Ethics, values, and decision making.

Throughout history, using one's values in personal decision making has implied integrity, ethical behavior, and leadership. I recently viewed a fascinating short documentary by Scott Sniffin titled Home of the Brave: When Southbury Said No to the Nazis. The film describes the attempted development of a military camp by the German American Bund movement in Southbury, Connecticut, in 1937 and details the actions of the townspeople to thwart the camp's development despite the fact that doing so would mean giving up an important freedom.As the Bund was in the initial stages of developing its twenty-fifth military training site in the rural town of Southbury, the townspeople, clergy, and selectman (mayor) held an open town meeting to discuss the camp's development and its implications for the town's residents. The townspeople strongly opposed the Bund's actions and decided at that town meeting not to let the Bund finish developing its site by creating obstacles to doing so. To carry out their task, they instituted zoning laws in the community that prohibited military training camps. While not a unanimous decision, as the townspeople had enjoyed the absence of zoning laws and restrictions, the majority agreed that it was more important to act in accordance with their values, even if they had to give up one of their freedoms in the process. The townsfolk did what they felt was right, demonstrating exemplary leadership, high-values-based behavior, and self-sacrifice.Today, healthcare executives and caregivers are guided by their respective professional code of ethics, which aims to protect patients, families, employees, and others from harm and mistreatment. An organization's ethical conduct ensures the safety of all who work, visit, or are cared for within its confines.Ruth W. Brinkley, FACHE, and John J. Donnellan Jr., FACHE, authors of the feature articles in this issue, reflect on the strong influences of an ethical and valuesbased culture within an organization. They both conclude that such a culture engenders high moral decision making, empowerment, fulfillment, and success among employees.THE IMPORTANCE OF ORGANIZATIONAL VALUES AND INDIVIDUAL CO MM IT MENT TO THOSE VALUESBrinkley raises a number of points that help explain the values that the Southbury townspeople displayed 75 years ago. She states: "Whether spoken or unspoken, values are important because they form the basis of culture, and culture drives performance. An organization's values and culture determine what is expendable and what is essential." At Greenwich Hospital, the service excellence culture has cascaded through all levels of the organization. From the time an employee is oriented into the facility, he or she learns what service excellence means for the hospital and is educated as to the ethical guidelines staff are expected to follow. Employees are mentored on their unit during the first year of their employment. The parameters are clearly understood and practiced, and they appeal to the inherent good within each employee.As part of our service excellence culture, employees are given permission to do the right thing for their patients. For example, if a patient leaves his or her slippers at home, the employee can purchase a new pair in the hospital's gift shop without bureaucratic hassle. It is the belief of Greenwich Hospital management, borne out in the patient satisfaction surveys that are conducted continuously, that happy patients lead to happy employees, which lead to increased patient satisfaction and heightened employee confidence to do the right thing when the right thing is in question. Employees' actions are celebrated weekly and monthly at quality award ceremonies; fear of retribution is nonexistent.Donnellan notes that "Process improvement methods succeed when staff are empowered to call attention to systems that are not working well or processes that can be improved." In an environment guided by a moral compass, staff members are allowed to solve problems whose resolutions contribute to the organization's success. …