Frank A. Riddick Jr. stated in an article by the NIH, The Code of Medical Ethics of the American Medical Association: “These principles are intended to aid physicians individually and collectively in maintaining a high level of ethical conduct. They are not laws but standards by which a physician may determine the propriety of his conduct in his relationship with patients, with colleagues, with members of allied professions, and with the public.”
The risks of non-compliance
An article titled: “US doctors are not following ethical guidelines” by the NIH states that, “Many doctors in the United States are failing to conform to professional guidelines. A survey sponsored by the US Institute of Medicine found that doctors often fail to conform to accepted norms in areas of self regulation, managing conflicts of interest, and ordering of unnecessary tests.”
Healthcare organizations that deviate from established guidelines risk severe damage to their professional reputation. Guidelines, while not legally binding, set the standard of care in medical practice and legal proceedings. Organizations operating outside these norms face increased litigation risks and regulatory scrutiny. Additionally, they may encounter difficulties with insurance reimbursements and accreditation status, as bodies like The Joint Commission require adherence to established standards. These guidelines exist to ensure quality care and patient safety - organizations that ignore them risk compromising both.
In the 2019-2020 case of Seattle Children's Hospital, the hospital faced a crisis when it discovered Aspergillus mold in its operating rooms, linked to 7 deaths and multiple infections over several years. The root cause was traced to the hospital's air handling system, which didn't meet industry guidelines for air filtration and pressure management in surgical areas.
The middle ground
Healthcare organizations can take a subtle approach by:
- Treating guidelines as valuable frameworks while recognizing that unique situations may require deviation
- Documenting and justifying any departures from standard guidelines
- Maintaining internal policies that often exceed baseline recommendations
- Staying informed about guideline updates and evolving standards]
Challenges with implementing association guidelines
According to Zhicheng Wang, Susan L. Norris, and Lisa Bero in The Advantages and Limitations of Guideline Adaptation Frameworks: “The implementation of evidence-based guidelines can improve clinical and public health outcomes by helping health professionals practice in the most effective manner, as well as assisting policy-makers in designing optimal programs. The development of guidelines without adequate consideration of implementation may hinder the target audiences’ adherence to the guidelines. Without proper implementation, the financial and human resources expended in the development of guidelines are wasted. The implementation of guidelines in a context that is different from where they were developed is particularly challenging. In addition, recommendations in public health guidelines are often more complex to implement than clinical guidelines and usually target health systems or multi-sector government institutions instead of individual clinical decisions. For example, WHO develops guidelines for a global audience; each guideline or recommendation in each guideline then needs to be considered for implementation at the country or sub-national level (e.g., within a health system). Other examples include implementation of national guidelines to the local (e.g., state or provincial) context, international guidelines to a local hospital, European guidelines to individual countries, and international guidelines to regions.”
FAQs
Can a healthcare organization face penalties for not following association guidelines?
While guidelines are not legally binding, failing to follow them can lead to malpractice claims, regulatory scrutiny, and loss of accreditation, indirectly impacting compliance with laws like HIPAA.
How do association guidelines relate to HIPAA regulations?
Association guidelines provide best practices for patient care, ethics, and security, many of which align with HIPAA's legal requirements for protecting patient information.
How does non-compliance with guidelines affect HIPAA compliance?
Deviating from association guidelines can lead to lapses in patient privacy and security, increasing the risk of HIPAA violations and penalties.
