Fulton State Hospital - Concordia University-Nebraska

Fulton State Hospital - Concordia University-Nebraska

Rationale: The following assignment was selected from the Human Resources class. It shows some of the skills and competencies I have learned in demonstrating principles of ethical reasoning and professional practice implicit in public health decisions to improve the publics health. For this assignment, we were to work as a group to develop a new employee orientation on an organization. We were to cover some overall aspects of the organization and some of the main policies including benefits, size, history, security, discipline, and the ethical decisions that may be faced at the organization. We chose to right about the facility that I work in and provided many details about its functions, the different roles employees have, benefits, etc. I wrote about the ethical framework of the organization. I wrote about a few of the ethical decisions that staff may face every day: medications, treatment, and transfers. Many people with mental illness are prescribed medications; we believe in choice, but sometimes and person is violent and too ill and refuses to take them. We may have to go through a process that forces medications which may be difficult for people to understand. Some staff may find it difficult to treat some of the patients that we treat; they are forensic patients, meaning they have committed some type of crime, some of them are very bad, and some staff may feel these people do not deserve to be treated. Doing therapy with that person every day may be very difficult for the staff member, but it is a struggle that they have to

accept because we believe in helping all individuals. There is the opposite dilemma for some staff. We can be slow to transfer someone out of the facility into a less-restrictive setting because we have to take not only the patients progress into account but what their crime was and whether we believe no one else will get hurt. We have to weigh the risk to society with the patients rights. This fits with this competency because I was able to show the ability to demonstrate ethical reasoning in making health decisions in an organization and how those decisions could contribute to improving health. Fulton State Hospital A forensic psychiatric hospital Objectives Learn about Fulton State Hospital (FSH) Identify a few of the legal and ethical frameworks

Review a vacant Case Manager job description Identify training and development needs Review some of the New Hire Orientation training Understand Performance Management in the organization Identify current trends in healthcare and HR at Overview FSH is a long-term forensic psychiatric hospital

Public, government funded, not-for-profit hospital Census is about 340 with a capacity of 376 85% male patient population 55% white; 42% African American; 2% Hispanic; 1% Asian Average Length of Stay is 4.5 years 1200 employees including approximately 900 in Overview Maximum, intermediate, and minimum security settings Seriously mentally ill with diagnoses of schizophrenia, bipolar disorder, borderline personality disorder, intellectual disabilities, autism, impulse disorder, etc

Nationally known evidence-based programming Social Learning Program New Outlook Program Competency Restoration Program Legal Concerns at FSH FSH is an equal opportunity employer Diversity leads to a stronger, more innovative organization Employment is based on personal capabilities and qualifications without discrimination Several Laws that guide our processes Civil Rights act of 1964 Equal Pay Act of 1963 Age Discrimination in Employment Act of 1967

Americans with Disabilities Act of 1990 HR Legal Frameworks Equal Employment Opportunity Commission (EEOC) Enforcement of the aforementioned laws is the responsibility of the EEOC. EEOC holds the greatest influence in enforcing the laws of any federal agency. Prosecutes accused employers. For additional EEOC information and guidance, visit http://www.eeoc.gov/laws/index.cfm Ethical Framework Ethical decision making process

respecting the right to make treatment choices Daily ethical decisions may include: Medications forced side-effects quality of life Ethical Decisions (continued) Treating a forensic patient

the patient the victims the families society Transferring a client when they do not want to go when you are worried about the next providers care Positions/Roles at Fulton State Hospital Psychiatrists Accountants

Medical physicians Chief Operating Officer Psychologists Administrative Assistants Nurses Ward Clerks Case Managers

Security Officers Social Workers Research Analysts Rehab services Infection Control Nurse Environmental Services Occupational Therapists Dietary staff

Director of Treatment Services HR Responsibilities Interview/Hire Train employees Educate employees on HR processes Provide recognition to employees Help the HR dept monitor TJC HR standards Review competency forms/audit HR files

HR Responsibilities Specific to New Hire Potential opening for case manager at Fulton Advertise position/provide job description Interview/Hire Train employees Educate employees on HR processes (Orientation) Maintain performance records Case Manager Responsibilities

Direct supervision of patients to ensure safety and well being of clients and staff Participation in individualized care plans for individual clients Works collaboratively with other treatment staff to ensure clients are meeting daily and weekly goals Promoting healthy behaviors of clients Utilizes evidence based interventions and strategies to promote health, growth and development Communicates effectively with fellow staff members and treatment team Participate in daily and weekly rounds Conduct therapeutic milieu activities and groups Case Manager Requirements Case managers are required to have:

a bachelors degree in psychology or related field at least one year of psychiatric care managing in residential facility the ability to prioritize information and tasks Case managers must: be a legal resident of the United States have valid drivers license be CPR and first aid certified

be proficient in Microsoft Office Preferred requirements: Training Needs and Development PLAN STRATEGY DATA COLLECTION DATA ANALYSIS IMPLEMENTATION EVALUATION, REVIEW, Training Needs and Development

Cultural Competency Understanding religious and cultural beliefs of patients Strengthening the ability to work with employees of all backgrounds Employee Development Leadership Training CEUs New Hire Orientation Mission, Vision and Values History of Fulton State Hospital Benefits Computer Access, Security and Internet Use

HIPAA, Incident Reporting and Grievances EEO and Diversity Disciplinary Process Staff recognition Mission, Vision and Values Mental illness affects many people and their families Every individual is worth helping Everyone should be given hope that they can excel in life We partner with the individual, the families, and the community Recovery is the ultimate goal Our prime purpose in this life is to help others. And if you can't help them, at least

don't hurt them. ~Dalai Lama History of Fulton Opened in 1851 At one time housed over 5000 patients, census is currently 340 Treating seriously mentally ill people Nationally known evidence-based programming for our patients SMART programcrisis management program developed by our staff Benefits Work hours vary by department/hospital

needs. Probationary period lasts 6 months, but can be extended 12 holidays per year (comp-time is earned if working) Employees earn 10 hours of vacation and sick time every month Benefits Continued 3 types of health insurance options HMO with smaller monthly premium but higher deductible ($600) HMO with higher monthly premium but higher deductible ($300) High-Deductible Health Plan (very small monthly

premium, but large deductible ($1500) Flexible Spending Account Dental and Eye insurance at an additional cost Life insurance Computer Access, Security and Internet Use Computer Access Everyone needs at least email access, this is an important tool in the communication process at the facility Security This is a highly secured environment Contraband and weapons take many different forms Internet use

Employees have access to the internet (email doesnt work without it) Internet use must be business related HIPAA, Incident Reporting and Grievances Health Insurance Portability and Accountability Act Privacy is very important to our patients and their families Incident Reporting Incident reporting allows the facility to collect data on safety and security in the hospital. Grievances Grievances are about employees (if you think a supervisor is treating you unfairly, another employee

is rude or harassing you, or complaints about work conditions) Disciplinary Process Written Reprimand is the first step in the disciplinary process Unacceptable Conduct Notice is the second step Suspension is the third step Dismissal is the final step Union and arbitration rights Security This is a highly secure environment Contraband comes in many different

forms. Here are a few examples: Compact mirrors Some combs Certain pens and notebooks And most importantly, cell phones! Weapons take many different forms, Staff Recognition Employee of the month (small monetary reward and parking space) Employee of the year (monetary reward) Department and discipline recognition (shirts, cups, pens, celebrations) Years of Service Awards

Seen Doing Good Awards Recognition Hotline Performance Management a w Re Ra ti g n i

rd ng Planning A systematic process by which an agency involves its employees, as individuals and members of a group, in improving organizational effectiveness in the accomplishment of agency mission and goals. Mo

ni to rin g ng i p lo e v De Job Performance Data Data collected from employee performance is

typically used for: administrative decisions (e.g. promotions, raises) developmental purposes to help an employee recognize strength and weaknesses Never mistake activity with accomplishment. ~ John Wooden Employee Performance Plan A performance plan is created with 1 to 3 elements defined by federal regulations. Critical Element required in a performance plan a duty of great importance that directly affects

performance rating and summary level a responsibility which the employee is expected to have control over Employee Performance Plan Non-Critical Element optional a dimension of performance that is important but not of such importance that one would fail if the standard is not met it is used to give a summary level

Additional Performance Element optional a dimension of performance thats important but doesnt affect the summary level Fulton State Hospital Case Manager Appraisals Multisource appraisal approach: supervisor peers

subordinates patients patients families Appraised on: job responsibilities leadership teamwork duties as assigned behavioral observations Trends Affecting Healthcare HR (as a whole) PassageP Passage of the Patient Protection and

Affordable Care Act (Obamacare) Competition for positions and/or employees Economic uncertainty Becoming more goal and results oriented; playing role in organizational strategic planning Utilization of software as a service Changes in recruitment processes

Trends Affecting HR at Fulton Implementation of PPACA and expanded Medicaid coverage Increased training and planning Staff recruitment and retention Technology advances Economic uncertainty References Appone. (2013). Audit Inpatient Mental Health Worker/Case Manager. Retrieved from https://www.appone.com/maininforeq.asp?Ad=171995&R_ID=758092&Refer=http://www.indeed.com/q-Inpatient-Ment al-Health-Counselor-jobs.html&B_ID=44 Brown, J. (n.d.). Employee orientation: keeping new employees on board! Retrieved from http://ipma-hr.org/sites/default/files/pdf/hrcenter/Employee%20Orientation/cpr_eo_Overview.pdf. Fried, B. J. & Fottler, M. D. (2011). Fundamentals of Human Resources in Healthcare. Chicago, IL: Health

Administration Press Industry Resource Articles (n.d.). HR Trends in Health Care Companies. Retrieved from http://www.unicornhro.com/articles/hr-trends-in-health-care-companies Missouri Department of Mental Health (DMH) (2014). Fulton State Hospital. Retrieved from http://dmh.mo.gov/fulton/ Office of Personnel Management. (n.d.). Performance Management Overview and History. Retrieved from References Office of Minority Health. (2013). What is cultural competency? Retrieved from http://minorityhealth.hhs.gov/templates/browse.aspx?lvl=2&lvlID=11 Parker, F. (2007) Ethics Column: "The Power of One" OJIN: Online Journal of Issues in Nursing. Vol. 13, No. 1. Retrieved from http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/Columns/Ethics/Power. html

World Health Organization. (n.d.). Mental Health Policy and Service Guidance Package: Human Resources and Training in Mental Health. Retrieved from http://www.who.int/mental_health/policy/Training_in_Mental_Health.pdf

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