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Ethical and Policy Factors in Care Coordination

Healthcare coordination is essential in the successful delivery of healthcare services. It is a process that involves organizing patient care activities between two or more persons. The healthcare coordination process involves including the patients to ensure effective service delivery. The primary objective of healthcare coordination is to help eliminate the fragmented healthcare process, meet the patients’ needs, deliver safe healthcare services, and reduce medical costs. Reducing medical costs is achieved through reducing readmission cases and emergency services. Therefore, the selected community organization or group of focus to promote learning of the policy problems impacting healthcare coordination is the nursing homes. The group can benefit from the effective coordination of healthcare services since most suffer from chronic diseases.

The Impact of the Government Policies Associated with Health and/or Community Safety on the Coordination of Care

Different policies developed by the government have a direct impact on the coordination of healthcare services. For example, the Affordable Care Act (ACA) and the Health Insurance Portability Accountability (HIPAA) are crucial in influencing the healthcare coordination process. The ACA focuses on implementing affordable insurance coverage, expanding Medicaid plans, and reducing medical costs (Bachynsky, 2020). The ACA policy is also focused on the Triple Aim objectives, which led to the emergence of the Center for Medicare and Medicaid Services (CMS) and the enhancement of the quality of services received by the patients and ensuring that providers are satisfied. Therefore, the policy ensures that the services delivered focus on quality and reduced cost.

There are many benefits from this policy on the population group, such as the elderly persons. The expansion of Medicare benefits has brought the benefits. The elderly population also benefits from the free preventive services offered under this policy. The ACA policy has ensured a reduction in Medicare Part B Premiums, prescription costs, and the protection of individuals against fraud in Medicare (Parker et al., 2019). Therefore, the ACA insurance plans and other essential initiatives available under this policy help ensure that elderly persons benefit through reduced Medicare costs by improving care coordination and the transition of healthcare services.

The HIPAA policy protects the patient’s health information and medical records from unauthorized access. The policy also focused on making it easier to access healthcare records by the patients (Nettrour et al., 2019). Consequently, there was an emergence of privacy and security rules. Therefore, the rules set under HIPAA policy help ensure that the national standards of practice guide the providers about disclosing the patient’s protected health information.

The privacy rule is also important to the patient receiving healthcare services. For example, patients can manage the information by influencing who uses such information, the type of individuals whom the information should be shared with, and how and who will have access to such information. Such guidelines about the privacy and security of patient health information are essential in the healthcare coordination process. In this case, the provider must collaborate with the patients to determine who should access the protected information. Security involves standardized procedures to ensure unauthorized disclosure or breach of security. Nevertheless, the security rules do not give specific measures to ensure the safety of such information. Therefore, most security measures healthcare organizations adopt include electronic information storage with specific login details.

Healthcare providers must protect the patient’s health information as a covered entity. As such, they ensure that the information received is electronically stored and transmitted to authorized persons. The introduction of the security and privacy rules ensured complete patient health information protection while simultaneously allowing coordinated healthcare (Nettrour et al., 2019). Any covered entity violating these rules is likely to be imprisoned and pay fines concerning the losses or damages caused. There is also a risk of losing the practice license. Therefore, adherence to such rules is mandatory.

Identification of the National, State, and the Local Policy Provisions Raising Ethical Questions or Dilemmas for Care Coordination.

Ethically, nurses have the responsibility to implement their jobs professionally. The affordable care policy is one of the national, state, and local policies. This policy is applied in healthcare, such as nursing homes (Tracey et al., 2019). Nevertheless, studies show that affordable policy raises ethical questions regarding healthcare coordination. Affordable healthcare increases the number of individuals in nursing homes (Campbell & Shore-Sheppard, 2020).

Consequently, it leads to education in healthcare quality since the policy fails to ensure an increase in the number of providers, such as nurses. The increase in the number of elderly persons in nursing homes without an increase in nurses leads to more harm than good. Therefore, affordable healthcare policy results in poor diagnosis and treatment of individuals.

The Impact of the Nursing Code of Ethics for Nurses on Care Coordination and Continuum

The moral values of healthcare professionals are among the paradigm that helps facilitate the development and ensure quality services in nursing homes. During their training, healthcare providers are well-trained about the importance of compliance with nurses’ code of ethics. The code of ethics includes nine provisions, with the first involving compassion and respecting persons’ dignity, worth, and unique features. In this case, nurses are responsible for ensuring they remain committed to upholding the dignity of the individuals they care for. Nurses are expected to respect patients, families, societal members, and the population. The third ethical principle is the nurse’s responsibility to promote, advocate for, and protect individuals’ rights, safety, and health.

The other provision of the ethical principle is for the nurse to use their power to ensure they always remain accountable and responsible for nursing practice. Under this provision, nurses are expected to make healthcare decisions and participate in actions focused on improving overall health and providing patient care services. Therefore, nurses are expected to preserve the wholeness nature of God and integrity, maintain competency, and participate in continuous professional growth.

The other provision is the roles and place of work. In this case, nurses have the responsibility of helping in the advancement of the profession by taking part in research activities, scholarly research, promoting professional standards, and the development and production of nursing health and policies. Nurses work with other healthcare professionals to protect human rights, support health diplomacy, and help reduce health disparity.

Healthy People 2020 policy outlines the eight and the nine ANA codes of ethics; the Healthy People policy focuses on attaining quality and longer life free from preventable diseases, injuries, disabilities, and premature deaths. The policy is also focused on attaining health equity and equality, eliminating health disparities, and enhancing the health status of all persons (Centers for Disease Control, 2019). Therefore, nurses and other healthcare providers are expected to work as a team towards ensuring that each need of the patients is addressed to promote safety and successful management of health.

Key Ethical and Policy Issues Affecting the Coordination and Continuum of Care In Nursing Homes

Moral values are crucial for healthcare providers in serving patients. Ethical values and policy issues play an essential role in the coordination of care in nursing homes. Some of the ethical issues are the involvement of a high level of professionalism when handling patients and promoting human dignity. The main policy used is affordable care, which ensures equal healthcare services. Therefore, as much as the policies and code of ethics are utilized, challenges affect the smooth relationship between the two factors. One of the main factors is the high level of ignorance among the team responsible for the implementation. Therefore, there is a need to ensure awareness about the policies and use of ethics in coordinating healthcare services.

Conclusions

Healthcare coordination helps in the effective delivery of healthcare services. The healthcare coordination process is focused on eliminating the fragmented healthcare system. Healthcare coordination helps meet patients’ needs, deliver safer healthcare services, and decrease healthcare costs. Nursing homes offer services, especially to elderly persons. The ethical and policy factors influence the role of care coordination in these facilities. Due to the age of this population group, there is a need to have a high level of focus on their well-being, health, and safety. Therefore, the government must ensure the effective development and implementation of policies and ethical considerations to deliver more quality services. Federal, state, and local policies such as the affordable care act (ACA) need to address issues such as shortages in healthcare providers like nurses to help provide quality services to elderly patients in nursing homes.

References

Bachynsky, N. (2020, January). Implications for policy: The triple aim, quadruple aim, and interprofessional collaboration. In Nursing Forum (Vol. 55, No. 1, pp. 54-64).

Campbell, A. L., & Shore-Sheppard, L. (2020). The social, political, and economic effects of the Affordable Care Act: introduction to the issue. RSF: The Russell. https://doi.org/10.7758/rsf.2020.6.2.01

Centers for Disease Control. (2019). Healthy People – Healthy People 2020. https://www.cdc.gov/nchs/healthy_people/hp2020.htm

Centers for Medicare & Medicaid (CMS). (n.d.). Medicare Coverage Database. https://www.cms.gov/medicare

Nettrour, J. F., Burch, M. B., & Bal, B. S. (2019). Patients, pictures, and privacy: managing clinical photographs in the smartphone era. Arthroplasty Today5(1), 57-60. https://doi.org/10.1016/j.artd.2018.10.001

Parker, K. J., Hickman, L. D., Phillips, J. L., & Ferguson, C. (2020). Interventions to optimize transitional care coordination for older people living with dementia and concomitant multimorbidity and their caregivers: A systematic review. Contemporary nurse, 56(5-6), 505-533.

Tracey Motter, D. N. P., & APRN-CNS, Y. S. P. (2019). Affordable care: Harnessing the power of nurses. Online Journal of Issues in Nursing, 24(2), 1-14. DOI:10.3912/OJIN.Vol24No02Man02

 

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