Certification of Organizational Management 1.0

C-CPE 2-2: Ethical Healthcare Practices

Submited by: Tom Goddard

The Basics

Under this standard, the organization must implement a documented, specific description of ethics in its healthcare practices. At a minimum, to gain all the points associated with this standard, those practices must include

  • A requirement to report practices that are impaired, incompetent, or unethical;
  • Prohibition of discrimination based on color, race, national origin, religion, age, sex, genetic information, pregnancy, disability;
  • Prohibition of harassment, sexual or otherwise;
  • Professional use of digital media;
  • Conflict of interest; and
  • Peer review.
In addition, URAC has added as optional healthcare practices to be included in the description the following:
  • Ethical obligation of the medical and/or clinical directors;
  • The responsibility to study and prevent errors;
  • Responsible stewardship of healthcare resources; and
  • Commitment to reducing disparities in health.

Management Tips

Note that the anti-discrimination requirement is limited to discrimination against consumers. 
If you need some assistance with the digital media issue, URAC recommends that you review the model guidelines at http://www. fsmb.org/Media/Default/PDF/ FSMB/Advocacy/pub-social-media- guidelines.pdf.
Your conflict of interest policies should clearly and explicitly identify what behaviors constitute a conflict. 
The peer review policy of your organization should address such issues as lack of expertise, prior involvement with a case, or having financial interests in the outcome of decisions.
The "stewardship of healthcare resources" provision addresses issues such as mechanisms to address over-utilization of healthcare services, coordination of services, and encouragement of the use of generic drugs.

Accreditation Tips

Desktop Review
The documentation required for this standard could come in a variety of forms, including policies, bylaws, screenshots, meeting minutes, and other official organization documentation that defines healthcare practices and provides examples.
Validation Review
Interview
The URAC reviewer will discuss ethical practices with senior management officials.

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