Yasser, Ryan Naif M.

3/24/2023
12042390 COBGOVE - K31
Reflection Paper
1. What major governance problems does WGH face? Which problems are the most
important and need to be fixed as soon as possible?
Wolfson General Hospital is currently facing a slew of governance problems that
affect the state of the workplace. For starters, WGH needs more proper leadership within
the Board, represented by the limited knowledge of the Board members about their
functions. It was mentioned that they were prolific medical people administering quality
health care but were not equipped with appropriate extensive Board expertise or
financial knowledge. I also believe that they do not place significant emphasis on
accountability as they do not value their mission statement which calls for their service
and integrity. This coincides with their insufficient internal financing control and reporting
which was shouldered by only one Board subcommittee, the Fiscal Advisory Committee.
There is no doubt that internal and external audits should be done across the board
committees to ensure completeness and transparency of financial information.
Additionally, there is no whistleblowing program that incentivizes and proliferates a
culture of integrity, to circumvent potential accounting, ethical, personnel, and medical
issues.
2. What are the most important ethical problems faced by a general hospital? How
could these ethical problems be managed?
Some of the most significant ethical problems a general hospital may face
include (1) patients’ rights, (2) confidentiality of patients, (3) conflicts of interest, (4)
equity of resources, (5) medical errors, and (5) informed consent, just to name a few.
The patients should be given their right to have access to proper medical treatment,
sufficient details or information regarding their case or medication, and their say on the
decisions for their respective treatment. The phrase ‘patient’s rights’ spans a multitude of
aspects but can be tied to the next ethical problems. Naturally, hospital personnel or staff
must be extra-careful about the privacy and confidentiality of the patients’ highly
sensitive information. Conflict of interest may be a tricky topic as it can be hard for
hospitals to ascertain or formulate a specific policy covering a broad subject. However,
this may comprise the colliding perspectives of healthcare professionals, pharmaceutical
teams, medical equipment, and companies. Equity of resources essentially refers to the
 impartial distribution of healthcare resources such as organs, medical equipment, and
medicines, which often begs the question of justice and fairness in such allocation.
Medical errors may have tremendous consequences for the families of the
patients which is why it is of utmost importance to thoroughly prepare for procedures,
and assess the effectiveness and consent of such treatments to prevent potential
problems that could lead to medical professionals facing legal and ethical
responsibilities. As per informed consent, it is no surprise that patients must be fully
informed about their medical conditions and their respective treatments or procedures.
By acquiring informed consent, decisions would be easier on the side of the doctors and
other associated individuals that deal with such matters.
To manage the first two aforementioned ethical problems, the hospital employees
particularly the staff and personnel may be subject to training in the field of maintaining
privacy and confidentiality while upholding protocols to promote effective management of
confidential patient information. Hospitals should develop and implement transparent
and equitable processes for distributing healthcare resources. They may introduce a new
kind of employee or assign a new role that involves evaluating the legitimacy and
fairness of the distribution. Apart from providing a consent form for family members or
guardians to sign, staff should be given guidelines on how to break the news to them
and properly inform them about the intricacies of the treatment and condition.
3. Should WGH introduce a crisis management process? If so, what should its
objective be? How could that be best achieved?
Yes, I believe that it is imperative for WGH to introduce a crisis management
process for the welfare of the hospital and its constituents, employees, and patients
alike. Its objective or goal should be the avoidance of crises by proactive planning and
preparation for internal and external hazards that may impede the hospital’s capacity to
perform at its fullest and best. Understanding the challenges and expectations of the
stakeholders, as well as how these affect the hospital can set the tone for a fruitful crisis
management initiative within the workplace. The maintenance and creation of an ethical
medical and business culture are also tantamount to suppressing the number or
prevalence of problems that can transform into disasters, which in turn would call for the
ethical responsibility of the crisis management team.
4. Why should WGH introduce a protected whistleblower program? Who should
administer it, what factors would make it successful, and how should it report?
 It was established in the paper that there was a practice of a “cone of silence”
within WGH. This implies that problems have gone unattended or unresolved since they
were never reported. Usually, in a medical setting where power hierarchies are present,
intimidation is commonplace – leading to potential medical, ethical, accounting, and
financial irregularities within the hospital. A protected whistleblower program is of the
essence since they are the ones that identify and report any possible forms of
misconduct, such as fraud, abuse, breach of consent, and violation of ethical standards
among other examples. An ethics officer should administer the order and implementation
of the whistleblower program. He/she shall provide protection to the whistleblower and
report to each respective department to maintain transparency and accountability. By
reporting to a subcommittee, there is more assurance that the information being
disclosed to these subcommittee members is being kept confidential. There should also
be a code of conduct accompanied by training for these officers so that they are
equipped with enough knowledge to prepare for unforeseen situations.
5. Are there any other governance issues that Kelly should consider?
I think another governance issue that stuck out to me was the period by which
the Vice Chair is automatically promoted to the position of Chair. It is my firm belief that a
two-year timeframe is not sufficient for a smooth transition of Vice-Chair, let alone
someone who is sure that she is not knowledgeable and experienced enough to lead the
executive role for the organization. Moreover, I believe that their current case calls for
the restructuring of the committees of the Board for a safer, more accountable, and
productive slate of leaders, at the helm of the most sensitive and arguably most essential
sector of WGH.
6. Should Kelly accept the nomination as Vice-Chair?
I do not think Kelly should accept the nomination as Vice-Chair. Given the fact
that she is up for promotion to Chair after two years as Vice-Chair, we would be giving
her too much benefit of the doubt and banking on her capability of accumulating hefty
loads of information about financial and executive management. While she
acknowledges the points of improvement in WGH as a good leader should do, she still
lacks the necessary training, particularly in the budgetary and governance aspects. I
would rely much on the short amount of time she has for training while on the job but I do
not doubt that she would gain these skills albeit at a slightly regressed level since she
would be forced to rush her growth. If she could leverage her close ties and relationships
to promote loyalty amongst the staff and personnel, she lead them in abiding by the code
of conduct and setting an example. Nevertheless, I think she should not accept the offer.