Patientenautonomie zwischen Individualisierung und Technisierung
Ausgabe: 1/2013
59. Jahrgang
Ärztliches und pflegerisches Berufsethos und Krankenhaus-Bürokratie
Hospital bureaucracy comprises three aspects: (1) Medical (patient-oriented), (2) administrative (organization-oriented) and (3) the external and internal bureaucracy of quality management. Ward physicians and ward nurses spend at least 3 hours of their daily work time fulfilling bureaucratic requirements. Patient-oriented documentation benefits sick people and is a necessary element of therapeutic work. Administrative bureaucracy consists in specific administrative activities, and under the DRG fee system allows the organization to intervene in the medical and nursing activities carried out. The data derived from external and internal quality management provide general strategic information for the health-care system and the business side of hospitals. The bureaucratic requirements within the current hospital structure, especially the time expenditure they necessitate, restrict the possibilities for implementing the ethical imperative of providing patient-oriented medical care. Hospital management is challenged to determine the degree of bureaucracy.
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