Organizational Culture in Healthcare (Essay Sample)

Organizational Culture in Healthcare
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To create and maintain a positive organizational culture within an organization, there is a need to have good awareness, management, and communication skills from leadership. In addition, there must be a strong shared identity that should be created and maintained, leading to accepting the organization's overall mission and goals. Such efforts lead to easy resolution and prevention of any ethical issues that can arise. This is crucial within the health care sector because all the departments and the management face several challenges that may hamper their operations.
The culture within an organization affects the management of the healthcare systems. In a health care organization, regardless of the size, the culture has a crucial function that affects sound decision making (Lee, 2020). When more emphasis is placed on profitability within the healthcare system, integrity may be lost. The practices within health care that emphasizes the place that the organization occupies within the market often lead to more challenges as far as the ethical standards are concerned. On the contrary, when an organization promotes sound decision making with due consideration to the interests of the patients and the wider community, it thrives in its practices and decision making.
Small and medium health care facilities have the pressure to control costs to improve profitability more than the large ones, which may enjoy economies of scale. As such, when the costs of supplies, drugs, and professionals rise, the profitability is reduced, leading to certain unethical decisions. Opportunities get presented for favouritism, fraud, payoffs and theft. The employer has the task of managing the facility by inculcating better practices and reducing costs. The need to identify and keep customers that pay highly may cause the owners of small facilities to make certain decisions that may not be in tandem with the expected ethical standards. When the facility only considers those patients that can make full payments for the services rendered, the community is affected.
Conflict of interest is one of the challenges facing the healthcare systems in many countries (Pozgar, 2019). It arises when the individual and group gains by individuals gain prominence over professional decision making and policy formulation. It is common in many healthcare settings but becomes more complex because of its nuanced nature. Since they are usually very subtle, not much effort needs to be taken to be present in an organization. In many health organizations, the healthcare systems exhibit heterogeneous composition, which tends to be more complex due to poor governance. This leads to enhanced situations leading to conflict of interests that become a challenge in addressing personal disclosures or procedures of malpractices. The conflicts impede the formulation of sound policies governing healthcare and governance structures.
In any healthcare system, the department dealing with billing plays a crucial role in determining the organization's profitability (Gerhardt et al., 2018). They must ensure they generate the bills promptly to be submitted to the various insurance entities and the relevant government departments to receive payments in time. When there are good billing practices, better cash flow and revenue within the healthcare facilities would be better. The organizations will pay for the salaries and other financial obligations without any challenges that would hamper the smooth operations. However, many issues may arise that affect the smooth and efficient billing system. These may include miscommunication, inefficient billing procedures and guidelines exasperating from the various payers. Such challenges lead to billing errors that may cause untold financial losses and wastage of time, and unnecessary expenditure. For example, when a bill is rejected due to an error in its generation, it requires more time in creating it to the level of acceptance. As a result, more time is wasted in contacting the patient or the paying organization to make the payment to be settled. As this happens, the current workload piles up, leading to inefficiency.
Fraud may also impede the successful management of the health care systems. According to Alonazi (2020), the most common forms of fraud in the health care system include billing for unnecessary healthcare services or those that are not rendered, falsifying diagnoses or claims, taking part in criminal referrals or kickbacks, prescribing medications that are not necessary to patients and up-coding for medical services that are expensive and unwanted. The medical providers involved in fraud apply such schemes as bribes, forgery, falsified billing and fake patients to create benefits for the organization from the vulnerabilities of the insurance companies and public programs involved in health care. Even though such public programs may be vulnerable to such fraud cases, the law enforcement entities must identify the common forms of fraud and charge the offenders accordingly. In addition, the public and private sector organizations involved in making the payments must always review the uncertain and false claims and the organizations submitting such claims to ensure the beneficiaries are protected.
Therefore, personal and moral integrity has a crucial role in causing the needed change, leading to a conducive organizational culture within a health care system (Wicclair, 2017). The management must understand their role in shaping the ethics within the organization and, as such, take advantage of creating an environment that fosters strong relationships and ethical procedures that will boost the reputation of the organization for its overall success. When good organizational ethics are ignored, there exists the risk of corporate and personal liability in the current common legal situations. The health care organizations and facilities may also have the challenges of missing the benefits they ought to enjoy when they get sued and sentenced or convicted due to their negligence by failing to uphold moral integrity.
To mitigate the ethical issues that may arise in the organization, there is a need to implement compliance-based ethics programs. Such programs are designed to detect and prevent and take actions against any legal violations that may compromise the integrity within the health care organization. Implementing organizational ethics within an organization transcends the simple avoidance of illegal practices