Promoting excellence - GMC
psychosocial issues, work-life balance, mental health issues and their impact on the “I think this is an outstandingly good document that will be extremely useful, and A. It is The Right Thing To Do: Business Ethics Second Meeting of WHO Collaborating Centres in .. excellence, solidarity, respect, and integrity are . Leading global excellence in procurement and supply with input Procurement professionals, working in conjunction with their suppliers, can demand desire to meet the demands of increasingly competitive supply chains. environmental performance is good for a buying organisation's SR/SSRwGuideBookpdf. PDF | This paper consists of a discussion of the three general theories of rion, whereas utilitarianism holds that the common good forms the true end. succeed in your job), then you need to do such and such (e.g., work hard). .. ( virtue, excellence, and perfection) which can in principle be ascribed to.
Specifically, many organizations have freedom and responsibility when they are small. Everyone knows each other, and everyone picks up the trash.
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As they grow, however, the business gets more complex, and sometimes the average talent and passion level goes down. As rules and procedures proliferate, the value system evolves into rule following i.
If this standard management approach is done well, then the company becomes very efficient at its business model — the system is dummy-proofed, and creative thinkers are told to stop questioning the status quo. This kind of organization is very specialized and well adapted to its business model. Eventually, however, over 10 to years, the business model inevitably has to change, and most of these companies are unable to adapt.
To avoid the rigidity of over-specialization, and avoid the chaos of growth, while retaining freedom, we work to have as simple a business as we can given our growth ambitions, and to keep employee excellence rising. We work to have a company of self-disciplined people who discover and fix issues without being told to do so.
We are dedicated to constantly increasing employee freedom3 to fight the python of process. Some examples of how we operate with unusual amounts of freedom are: We share documents internally broadly and systematically. Nearly every document is fully open for anyone to read and comment on, and everything is cross-linked.
There are virtually no spending controls or contract signing controls. Each employee is expected to seek advice and perspective as appropriate. Our policy for travel, entertainment, gifts, and other expenses is 5 words long: Our leaders make sure they set good examples by taking vacations, often coming back with fresh ideas, and encourage the rest of the team to do the same.
Our parental leave policy is: Each employee chooses each year how much of their compensation they want in salary versus stock options. You can choose all cash, all options, or whatever combination suits you4. You choose how much risk and upside you want. These year stock options are fully-vested and you keep them even if you leave Netflix. There are no compensation handcuffs vesting requiring you to stay in order to get your money. People are free to leave at any time, without loss of money, and yet they overwhelmingly choose to stay.
We want managers to create conditions where people love being here, for the great work and great pay. You might think that such freedom would lead to chaos. Most people understand the benefits of wearing clothes at work. There are a few important exceptions to our anti-rules pro-freedom philosophy. We are strict about ethical issues and safety issues. Harassment of employees or trading on insider information are zero tolerance issues, for example.
Transferring large amounts of cash from our company bank accounts has strict controls. But these are edge cases. In general, freedom and rapid recovery is better than trying to prevent error. We are in a creative business, not a safety-critical business.
Our big threat over time is lack of innovation, so we should be relatively error tolerant. Rapid recovery is possible if people have great judgment. The seduction is that error prevention just sounds so good, even if it is often ineffective.
We are always on guard if too much error prevention hinders inventive, creative work. On rare occasion, freedom is abused. We had one senior employee who organized kickbacks on IT contracts for several years before being caught. But those are the exceptions, and we avoid over-correcting.
Some processes are about increased productivity, rather than error avoidance, and we like process that helps us get more done. One such process we do well at is effective scheduled meetings. We have a regular cadence of many types of meetings; we start and end on time, and have well-prepared agendas.
We use these meetings to learn from each other and get more done, rather than to prevent errors or approve decisions. We avoid committees making decisions because that would slow us down, and diffuse responsibility and accountability. We are clear, however, that decisions are not made by a majority or committee vote. When the captain of any particular decision is reasonably confident of the right bet for us to take, they decide and we take that bet.
Afterwards, it is important for us to reflect on the decision, and see if we could do even better in the future.
Disagree Openly If you disagree on a material issue, it is your responsibility to explain why you disagree, ideally in both discussion and in writing. The back and forth of discussion can clarify the different views, and concise writing of the core issues helps people reflect on what is the wise course, as well as making it easy to share views widely.
The informed captain on that decision has the responsibility to welcome, understand, and consider your opinions, but may not agree. Once the captain makes a decision, we expect everyone to help make it as successful as possible. Later, if significant new information becomes available, it is fine to ask the captain to revisit the topic.
Silent disagreement is unacceptable and unproductive. Context Not Control We want employees to be great independent decision makers, and to only consult their manager when they are unsure of the right decision.
The legend of Steve Jobs was that his micromanagement made the iPhone a great product. Others take it to new extremes, proudly calling themselves nano-managers.
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The heads of major networks and studios sometimes make many decisions in the creative process of their content. We do not emulate these top-down models because we believe we are most effective and innovative when employees throughout the company make and own decisions. We strive to develop good decision-making muscle everywhere in our company.
We pride ourselves on how few, not how many, decisions senior management makes. The only way to figure out how the context setting needs to improve is to explore a sample of all the details.
But unlike the micro-manager, the goal of knowing those details is not to change certain small decisions, but to learn how to adjust context so more decisions are made well. We tell people not to seek to please their boss. Instead, seek to serve the business. Let me know if you want to specifically override my decision. Highly Aligned, Loosely Coupled As companies grow, they often become highly centralized and inflexible.
Senior management is involved in many small decisions There are numerous cross-departmental buy-in meetings to socialize tactics Pleasing other internal groups takes precedence over pleasing customers The organization is highly coordinated and less prone to error, but slow and frustrating We avoid this by being highly aligned and loosely coupled.
We spend lots of time debating strategy together, and then trust each other to execute on tactics without prior approvals. We may find that the strategy was too vague or the tactics were not aligned with the agreed strategy. And we discuss generally how we can do better in the future. Ultimately, the end goal is to grow the business for bigger impact while increasing flexibility and agility.
We seek to be big, fast and nimble. Seeking Excellence New employees often comment in the first few months that they are surprised how accurate this culture description is to the actual culture they experience.
Around the world, we live and create our culture together. In fact, hundreds of our global employees contributed to this document. We do not seek to preserve our culture — we seek to improve it.
Every person who joins us helps to shape and evolve the culture further. We find new ways to accomplish more together. Every few years we can feel a real difference in how much more effectively we are operating than in the past.
Operations management was important following World War II. At that time, organizations were concerned with time, production, and automation. The hospital purchased the medical record librarian's time. For example, a discussion of ethics for medical record librarians notes: An introduction that described the role of the HIM practitioner and the professional association was added. The individual was evaluated in the context of the larger community and network of relationships. The code of ethics dealt with association responsibilities the larger community within which HIM professionals functioned and moved beyond the focus on the patient to others in the world of work and the professional communities.
In addition to the resequencing of the principle statements to put service to the association first, two additional principles related to the association were added.
The code also added a principle related to the protection of secondary records, the right to privacy of medical and social information, and the reporting of breaches to a professional ethics committee. This code of ethics supported promoting the quality of healthcare, advancing medical care, and respecting all healthcare professionals.
This code of ethics reinforced the integrity and trustworthiness of the HIM professional. The code of ethics appropriately emphasized the dignity of all individuals. The code used language referring to quality several times in the guiding principles.
The language and sequence included the following items: Respect the rights and dignity of all individuals; Comply with all laws, regulations, and standards governing the practice of health information management; Strive for professional excellence through self-assessment and continuing education; Truthfully and accurately represent professional credentials, education, and experience; Adhere to the vision, mission, and values of the association; Promote and protect the confidentiality and security of health records and health information; Strive to provide accurate and timely information; Promote high standards for health information management practice, education, and research; and Act with integrity and avoid conflicts of interest in the performance of professional and AHIMA responsibilities.
These changes, which were consistent with the association name change, were a sign of the times. The use of electronic rather than paper health records increased, and the roles and responsibilities of the HIM professional expanded. Examples of ethical and unethical behavior were included to guide ethical decision-making.
Forty-two guiding statements were associated with the principles.
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The HIM professional should put others first and make a difference in the quality of the services that are provided. The code included the values of quality, integrity, respect, and leadership. This code strengthened guidelines to prevent inappropriate use of electronic and written information and addressed concerns related to the Health Insurance Portability and Accountability Act HIPAA.
It included a reference to the professional ethics committee's policies and procedures to help navigate issues that may include potential ethics violations, and it encouraged all members to actively recruit and mentor students, peers, and colleagues.
It strengthened guidelines to support operations within the professional association and continuing education efforts. The code also dealt with formalizing processes given the growth of the profession and the complexity of electronic health information systems and the external systems that influence these systems.
Ethical principles such as beneficence, autonomy, justice, and fidelity will be challenged as electronic health information systems evolve.
Although electronic health records EHRs will be beneficial, their universal adoption will not come without conflict. Autonomy must be addressed in bills of patient rights. Patients must have the right to review and make corrections in their electronic record, and this right must be honored especially as states and organizations develop health information exchanges HIEs.
The principle of justice can be violated in use of public data—data from the EHR must be presented and used in ways that promote justice.
Justice can also be demonstrated by allowing access to health information for all individuals and reducing disparities. Finally, breaches in the electronic health record can destroy the principle of fidelity. The focus on technology and human relationships increases ethical imperatives because what is done, how it is done, and what the intended and sometimes unintended outcomes are must be carefully examined. There is no linear path that can predict the requirements of each new code of ethics.
It is important for HIM professionals who work on each code of ethics to be aware of the changes in the political, social, and healthcare environment that may need to be addressed in the principles and guidelines for action.
The pledge and the six codes of ethics for the HIM professional association have provided guidance for ethical leadership across a continuum of time, roles, and responsibilities.
These codes are an invaluable resource to assist the professional faced with complex challenges at work. HIM professionals can use the code of ethics to provide guidance for ethical decision-making. Bioethical decisions always require action. Ethical actions at work always require courage. It would be feasible for the association to review and approve a new code of ethics inthe th anniversary of the founding of the association.
The HIM association was launched by medical librarians now called medical science librarians who recognized the importance of the information maintained in medical records. Even today, HIM professionals have much in common with medical science librarians: A analysis of accreditation standards for baccalaureate and master's programs in HIM and master's programs in medical library and information science programs identified shared curriculum requirements across the two disciplines, including information technology; healthcare information systems; healthcare information requirements and standards; health data content and structures; the healthcare delivery system; organization and management; research, analysis, and interpretation; and health information services management.
It is therefore conceivable that the code of ethics could be written in collaboration with medical science librarians. Contributor Information Cathy A. Medical Record Management, 7th ed. Principles of Biomedical Ethics. Ethical Challenges in the Management of Health Information 2nd ed. Manual for Medical Record Librarians 6th ed. American Medical Record Association.
Bylaws and Code of Ethics. Code of Ethics and Bylaws. American Health Information Management Association.