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Occasionally, conflicts may arise between a patient's autonomy and the facility's duty toward the patien

1 DQ
Occasionally, conflicts may arise between a patient's autonomy and the facility's duty toward the patient. Such conflicts should be resolved by taking into consideration legal requirements, regulatory constraints, and ethics (Singh, pg 165).
Nursing facilities have five main on-going challenges in trying to provide quality of care and resident centered care. These include the juggling of providing clinical care according to current standards and best practices. Economic circumstances are increasingly challenging as public funds are cut and private funds are limited. There are patient-related constraints that often include behaviors or comprised decision making, yet an effort must be made to return some of the responsibility back to the resident for his or her own health care. A facility also must be in substantial compliance with regulations, meaning that violations should not endanger the health and safety of patients. Manage conflicting rights can be difficult as each resident's desires, interests and rights can directly affect the interest and legitimate expectations of other residents (Singh, pg 159). Balance and compromise are required in person-centered care.
A decision to go the Eden Alternative or another culture change program is not a mistake. Facilities that do not adopt this growing movement will be left behind and find themselves in an uncompetitive position, and perhaps out of business at some point (Singh, pg 177). Regardless of the extent of culture change that a facility establishes, the facility must meet its responsibility to do what is in the patients' best interest. Thankfully, efforts are being made to link culture change and compliance with regulations, and as such, there are changes being made to the Interpretive Guidelines. Also, we can hope that the Quality Indicator Survey will produce a standardized resident centered, outcome-oriented quality review as was intended by CMS.
Class, after reading this chapter, what are your thoughts?
Effective Management of Long-Term Care Facilities, Third Edition, Singh, 2016

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