Care coordination facilitates delivering high-quality, efficient, and effective patient care to vulnerable populations. Margherita et al. (2021) define care coordination as a deliberate process of organizing a patient’s medical-related actions and sharing essential health-related information with all parties involved in the patient’s care. Studies show that the National Quality Strategy prioritizes the promotion of care coordination for better health outcomes (Chen et al., 2020). Additionally, care coordination practices initiated at the hospital level significantly improve quality (Chen et al., 2020). Effective information exchange between community providers and hospitals reduces care costs by eliminating repetitive services, including repeated diagnostic X-rays (Chen et al., 2020). However, hospital management faces challenges in enhancing care coordination among vulnerable populations. As a result, the American Heart Association (AHA) surveyed community hospital management on their service integration and care coordination strategies. This paper focuses on policy and ethical factors impacting care coordination for people struggling with heart disease and stroke.
The Impact of Governmental Policies Related to the Health and Safety of Persons with Cardiac Diseases and Stroke on the Care Coordination
Federal and state governments significantly influence clinical practices and health outcomes.Government policies significantly impact the health and safety of vulnerable populations (Treglia et al., 2019). In particular, government policies influence care coordination for persons diagnosed with cardiac diseases and stroke. The federal government introduced the “Health Insurance Portability and Accountability Act (HIPAA) to promote the privacy and security of health-related information for individuals (Chen et al., 2020). This policy promotes safety by regulating the sharing of patients’ electronically documented medical data. Thus, HIPAA compromises care coordination for heart disease and stroke patients since it prohibits hospitals from sharing an individual’s health-related and personal information with third parties, including community healthcare providers, without the owner’s approver. Limited access to an individual patient’s essential health-related information by healthcare experts from the American Heart Association compromises coordinated treatment, resulting in adverse health outcomes, including frequent hospital admissions.
Policy Provisions at National, State, and Local Levels Associated with Care Coordination Dilemma
The Affordable Care Act (ACA) is a healthcare policy applicable at the National, state, and local levels. The ACA extended health insurance coverage to millions of Americans, improving access to medical services (Ercia, 2021). Specifically, the ACA enhanced access to healthcare services among Americans diagnosed with cardiac diseases and stroke (Harrington et al., 2020). However, the ACA raises an ethical dilemma regarding care coordination. The ACA has increased the number of Americans seeking treatment for cardiovascular disorders (CVDs) significantly (Harrington et al., 2020). Nurses are significant in providing direct and indirect care to persons with CVDs. The number of nurses working in various clinical settings has not increased despite a dramatic rise in the number of CVDs patients seeking medical care from these healthcare organizations. Consequently, nurses are allocated more patients, resulting in burnout and work-related distress. As a result, nurses’ ethical and professional responsibility to provide high-quality and effective care to their patients is compromised. Therefore, the ACA exposes persons with CVDs to adverse health outcomes, including a high rate of hospital admissions and deaths.
The Effect of Nurses’ Code of Ethics on the Continuum and Coordination of Patient Care
Nurses adhere to the code of ethics in all their clinical practices. The code of ethics states nurses’ expected professional and ethical conduct and how they should make decisions when faced with barriers that hinder the fulfillment of their professional duties and obligations. Therefore, the code of ethics enables nurses to make ethical decisions during care delivery, avoiding implications associated with ethical issues. The code of ethics guides nursing practice through nine provisions. The first provision entails compassion and respect for an individual’s dignity, unique features, and worth. Thus, nurses are responsible for respecting their patients and upholding their dignity. Additionally, nurses must respect other parties influencing the patient’s health, including families and the entire community.
The third provision involves the nurse’s responsibility to advocate for, protect, and promote individual patients’ safety, rights, and health. This ethical provision enhances care coordination since it enables nurses to promote patient health and safety by involving other healthcare experts in making significant decisions regarding an individual’s treatment. The following provision holds nurses accountable for their actions and nursing practice. Therefore, nurses must participate in healthcare decisions and actions to improve the quality of patient care to avoid implications of adverse health outcomes. Moreover, ethical provisions focus on the place of work and nurses’ roles. In this case, nurses must contribute to the profession’s advancement by engaging in research activities, participating in health policy activities, and promoting professional standards. Nurses must also work with other healthcare experts to support health diplomacy, protect human rights, and reduce health disparity to enhance access to medical care.
Social determinant of health (SDoH) factors significantly impact individuals’ health, health disparities, and access to healthcare services. For instance, Americans with a high-income secure health insurance coverage, enhancing their access to high-quality medical care services (Glied et al., 2020). On the other hand, being uninsured limits low-income persons from accessing healthcare services. Therefore, income levels significantly contribute to health disparity. The Healthy People 2020 policy was introduced to minimize the effect of SDoH on individuals’ health, access to healthcare services, and health disparities. This policy focuses on achieving longer and quality lives by eliminating preventable diseases, disabilities, injuries, and premature deaths (Gómez et al., 2021). Moreover, the policy intends to promote health equality and equity by eliminating health disparities and promoting individuals’ health status. Therefore, nurses must collaborate with other healthcare professionals to address all Americans’ healthcare needs to eliminate health disparity and promote their health status and quality of life.
Policy and Ethical Issues Influencing Continuum and Coordination of Care for the AHA
Healthcare providers must uphold moral values throughout the care process. Policy and ethical issues significantly influence the coordination of care in the AHA. Nurses are expected to demonstrate a high degree of professionalism when dealing with stroke and heart disease patients. They should also promote human dignity and respect their patients, families, and society. Additionally, the ACA has promoted equal access to healthcare services, increasing the number of patients seeking treatment for CVDs. Therefore, applying the ACA and code of ethics in the AHA hinders smooth interpersonal relationships between healthcare professionals and their patients, compromising the quality and safety of care and overall health outcomes.
Conclusions
Care coordination promotes effective and efficient delivery of high-quality healthcare services. Health policies like the ACA promote access to quality medical care services at all levels. Healthcare providers must incorporate ethical guidelines into their practices to prevent ethical issues. In the AHA, care coordination for persons diagnosed with CVDs is compromised by the ACA. A significant increase in several persons seeking treatment for CVDs without an increase in the number of nurses compromises the delivery of safe and high-quality medical care. The HIPAA privacy rule also limits patient medical data access, jeopardizing care coordination. Additionally, the ethical code of conduct hinders healthcare providers’ interactions with their patients since medical officers must act professionally while dealing with their patients.
References
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