BORROWED*

1. Comply with the Law. Lawrence Memorial Hospital is subject to numerous local, state and federal laws pertaining to all aspects of its operation. All employees are required to understand and abide by those laws which are applicable to them in the performance of their jobs.

2. Provide Excellent Patient Care. Lawrence Memorial Hospital employees shall strive to treat all patients with a spirit of kindness, patience and understanding. Each patient is an individual and should be treated as such. Each patient should be respected, with their needs and desires considered as health care decisions are made. Steps shall be taken so that each patient understands his or her treatment needs and options, treatment methods utilized, and treatment outcomes. LMH will provide services in a manner that does not discriminate against any person because of age, race, religion, gender, sexual orientation, disability, national origin, or for any other reason prohibited by applicable state and Federal law. At all times, competent and qualified individuals will provide appropriate care, while considering the safety and well being of the patients.

3. Protect Confidential Information. Lawrence Memorial Hospital is committed to maintaining the confidentiality of patient, personnel, and other proprietary information in accordance with applicable legal and ethical standards.

4. Adhere to Anti-Referral and Health Care Fraud and Abuse Legislation. All employees of Lawrence Memorial Hospital are required to comply with laws which prohibit health care fraud and abuse. Activities that are prohibited include, but are not limited to:

Intentionally or knowingly making false or fraudulent claims for payment or approval;

* Offering or receiving remuneration (such as a kickback, bribe, or rebate) as an inducement to make a referral for the furnishing (or arranging for the furnishing) of any item or service;
* Submitting false information for the purpose of gaining or retaining the right to participate in a plan or obtain reimbursement for services; and,
* Referrals by a physician of Medicare or Medicaid patients to any entity for "designated health services" when the physician or an immediate family member has a financial relationship with the entity (unless the arrangement complies with applicable legal exceptions).

5. Not Accept Inappropriate Gifts or Gratuities. The following standards apply to the giving or receiving of gifts and gratuities. Receiving Gifts from Patients and vendors. Employees are prohibited from soliciting tips, personal gratuities or gifts from patients and vendors. Employees may, however, accept non-monetary gratuities or gifts of a nominal value, such as cookies, flowers or candy if the gift would not influence, or reasonably appear to others to be capable of influencing, the employee's business judgment in conducting affairs with the patient or vendor.

If the value of the gift is substantial or there is any question regarding whether the gift meets this standard of reasonableness, the employee must seek prior approval from the Corporate Compliance Officer (who will take the request to the Compliance Committee for review) or refuse the gift and promptly return the gift to the vendor or patient. Substantial gifts to LMH can be made by contacting the Chief Development Officer for the LMH Endowment Association.

Giving Gifts to Patients and Vendors: Employees shall not offer or give money, services or other things of value with the expectation of influencing the judgment or decision making process of any purchaser, vendor, patient, governmental official or any other person.

An employee who is in doubt about whether a situation involving the giving or receiving of something of value is acceptable, should ask his or her supervisor, or the Corporate Compliance Officer.

6. Avoid Conflicts of Interest. It is the policy of Lawrence Memorial Hospital to prohibit its employees and other associates from engaging in any activity, practice, or act which conflicts with, or appears to conflict with, the interests of Lawrence Memorial Hospital, its patients or its vendors. Therefore, Employees, Medical Staff members, Board members, and other individuals must disclose to their supervisor or the Compliance Officer any potential conflict of interest they or their immediate family have in any firm which does business with Lawrence Memorial Hospital or which competes with Lawrence Memorial Hospital.

7. Follow All Antitrust Regulations. A number of activities engaged in by Lawrence Memorial Hospital are subject to state and federal antitrust laws. Generally, these laws prohibit agreements or actions that may illegally restrain trade or reduce competition. Examples of activities that violate these laws include, but are not limited to, agreements among competitors to fix or stabilize prices, inappropriate exclusive dealings, and boycotts of specified suppliers or customers.

8. Keep Accurate and Complete Records. It is essential that Lawrence Memorial Hospital report accurate information to governmental entities and other third parties. In order to meet this obligation, it is equally essential that every employee accurately and clearly report the relevant facts or the true nature of a transaction. No employee should knowingly or with reckless disregard for the truth make any false or misleading statement on any form or to any other officer, employee or auditor for Lawrence Memorial Hospital. All patient records must meet the documentation standards required for quality care and to meet reimbursement regulations. Employee travel and entertainment related expenses must be accurately documented and supported when seeking reimbursement from the hospital.

9. Conduct Political Activities According to the Law. Lawrence Memorial Hospital does not participate or intervene in (including the publishing or distributing of statements), any political campaign on behalf of or in opposition to any candidate for public office.

While Lawrence Memorial Hospital supports employee participation in the political process, employees are not permitted to use positions in Lawrence Memorial Hospital to try to influence the personal decisions of others to contribute or otherwise support political parties or candidates except as lawfully permitted through political action committees.

Lawrence Memorial Hospital may participate in lobbying activities or advocating the passage or defeat of certain legislation that pertains to issues that affect the healthcare community. Lobbying activities, or advocating the passage or defeat of certain legislation, shall not constitute a substantial part of the activities of Lawrence Memorial Hospital.

10. Protect the Environment. It is the policy of Lawrence Memorial Hospital to comply with all state and federal laws protecting the environment. Employees shall dispose of all waste and other materials and store all chemicals and substances in accordance with applicable laws and regulations. It is important to file all necessary environmental reports accurately and promptly and to cooperate fully with all governmental authorities in the event of an environmental incident.

11. Provide a Safe Workplace. It is the policy of Lawrence Memorial Hospital to comply with all applicable state and federal laws designed to improve workplace safety. Lawrence Memorial Hospital is committed to training employees to carry out their work in manner that is safe for them, their coworkers and the patients they serve.

12. Not Tolerate Harassment or Discrimination. It is Lawrence Memorial Hospital’s policy not to discriminate on the basis of race, color, religion, national origin, age, disability, sexual orientation, or gender in providing services to patients or the public, nor in relation to employment practices. Furthermore, Lawrence Memorial Hospital prohibits harassment of its employees in any form by supervisors, coworkers, customers or vendors.

13. Appropriately Use its Assets. All employees are charged with protecting and preserving Lawrence Memorial Hospital’s assets and resources by following procedures to prevent their loss, theft or unauthorized use. No part of the net earnings of Lawrence Memorial Hospital shall inure to the benefit of, or be distributed to, its trustees, Executive Staff, employees or other private persons having directly or indirectly any personal or private interest in the activities of Lawrence Memorial Hospital, except to the extent that such payments constitute reasonable compensation for services rendered in the necessary course of Lawrence Memorial Hospital’s business.

14. Protect Access to Information Systems. Lawrence Memorial Hospital is committed to protecting all aspects of its information systems. All employees and other associates with access to Lawrence Memorial Hospital’s computerized information system shall sign and abide by Lawrence Memorial Hospital’s Responsible Use Policy, including the protection of confidential passwords and other access information.

15. Adhere to Intellectual Property Laws. Lawrence Memorial Hospital is commited to adhering to all applicable intellectual property laws. All software used in connection with Lawrence Memorial Hospital’s business must be properly licensed and used in accordance with that license. Additionally, Lawrence Memorial Hospital will respect the intellectual property and copyright laws regarding books, trade journals, magazines, and other applicable resources.

 

[moonlight elf]

I don't really have anything to add.....looks like others have given you some ideas. Try checking with Vampy for legally tight language.

 

[impressive]

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[lucky-E-leven]

3. Staff shall, to the best of their abilities, strive to uphold and encourage the dignity, health and quality of life of the clients.

(The clients are people, and those three areas of self esteem are central proper care. Even teh politicians should embrce this concept as laws and funding are debated.)

4. Staff shall extend all due respect, including respect to privacy, respect to preferences and respect to confidence, to the clients at all times unless and only if treatments demand otherwise and to the greatest extent that it enhances their
health, well being and sense of pride.

(In caring for others, we see them at their most vulnerable and most potentially embarassing. Guard their pride by not spreading stories of how Mister so and so dumped a bowl of oatmeal on his head or Missus Such and such talked about her buried treasure in a moment of dementia).

That's teh two off the top of my head I could come up with.

These are good, but the difficulty (as I understand it) with building an enforcable code is that each item must have the ability to be measured.

3. Staff shall, to the best of their abilities, strive to uphold and encourage the dignity, health and quality of life of the clients as detailed by xyz handbook of quality assistance (wherein things such as discrimination, gender bias, abuse of power, etc... are given parameters).

Care provided to the best of one's ability is highly subjective, and in order to say it was deficient by any authority they must have a baseline in writing that can be measured by documented review and referred to in situations of debate.

 

[lucky-E-leven]

Great stuff, guys! Please keep it comin'

One of the most ticklish aspects of this from the agency perspective is the balance between client freedom and safety. Agencies view "freedom" as "liability."

The other big issue is quality of care. Most staff are employed by an agency. Some are independently contracted. Pay (as you might expect) sucks ... anywhere from minimum wage up to around $7.50/hour tops. Some agencies prohibit staff from working full-time to avoid having to pay certain benefits. Turnover is high. Ethics are often quite lacking.

In one instance, staff has "borrowed" over $1000 from a client (whose only income is a Social Security check) over the period of a few months. That client then bounced checks and incurred a ton of overdraft charges, etc. The agency says it can do nothing to prevent this because it was voluntarily loaned. (Coerced, is more like it -- and the client is afraid to say anything for fear he'll lose his staff person and basically be trapped in his home without staff to take him out into the community.)

In another instance, a client was left sitting in a car in sweltering heat (in a nasty neighborhood) while the staff person went inside an apartment to buy some drugs. They were supposed to be on a "community outing." Again, the agency claims it cannot prevent this.

To hell with civil liberties ...

Just out of curiosity, is there a certification/review board for the agencies providing care staff? I know when I taught in a haughty-taughty preschool there were tons of accreditations and drop-in inspections that kept the owners honest.

 

[impressive]

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[gauchecritic]

Isn't all this in their working contract? Health and safety requirements, police checks (for previous criminality), data protection etc.

If it isn't, then why not?

 

[impressive]

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[rgraham666]

Ask the agencies to imagine themselves in their client's positions.

Then ask them to imagine them how they would feel if treated like victims.

Perhaps they should go through a training period of being confined to bed or wheelchair for a week.

Sigh. Wish I had some practical advice, Imp.

 

[ABSTRUSE]

Is this along the lines of a patients bill of rights?

 

[impressive]

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[ABSTRUSE]

Similar, but with a presumption of competence rather than one of incompetence.

gotcha. Let me think about this. I'll channel all the misery I felt when my mom was in the hospital.

 

[rgraham666]

Maybe I do have a practical idea.

Start a PAC.

It sounds like it's more lack of political will than non-existent guidelines that are causing the problem. I'm sure all the tools are there to punish malefactors, both individual and institutional.

If you can bring pressure to bear, in the form of money and propaganda, on the politicians, there will be a lot more will from them to prosecute people who abuse the helpless.

 

[impressive]

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[rgraham666]

Good. Wish I had the type of mind that can think up the sort of thing you want.

I keep coming back to my favourite book on business which stated, "If you must have a company policy, publish The Ten Commandments"

 

[oggbashan]

UK guidelines aren't much help

I searched through some of the UK sites.

There are reams of information there but based on UK and European legislation.

Edited to add: This site has information on UK Social Work Whistleblowing

I found this: Virginia that might be worth searching.

I'm still looking.

Og

 

[impressive]

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[oggbashan]

Another site: British Association for Social Work

Conditions in the UK seem over-regulated by comparison with the US - BUT abuse of disabled people, particularly those with mental incapacity and dementia, still occurs too frequently for comfort.

It isn't necessarily the professional or volunteer carers. Sometimes it is their own family members.

Og