Responding to recent corporate scandals both within and outside the healthcare industry, the American College of Healthcare Executives has shored up its two-page code of ethics by more specifically targeting financial conflicts of interest, fraud and abuses of power that compromise patient safety as practices that executives should avoid when carrying out their duties.
"In this Enron era, we are going to be reminding people of the value of ethics," said Thomas Dolan, the ACHE's president and chief executive officer. "We make it crystal clear what their responsibilities are."
The Chicago-based ACHE's Board of Governors amended the code in November after a survey of members by the college's ethics committee showed respondents wanted a shorter, more explicit code that was user-friendly. The revisions come as members prepare to attend the ACHE's annual congress set for March 1-4 in Chicago (See story, p. 28).
As a result, the ACHE added several standards to the code of ethics, which dates back to 1941 and has been revised through the years. Among its refinements, the ACHE now explicitly recommends that executives should avoid financial and other conflicts of interest while managing their organizations.
When working with patients, executives should have a plan in place to avoid conflicts of interest when the values of patients and their families differ from those of physicians and employees. Creating a process would help avoid difficulties when families are faced with ending the lives of loved ones, Dolan said. Healthcare executives also should not tolerate any abuses of power by employees in their work with patients and others they serve.
"With the corporate abuses we have seen in the past, we want to remind people we are here to serve patients," Dolan said. "We want people to look at ethical guidelines and put them at the top of the radar screen."
Executives also are urged to report negative financial information promptly and prevent aggressive accounting practices that could result in questionable earnings, according to the new ethics code.
The code also recommends that executives create an environment in which clinical and management mistakes are reported and addressed. Executives should create their own codes of ethics for their organizations and provide ethics resources for staff members.
The changes in the code will "make it a more usable tool for local healthcare organizations," said Samuel Odle, the ACHE's chairman elect, senior vice president of Clarian Health Partners, and chief administrative officer at Clarian's Methodist Hospital, Indianapolis.
"You don't have to look far to see that there are a lot of people in healthcare who slip off the path of ethical conduct," Odle said. "It is really important to hold up the ethical standards."
Odle said he consults the code frequently and the changes make it more contemporary. "People are thankful they have it when they make tough choices," he said. "This represents the standard of behavior they want."
The ACHE's ethics committee randomly surveyed its affiliates and leaders about ethical challenges they face and the changes they thought the code needed. Of the 799 affiliates who were mailed surveys, 319, or 40%, responded, while 108 of 123 ACHE regents, governors and chairmen, or 88% of those surveyed, responded.
According to the survey, 26% of leaders said the code should be more explicit, while 16% said the length of the code should be reduced. More than 60% of the two groups of respondents said they used the code for self-guidance and more than 40% said the code provided guidance for their organizations.
With the revisions, ACHE members will see a more concise code that acts as a proactive tool in addressing conflicts and ethical issues, Dolan said. "You have to be careful-if you don't look at it every year, it gets stale," he said.