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Fundamental Principles of Care Coordination

The delicate nature of patient management and treatment requires efforts and communication among different health professionals. For effective treatment and management of patients, their information has to get shared by medical professionals. Care coordination deliberately organizes medical care activities between patients and medical professionals. It aims at patient wellness and reduction in healthcare costs. Care coordination promotes patient safety and efficiency in accessing treatment, especially for patients with adverse conditions like cancer. Care coordination improves patient outcomes by making patients aware of their conditions, enabling healthcare continuity, and eliminating medical errors in treatment. Nurses play a significant role in care coordination, but their efforts should collaborate with several other factors to make care coordination successful.

Key Factors for Nurses to Consider for Effective Care Coordination Process

Community Resources

Nurses should use community resources at their disposal to offer adequate care to patients. The resources are medical facilities, personnel, and community support groups. Patients may, at times, find it more challenging to share their health issues with nurses than with members of social support groups. Nurses should work closely with community support groups to gain information that could help better patient care. Nurses can also join community health educators in teaching patients the relevance of care coordination. Nurses could organize support groups for patients/ families with similar medical issues or advise patients on which institutions to visit for referrals. The involved parties can then discuss how they handle different medical problems.

Ethics

Ethics are moral principles that nurses follow in care coordination. They help uphold professionalism and protect the patient’s rights. Patients seeking extra care are prone to suffering malpractices like exaggerated drug prices by healthcare providers. Nurses should also adhere to legal obligations like observing to avoid disciplinary action for professional misconduct. Nurses should treat patient records with confidentiality. They should avail information regarding treatment to patients and involve them in decision-making. If critical treatment decisions are imminent and the patient is not in the right mind to decide, nurses should contact the patient’s family. Therefore, nurses should uphold professionalism and respect patient rights in care coordination.

Policies

Advocacy is one policy that nurses can use to ensure care coordination suits the patients’ needs. The ANA Ethics Code supports care coordination by providing patient advocacy. Advocacy policy ensures that nurses advocate for patient rights and the provision of essential services. Nurses should be conscious of policies that govern health care. According to the government policy regarding labor, the working hours for nurses in care coordination are from 0900 to 1700 hours. Nurses should not waver the working duration unless where the management allows it. Care coordination is sometimes challenging, especially in care homes where a nurse may get assigned to fifteen patients. Nurses should withstand such challenges and environments.

Effective Strategies for Collaborating with Patients and their Families for Desired Health Outcomes

Education Intervention

Education intervention entails organizing interactive learning sessions where nurses educate patients and their families on the importance of collaborating in care coordination. It builds patient-nurse friendship, which eases the care coordination process. Nurses should educate the patient’s family on the importance of transparency. For instance, a patient’s family may shy from telling the nurse that their patient declines medications. Nurses should address factors like fear, medication, and stress obstructing sharing of patient information. Thus, education intervention teaches the patient’s family that information sharing is paramount for effective care coordination.

Cultural Competence

Cultural competence entails acknowledging that different cultural and demographic elements influence care coordination. Nurses should deliver care coordination to precisely fit different patients’ cultural and linguistic contexts. They should eliminate cultural barriers to effective care coordination by ensuring that diverse patients have equal access to care and a language-diverse workforce. Linguistic differences cause patient-nurse misunderstandings, dissatisfaction, and delivery of low-quality care. Nurses should encourage patients to obtain health insurance coverage because it removes some cultural restrictions to proper healthcare. For instance, a study explains that healthcare access differs between cultural groups like blacks and Whites in America (Georgetown University, 2018). Thus, nurses should not diminish patients’ cultural aspects but should consider and eliminate racial or ethnic disparities.

Aspects of Change Management that Affect Patient Experience

Training

Training involves equipping nurses with the knowledge needed to improve care coordination. It enhances the patient experience because caregivers learn how to meet patient needs effectively. The training required is both technical and behavioral. For instance, when adopting new methods of care coordination, training is essential to help nurses tailor the procedures to patients’ satisfaction. Thus, training improves the patient experience by availing knowledge to handle challenges in care coordination.

Communication

Communication is either interhospital or intrahospital. Intrahospital communication involves sharing patient details within several departments of one institution while sharing patient intel between various medical care facilities is interhospital communication. Patients benefit from communication through timely access to their records and declined medical errors. Thus, effective communication saves patients from the cost of moving to different care facilities or departments to acquire information.

The rationale for Care Coordination Plans Based on Ethical Decision Making

Care coordination requires ethical decision-making for the effective administration of care. Ethical decision-making involves evaluating the prevailing alternatives and choosing the one that best fits acceptable moral standards. It is paramount to single out unethical choices in care coordination. Nurses should adhere to professional codes in making ethical decisions against the dilemmas they face in care coordination. For instance, nurses make ethical decisions when a patient gets hindered from receiving necessary treatment by their family. Care coordinators apply ethical theories in decision-making when patients’ lives are at risk, and the dilemma is not covered in the professional code of conduct. Utilitarianism requires care coordinators to consider the most significant positive consequences, while deontological nurses use universally acceptable laws in critical decision-making. Thus, ethical decision-making enhances care coordination plans because nurses make critically informed patient care decisions.

Consequences of an Ethical Approach to Care

Conflicts

At times, nurses encounter dilemmas in care coordination, which often conflict with the codes of ethics of the medical profession. Hence, conflicts arise between what a caregiver is supposed to do and what they decide to do. For instance, if a patient rejects medication that could cure them, a nurse should adhere to the patient’s demands (Haddad & Geiger, 2021). Thus, an ethical approach helps minimize conflicts in care coordination using ethical principles.

Improved Patient care

An ethical approach to care coordination usually has the patients’ interests at heart—for instance, the principle of non-maleficence advocates for protecting patients from harm. The beneficence principle requires nurses to provide balanced patient benefits, like assistance in task performance. Thus, an ethical approach improves patient care by protecting the patients’ rights.

The basic assumption of an ethical approach to care is responsibility acceptance. For instance, if a nurse believes a situation requires applying the utilitarian principle, they must accept their role in influencing the outcomes. Another assumption is that the chance of decision-making falls solely on the nurse, and the number of alternatives is limited.

Impacts of Health Care Policies on Patient Experience and Outcomes

The Affordable Care Act (ACA) is a policy that aims at enlarging the coverage of health insurance in America. The policy has enabled most low-income earners to gain insurance coverage and reduced the percentage of uninsured citizens (Kominski et al., 2017). Patients continue to receive free care, courtesy of the policy. ACA removes barriers o health care access through cost-sharing plans. The act enabled young adults under 26 to gain coverage from parents’ insurance plans. Thus, the outcome of the ACA on patient experience is increased patient health coverage.

Consequences of the Affordable Care Act Provisions

Some significant provisions of the ACA are the dependent coverage provision, financial incentives to rural health workers, and mandatory employer coverage. The dependent coverage provision enables the policy to insure more young adults. Hence, more people gain access to treatment. The financial incentive provision has helped rural and underserved populations access health services (French et al., 2016). Nurses and other medical personnel in underserved regions get more pay than those in urban areas. It benefits the patients more because rural patients access care services quickly. Mandatory insurance coverage helps employees gain medical insurance through their employer if their number in a workstation exceeds 100.

In summary, care coordination is the deliberate organization of medical care activities and information between patients and medical professionals. Nurses play a vital role in the care coordination process. Community resources, ethics, and policies are some key factors that nurses should consider in coordinating care. The aspects of change management that affect patient experience are communication and training. Intrahospital communication pertains sharing of patient information between different departments of the same hospital. In interhospital communication, patient information gets shared between different facilities. Communication in care coordination saves patients from movement time and records errors, while training improves the quality of care delivered to patients. An example of a health care policy is the Affordable Care Act (ACA). Mandatory employer coverage, dependent coverage, and incentive offer to nurses in underserved areas are some provisions of the ACA.

References

French, M. T., Homer, J., Gumus, G., & Hickling, L. (2016). Key Provisions of the Patient Protection and Affordable Care Act (ACA): A Systematic Review and Presentation of Early Research Findings. Health Services Research51(5), 1735–1771. https://doi.org/10.1111/1475-6773.12511

Georgetown University. (2018). Cultural Competence in Health Care: Is it important for people with chronic conditions? – Health Policy Institute. Health Policy Institute; GeorgeTown University. https://hpi.georgetown.edu/cultural/ ‌

Haddad, L. M., & Geiger, R. A. (2021). Nursing ethical considerations. NCBI; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK526054/

Kominski, G. F., Nonzee, N. J., & Sorensen, A. (2017). The Affordable Care Act’s impacts on access to insurance and healthcare for low-income populations. Annual Review of Public Health38(1), 489–505. https://doi.org/10.1146/annurev-publhealth-031816-044555

 

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