NURS FPX 4050 Assessment 2 Ethical and Policy Factors in Care Coordination

Introduction:

Hello, Today my topic of presentation is ethical and policy aspects in care coordination which affect care coordination.

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Care coordination

Care coordination is a key need of healthcare institutes. Agency of Healthcare Research and Quality (AHRQ) defines care coordination as a systematic process in which there is information sharing with interprofessional team members to handle patient care activities with the help of coordinated choice-making (Karam et al., 2021).

The objectives of care coordination are provision of elite quality patient care facilities and strong communication among healthcare workers while aiming at patient’s requirements (Dinsdale et al., 2019). To prevent ethical issues and adverse outcomes, nurses should comply with professional ethical codes and healthcare regulations in a hospital setting.

My targeted community to explain ethical and policy problems is nursing homes that can face different problems during provision of care coordination.

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Governmental Policies

Governmental Policies Related to the Health and Safety of a Community

In the US, there are different government-level policy frameworks assisting people for economical healthcare insurance options and facilities. These policy frameworks are for people’s well-being and betterment which provide equal safe and high-quality healthcare services to all community members without any discrepancy.

Though there are many notable policies in the United States for provision of affordable healthcare services, the Affordable Care Act (ACA) is highly reputed (Ercia, 2021). To guarantee high-quality and safe health services in nursing homes, the Nursing Home Transparency and Improvement Act is important as the targeted community is nursing homes (Harrington et al., 2019). For protecting patient’s healthcare information, HIPAA (Health Insurance Portability and Accountability Act) is important (Chinmoy et al., 2020).

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Clear Instances of Particular Policies Affecting Care Coordination

The most extensive healthcare policy framework is the ACA which has three key objectives. The first objective is to guarantee economical healthcare insurance options, the second is to increase the accessibility of people from lower income class to health services and the third is to encourage such patient care services which decrease healthcare expenditure (Sturmberg & Bircher, 2019). ACA impacts the healthcare standard at different levels i.e., improving the quality of healthcare services by providing economical healthcare insurance options to people from lower income class.

It also works for the community’s health and well-being by different illness prevention plans.

People in nursing homes are suffering from chronic illnesses i.e., high blood pressure, Chronic Obstructive Pulmonary Disease (COPD), pneumonia, and cardiovascular problems. People suffering from chronic and pre-existing diseases can have elite-quality healthcare facilities under the Affordable Care Act (ACA).

People in nursing homes can get intervention assistance from an expert and able healthcare providers working there. ACA has an impact on care coordination as healthcare facilities are expensive for people and there are unaffordable insurance choices, resulting in people deciding to ignore their health state. ACA is also assisting in managing the disease rate.

Effective healthcare screening ensures timely medical interventions for patients in nursing homes which reduces the death and disease rate.

ACA has also introduced the Hospital Readmission Reduction Program (HRRP) to discipline healthcare organizations such as nursing homes for increased hospitalization rates (Pugh et al., 2021).

HRRP motivates healthcare institutes to strengthen their communication and care coordination. This has improved patient and healthcare providers involvement in hospital discharge which is eventually controlling the hospitalization rates (Ayabakan et al., 2021). HRRP enhanced the American Healthcare System as it encouraged healthcare organizations to enhance care coordination activities by involving patients in post-discharge design (Centers for Medicare and Medicaid Services, 2022).

The provision of elite-quality healthcare facilities to all and strong communication with healthcare workers is a major challenge at nursing homes. Changes in the transparency of patient healthcare information is brought about by the Nursing Home Transparency and Improvement Act which directly impacts care coordination (National Academies of Sciences et al., 2022).

This policy framework guarantees the healthcare providers’ accountability for patient care and healthcare facilities in nursing homes. Patients can inquire about the healthcare services standard offered in nursing homes. Ethical frameworks are also implemented under this policy framework to assess civil, administrative violations, performance and quality enhancement designs in nursing homes (Yew, 2020).

HIPAA regulations were formulated and passed by the US federal government in 1996 to ensure confidentiality and privacy for patient’s healthcare information (Moore & Frye, 2019).

It forbids any act of sharing a patient’s information without consent (Cramer, 2023). HIPAA policy framework has been introduced for avoiding mishandling and breach of medical data. Under HIPAA, all the patient’s health information is kept secured and transferred safely among healthcare workers during care coordination. There are huge fines and penalties for breaching a patient’s data confidentiality (Anderson, 2019).

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National, State, and Local Policy Provisions that Raise Ethical Questions

Here’s the discussion about two state- and local-level policy frameworks which assisted the community but had many ethical concerns. ACA is the first policy framework and HRRP (Hospital Readmission and Reduction Program) is the second policy under discussion (Pugh et al., 2021).

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Ethical Dilemma for ACA, its Implication and Consequences

One of the reputable healthcare policy frameworks across the US is ACA which is providing economical healthcare services to many people (Cyr et al., 2019). For provision of affordable healthcare services to lower-income class and impoverished people, affordable insurance options are important (Habib & Zaidi, 2021).

The ethical dilemmas of ACA are associated with healthcare expenditures. The target of ACA is to enhance healthcare quality, provision and reduce healthcare expenditures (Levine et al., 2022). ACA not only benefits insured people, but it is also beneficial for the uninsured people who are unable to bear the healthcare expenditures.

In case of the unavailability of insurance options, people do not get appropriate treatment or get incomplete healthcare services (Sriram & Khan, 2020).

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Ethical Dilemma for HRRP, its Implication, and Consequences

Another measure to cater to the ethical problems is the government’s hospitalization reduction policy framework. HRRP is a strong framework which has assisted many healthcare providers including doctors and nurses for maintaining honest and trustworthy patient relationship (Warchol et al., 2019).

The notable impacts of HRRP are reduced hospitalizations, decreased healthcare expenditures, improved patient’s contentedness and healthcare standards (Gai & Pachamanova, 2019). Though HRRP is beneficial, it has raised many ethical concerns such as misinterpretation and weak communication between healthcare workers and patients as the focus of healthcare providers’ shift from high-quality care provision to reduction of hospitalization. It gives rise to wrong disease identification and administrative faults regarding hospitalizations.

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Effect of the Nursing Code of Ethics on Coordination and Continuum of Care

In nursing practice, it is important to follow ethical codes while providing healthcare services with honesty and deliberation. The American Nurse Association is a government body that is responsible for compliance of nursing ethical codes.

ANA has highlighted that nursing ethical codes are highly important to forge the nurses’ conduct and enhance their productivity in patient care provision (Hadian Jazi et al., 2019). A nurse should strictly comply with the ethical values of justice, kindness, self-determination, and assistance for healthcare unity, avoiding patient harm, patient-centric decision making, and prevention of adverse outcomes respectively (Alnajjar, PhD & Abou Hashish, PhD, 2021).

Patient’s self-determination and autonomy in healthcare decision-making is extremely important which enables them to choose their care plan. For instance, a patient has full authority to select the healthcare treatment in accordance with his individual choice and autonomy (Dutta et al., 2019).

Nurse must give all available choices and full rights to the patient for decision-making. Justice is a healthcare ethical value that guarantees equal treatment and intervention for all patients regardless of their color, caste, race, or ethnicity (Olejarczyk & Young, 2022).

By complying with these ethical principles, effective care coordination can be ensured. The patient is responsible for his healthcare thus there should be strong communication with him. An open and friendly conversation with patients can help care coordination by excluding misinterpretations about intervention options and related misunderstandings. Furthermore, a patient’s self-determination can improve communication and interpretation as patients are contributing in choosing the healthcare treatment (Arrieta Valero, 2019).

When patients have realization about fair treatment, positive environment and healthy interaction with the healthcare workers; their confidence in healthcare service provision is enhanced (Søvold et al., 2021).

By adhering to this idea of ethical codes, nurses will be unbiased and have a just behavior with all individuals regardless of color, caste, creed or culture.

It is the responsibility of a nurse to provide equal healthcare services to all patients irrespective of their gender, culture, age or religion. To prevent violation of kindness, healthcare providers will find a least harmful intervention for the patients. Confidence between healthcare workers and patients can be strengthened by benefaction in care coordination (Bradshaw et al., 2022).

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Social Determinants of Health: Healthy People 2030

It is also important to focus on health’s social determinants such as income status of people, educational and social background and living environment (Office of Disease Prevention and Health Promotion, 2023).

There is a direct correlation between people’s health and social determinants of health. For instance, when a person is living in a substandard environment, it can provoke various illnesses, particularly in people of lower income class (Rowley et al., 2021).

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Factors Continuing in Health Disparities

There are various factors causing health care discrepancies i.e., lack of education, inaccessibility, limited resources, income level, unhealthy environment and inaccessibility to elite-quality healthcare facilities (CDC, 2020).

Conclusion

Conclusively, elite quality patient care can be ensured by different governmental acts impacting care coordination. However, many ethical dilemmas can be raised by some state- and federal level policy regulations.

The presentation explains that the Affordable Care Act (ACA) guarantees provision of affordable and comprehensive insurance options. Whereas, HRRP has reduced the hospitalization rates in nursing homes.

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