Do you think some of the future changes as a result of the pandemic will be positive?
Absolutely! Some of the changes that occurred during the pandemic will be positive, while some would be unsustainable. The leadership team adhered to all good leadership criteria to manage the crisis, such as; visibility especially during non-administrative hours, available 24/7, gratitude for the responsiveness of staff, admiration for the ability of staff to function under significant stress, competence to communicate quickly, positivity and calmness in the face of a
bewildering environment and transparency to establish trust (Caroselli, 2020, p.170).
More so, believe it or not, the COVID 19 pandemic has changed our way of life. Most changes yet to come will be positive, while some might infringe on personal believes or religion. This will include mandatory vaccination, early isolation of suspected cases, testing for COVID as part of onboarding requirements and signing of waivers if infected while working for the organization.
Lastly, the handling of the pandemic crisis was a disaster from the get-go. The entire healthcare system was in chaos, as the CDC struggled to relay information that fosters a safe work environment. Healthcare leaders must prepare staff for the future by building stronger organizations based on lessons learned, a reaffirmation of values fundamental to health care, and a commitment to creativity in patient care and staff advocacy (Caroselli, 2020, p.170).
References
Caroselli, C. (2020). Lessons Learned. A Journey Through Unchartered Territory: A Nurse
Executive’s Frontline Pandemic Response. Nursing Economic$, 38(3), 164–171.
A Sample Answer 3 For the Assignment: NURS 6053 Discussion Organizational Policies and Practices to Support Healthcare Issues Walden
Title: NURS 6053 Discussion Organizational Policies and Practices to Support Healthcare Issues Walden
(Response #1) I absolutely concur with your stand that COVID-19, which has been declared a global pandemic, is a current stressor that has given the whole world sleepless nights. In the real sense, this pandemic has contributed to more competing needs like a high unemployment rate, shortage of PPEs (personal protective equipment), shortage of health care facilities, inadequate number of health care workers, and bankruptcy, as stated in your discussion post. The world is currently in great recession as many organizations continue to shut down, GDP continues to decline as an employment rate continues to escalate. According to Duffin (2020), major economies in the world are expected to lose at least 2.4% of their GDP by the end of 2020 alone.
The competing needs have impacted policy formulation is all countries worldwide. According to Weible et al. (2020), many countries have established strict policies like closing their borders, restriction of movement, launching of mass testing, and enforcement of WHO guidelines (social distance, wearing of recommended masks, and regular washing or sanitizing of hands). Besides, health care organizations also imposed policies such as reuse of PPEs (gown and N95 mask) as per CDC guidelines to address the issue of inadequate personal protective equipment and limiting visitation to curb the spread of the virus, as outlined in your discussion. Since the competing needs caused by the pandemic are countless, the best cure is to follow CDC and WHO guidelines strictly to contain the spread of the virus so that normalcy can resume as soon as possible.
References
Duffin, E. (2020). Impact of the coronavirus pandemic on the global economy – Statistics & Facts. Retrieved from https://www.statista.com/topics/6139/covid-19-impact-on-the-global-economy/
Weible, C., Nohrstedt, D., Cairney, P., Carter, D., Crow, D., & Durnová, A. et al. (2020). COVID-19 and the policy sciences: initial reactions and perspectives. Retrieved from https://link.springer.com/article/10.1007/s11077-020-09381-4
A Sample Answer 4 For the Assignment: NURS 6053 Discussion Organizational Policies and Practices to Support Healthcare Issues Walden
Title: NURS 6053 Discussion Organizational Policies and Practices to Support Healthcare Issues Walden
The healthcare systems have to provide the best quality of care to meet the rising demand for such services. The population growth, increasing percentage of the geriatric populations, and the emergence of many chronic illnesses contribute to the high demand for healthcare services. On the other hand, the rising costs of living make life unbearable for many and influence the many cases of mental health issues among the populations. The impact of the high cost of living is also evident in healthcare institutions. The U.S government introduced the Medicare and Medicaid program to increase access to healthcare services by people from low-income families. Such an initiative would increase their access to healthcare services. Besides, government policies on the Medicaid and Medicare programs require healthcare institutions to minimize unnecessary interventions and offer quality healthcare services to their patients. Healthcare institutions are always caught in the competing need to offer high-quality care which may require additional resources and reducing the cost of medication.
Description of the Competing Needs
The healthcare institution where I work is committed to offering the best healthcare services to patients. The institution services many people with more of them being from poor backgrounds. The access to healthcare services to the poor families increased courtesy of the Medicaid program. The increasing number of patients visiting the hospital meant that the institution had to recruit more staff. The healthcare institution adopted the patient-centered care delivery approach and this means that they would give adequate time to the patients’ interactions to obtain relevant data for better patient management. Spending more time on a patient was necessary for offering the best quality of care, making the right diagnoses, and minimizing undesirable outcomes in their patients. On the other hand, the approach would require that the hospital recruits more healthcare staff to meet the demand for healthcare services. Therefore, the need to have more staff to offer high-quality services and the need to reduce the cost of the medication will be competing.
Relevant Policy or Practice
In responding to the competing need, the healthcare institution developed a policy that would require the healthcare providers to have mandatory overtime. Though the policy would increase the cost of a treatment since the nurses for the overtime; the cost incurred will be less compared to that needed for recruiting other full-time staff. The nurses and healthcare providers are required to attend to all the booked patients in a day. The number of extra hours spent on the work will depend on the patients in the queue. The healthcare providers are compensated based on the number of extra hours worked. The healthcare institution developed the policy as the cheap available alternative for addressing the need to meet the growing number of patients. The policy means that the healthcare institution will still be able to attend to their patients without any going unattended. Besides, the healthcare providers will commit themselves to offer a patient-centered care approach.
Critique of the Policy
The mandatory overtime policy in the healthcare institution aims at benefiting the patients and ensuring their needs are addressed accordingly. The patients will benefit because they will have adequate time to interact with the healthcare providers. Furthermore, the healthcare providers will have additional money from the overtime compensation and this may motivate some of them. Employees derive motivation from different things with some having more value on the monetary rewards and this constitutes a major strength to the policy.
The Healthcare system is highly sensitive because a slight error can even lead to a patient’s death. According to Zaree et al. (2018), the psychological well-being of the healthcare providers influences the quality of the care they deliver to the patients. Healthcare providers experiencing burnout are less likely to offer the best care to their patients. Furthermore, they will lack the moral to interact with their patients in a friendly manner. The healthcare organization must aim at creating a suitable environment that will promote high productivity among the patients. Both patients and healthcare providers are important stakeholders that influence the sustainability of the health organization’s operation. There must be a proper balance between the protection for the patients and the protection for the healthcare providers. The best way for the healthcare institution to promote the healthcare providers’ wellbeing is by ensuring they have a good working environment with all the resources and have adequate time for rest.
On the other hand, there are significant concerns related to the policy, especially on the healthcare providers’ part. The first concern is that employees should not be forced to work beyond the set working hours. Employees should be allowed to participate in the overtime program voluntarily because some value their families while others require personal time. Forcing all the healthcare providers into the mandatory overtime program means that some will be emotionally and psychologically drained. The emotional and psychological draining reduces the effectiveness of the healthcare providers in their duty delivery. Besides, there could be many cases of burnout and absenteeism arising from the employees who feel fatigued and exploited in their professional practice.
Furthermore, working for long hours could expose healthcare providers to physical injuries and other healthcare issues. According to Son et al. (2019), overtime is associated with inadequate sleep and fatigue. Also, some of the nurses are likely to have lower back pain because they have overworked. Fatigued nurses or other healthcare providers are prone to medical errors and this could cause more harm to the patients and this is ethically wrong (Milliken, 2018). Therefore, the major ethical concern in the policy is whether it is justifiable to expose the healthcare providers to health risks in the process of promoting the patient’s experiences. The harm presented to the healthcare providers is greater than the benefits emerging from the policy and thus making it unethical (Kelly & Porr, 2018).
Best Practices
The need to offer the best healthcare services at an affordable cost cannot be overlooked. The quadruple aim address four issues including promoting the quality of healthcare delivered to the patients, better population health, reduced cost of medication, and better quality of life for the healthcare providers. The increasing number of patients seeking medical services presents a major challenge to achieving the quadruple aim without straining the available resources in the healthcare institutions. However, the use of telehealth can significantly address the challenges because it will reduce the number of patients visiting the healthcare facility. According to Monaghesh & Hajizadeh (2020), the use of telehealth has been effective in managing patients during the Covid-19 pandemic. Adopting the policy will help the healthcare institution serve many patients at a reduced cost.
The policy will require the healthcare providers to intensify the patient education provided to the patients and equipping them with self-care skills. Patient’s education allows them to take control over their lives and so reduce their dependence on the healthcare providers (Tuckson et al., 2017). Furthermore, the patients will be committed to healthy behavioral practices and so there will be reduced cases of adverse treatment outcomes. Healthcare providers derive happiness when they realize that their patients have recovered and have better health status. On the other hand, high incidences of mortality and poor treatment outcomes affect the healthcare providers’ emotions negatively. The telehealth system will be the best solution to addressing the competing needs in the healthcare institution (Salles et al., 2021). There will be no need for mandatory over time and so the healthcare providers will have adequate time for personal life.
Conclusion
Competing needs in healthcare systems are common; therefore, healthcare providers must constantly develop measures to improve the quality of care delivered to the patients and maintain low operational costs. The healthcare institution developed a mandatory overtime policy which is not efficient because of the many adverse outcomes to the healthcare providers. Instead, adopting the telehealth system would be the best policy for addressing the need to reduce costs and improve the quality of care concurrently. The policy will reduce the number of patients visiting the healthcare institutions and so reduce congestion and the pressure exerted on the limited number of healthcare providers. Providing patients’ education will promote independence and this is needed for quality health outcomes.
References
Kelly, P., & Porr, C. (2018). Ethical nursing care versus cost containment: Considerations to enhance RN practice. OJIN: Online Journal of Issues in Nursing, 23(1), 6. doi:10.3912/OJIN.Vol23No01Man06.
Milliken, A. (2018). Ethical Awareness: What it is and why it matters. OJIN: Online Journal of Issues in Nursing, 23(1), 1. doi:10.3912/OJIN.Vol23No01Man01.
Monaghesh, E., & Hajizadeh, A. (2020). The role of Telehealth during COVID-19 outbreak: A systematic review based on current evidence. BMC Public Health, 20, 1193 https://doi.org/10.21203/rs.3.rs-23906/v3
Salles, N., Saillour-Glénisson, F., Sibe, M., Langlois, E., Kret, M., Durrieu, J., Arditi, N., Abraham, M., & Perry, F. (2021). Effectiveness and organizational conditions of effectiveness of telemedicine in nursing homes. A study protocol of a comparative prospective cohort (EFFORT study). DIGITAL HEALTH, 7, 205520762098242. https://doi.org/10.1177/2055207620982422
Son, Y., Lee, E. K., & Ko, Y. (2019). Association of working hours and patient safety competencies with adverse nurse outcomes: A cross-sectional study. International Journal of Environmental Research and Public Health, 16(21), 4083. https://doi.org/10.3390/ijerph16214083
Tuckson, R. V., Edmunds, M., & Hodgkins, M. L. (2017). Telehealth. New England Journal of Medicine, 377(16), 1585-1592. https://doi.org/10.1056/nejmsr1503323
Zaree, T. Y., Nazari, J., Asghary Jafarabadi, M., & Alinia, T. (2018). Impact of psychosocial factors on the occurrence of medication errors among Tehran public hospitals nurses by evaluating the balance between effort and reward. Safety and Health at Work, 9(4), 447-453. https://doi.org/10.1016/j.shaw.2017.12.005
A Sample Answer 5 For the Assignment: NURS 6053 Discussion Organizational Policies and Practices to Support Healthcare Issues Walden
Title: NURS 6053 Discussion Organizational Policies and Practices to Support Healthcare Issues Walden
Healthcare organizations develop policies to guide the daily activities and meet their expected treatment outcomes and standards. The operation of a healthcare institution depends on both internal and external structures. The internal components include the staffing, the working hours, and schedule policies, and collaboration structures (Laureate Education (Producer), 2018). On the other hand, the external factors include the government policies such as the Medicaid and Medicare programs and the 30 days-readmission policy among others. Therefore, healthcare institutions have to work to meet both external and internal needs. Though, in most cases, the competing needs presented by the policies could affect operational efficiency. The current discussion focuses on the rising cost of the medication issue and the need to improve the patients’ experiences.
The patient’s experience depends on various factors including their interactions with the healthcare providers and the quality of medications they receive. Healthcare institutions may be required to recruit enough healthcare staff to meet the desired healthcare provider patients ratio. Also, the institution may have to stock high-quality drugs to achieve the best therapeutic outcomes in the patients as per the bioethical requirements (Milliken, 2018). The fact is that improved patient experiences result in a lower cost of medication because the patients will have few cases of complications and the number of days they spent in hospitals (Kelly & Porr, 2018). However, the healthcare personnel may be required to engage intensive care approach including taking more time to understand the patients’ needs and developing the right diagnosis. Furthermore, they will have to explore other socio-cultural issues that could be affecting the treatment outcomes for the patients. In such as case, the healthcare institution will have to invest heavily in the resources needed for proper diagnosis and ensure that healthcare staff adequately meet the patients’ needs.
The illustration indicates that the healthcare institutions will struggle between meeting the patients’ needs and keeping the medication costs low (Hardin et al., 2017). Investing in the resources needed to offer the best care will mean that the costs for the healthcare services will increase. Healthcare institutions operate to make a profit and so must balance between their expenses and income. It will be unrealistic to have high-standard healthcare services at a low cost (Paterick et al., 2017).
Policies such as mandatory patient education and promoting self-care practices can help address the issue. Educating the patients means that they will have the required knowledge to promote healthy behavioural practices. Adopting the policy will reduce the risk of poor treatment outcomes and complications likely to emerge due to the patient’s non-adherence and unhealthy behaviours (Toukhsati et al., 2019). In addition, the patients will understand what they have to do to better their quality of life and so reduce their level of dependence on the healthcare providers (Figueroa et al., 2019). The number of patients seeking healthcare services continues to rise; therefore, adopting the policy will ensure that the healthcare institution serves a large population without straining the resources and this will reduce the cost of treatment.
Finally, competing needs are common in healthcare systems. However, healthcare providers must always develop new measures and policies for addressing health issues. Adopting the policy on patient education on self-care skills will reduce the burden presented on the healthcare institutions by the increasing number of patients and the rising cost of medication. Furthermore, the healthcare institution will be able to manage their staff without exposing them to any health harm and so achieve the quadruple aim.
References
Figueroa, C. A., Harrison, R., Chauhan, A., & Meyer, L. (2019). Priorities and challenges for health leadership and workforce management globally: A rapid review. BMC Health Services Research, 19(1). https://doi.org/10.1186/s12913-019-4080-7
Hardin, L., Kilian, A., & Spykerman, K. (2017). Competing health care systems and complex patients: An inter-professional collaboration to improve outcomes and reduce health care costs. Journal of Interprofessional Education & Practice, 7, 5-10. https://doi.org/10.1016/j.xjep.2017.01.002
Kelly, P., & Porr, C. (2018). Ethical nursing care versus cost containment: Considerations to enhance RN practice. OJIN: Online Journal of Issues in Nursing, 23(1), Manuscript 6. doi:10.3912/OJIN.Vol23No01Man06.
Laureate Education (Producer). (2018). Moral Leadership [Video file]. Baltimore, MD: Author.
Milliken, A. (2018). Ethical Awareness: What it is and why it matters. OJIN: Online Journal of Issues in Nursing, 23(1), Manuscript 1. doi:10.3912/OJIN.Vol23No01Man01.
Paterick, T. E., Patel, N., Tajik, A. J., & Chandrasekaran, K. (2017). Improving health outcomes through patient education and partnerships with patients. Baylor University Medical Center Proceedings, 30(1), 112-113. https://doi.org/10.1080/08998280.2017.11929552
Toukhsati, S., Jaarsma, T., Babu, A., Driscoll, A., & Hare, D. (2019). Self-care interventions that reduce hospital readmissions in patients with heart failure; Towards the identification of change agents. Clinical Medicine Insights: Cardiology, 13, 117954681985685. https://doi.org/10.1177/1179546819856855
A Sample Answer 6 For the Assignment: NURS 6053 Discussion Organizational Policies and Practices to Support Healthcare Issues Walden
Title: NURS 6053 Discussion Organizational Policies and Practices to Support Healthcare Issues Walden
A block of time for care coordination sounds like a great intervention for these complicated patients that get stuck in hospitals. This approach also assists with value-based healthcare (VBHC), since it could help with finding solutions and improving outcomes for these difficult patients (NEJM Catalyst, 2017). Unfortunately, my experience with VBHC is that since payers (Medicare in particular) reimburse based on outcomes, they are more focused on undesired outcomes than positive ones so they can avoid payments. This has trickled down to organizations that base any new policies around the negative outcomes associated with not being paid back. Instead of focusing on positive outcomes with policies like increased time for collaborative care coordination, the old business model of healthcare is just manifesting itself in a new way (Kelly & Porr, 2018). Healthcare systems and payers using VBHC need to integrate inevitable negative outcomes in a way that is not punitive and find ways to reward desired outcomes. For example, fall prevention is an even bigger priority in hospitals since the implementation of VBHC by Medicare means falls impact hospital reimbursement.
This priority conflicts with the evidence-based health benefit of early mobilization of patients since nurses are trained to over-use bed alarms and patients end up feeling like they are bothersome when alarms are involved. This newer policy-based barrier to mobilizing patients combines with inappropriate activity orders, staff not having time, patients refusing, and patients only moving with physical and occupational services. (Young et al., 2022). Ironically, an attempt to improve outcomes through VBHC can do the exact opposite. Bed alarms are, of course, appropriate and preventative intervention for falls in many cases, but nurses being scared to move patients and patients being afraid to set off bed alarms leads to deconditioning, longer hospital stays, and other health complications. Financial prioritization by hospitals often leads to trading off patient-centered care like this example with fall prevention grossly outweighing mobility.
The Affordable Healthcare Act was a health care act that impacted the lives of millions of Americans as it allowed millions who were not insured because of pre-existing conditions to finally get insurance. The Act also allowed parents to keep their children in their insurance up to age 26, but the Act has had challenges because of competing needs. For insurance companies, the Affordable Care Act has forced many of them to insure people with preexisting conditions that they did not insure in the past, and that has increased the cost of operation for some of the companies. Another issue of contention in adopting the Affordable Care Act is the increase of the age of insured children from 18 to 26. For parents, the age increase saves money as they do not have to get new insurance policies for the children throughout their college years. However, this policy change has also increased the cost of operation for some of the insurance companies The Affordable Care Act also had a positive impact on hospitals and other health care institutions. Before passing of the Act, many of the insured simply went to the emergency department for treatment and those clogged hospitals, especially at night. However, since the number of people that are insured has now been increased, many of the people that used to visit the emergency department for regular health service now go to their doctor’s office for visits. The Affordable Care Act has also empowered nurses by providing ways for them to return to school and advance their education (Corlette et. al,2020).
To address the competing needs of the insurance companies, parents, patients and nurses, the ACA also has some incentives for insurers. The Act gave insurers more incentives to manage their risks and cost through health insurance Marketplaces, and new programs to promote insurer competition. The ACA has also given government program like Medicare and Medicaid to become more cost effective by enforcing laws that hold hospitals and other institutions accountable for medical bills (Kelly and Porr, 2018). By giving this type of balance among many competing bodies, the Affordable Care Act has survived the many challenges it has faced over the years and still it remains.
The Affordable Care Act in reference to the opioid crisis aided states in addressing the opioid epidemic through four principal processes: “insurance coverage expansions, regulatory insurance reforms that require inclusion of substance abuse/use disorder treatments (SUD), enhanced parity, and opportunities to integrate SUD treatment and mainstream health care. It also provided requirements for SUD treatments to be offered on par with medical and surgical procedures”. It was noted that states that had expanded Medicaid were in better positions to address the opioid epidemic/crisis but the states that were hit the hardest by this crisis had decided not to expand Medicaid (Abraham et. al, 2017).
References
Abraham, A. J., Andrews, C. M., Grogan, C. M., D’Aunno, T., Humphreys, K. N., Pollack, H. A., & Friedmann, P. D. (2017). The Affordable Care Act Transformation of Substance Use Disorder Treatment. American journal of public health, 107(1), 31–32. https://doi.org/10.2105/AJPH.2016.303558
Corlette, S., Blumberg, L. J., and Lucia, K. (2020). The ACA’s effect n on the individual insurance market. Health Affairs, 39(3). https://www.healthaffairs.org/doi/10.1377/hlthaff.2019.01363Links to an external site.
Kelly, P., & Porr, C. (2018). Ethical nursing care versus cost containment:
Considerations to enhance RN practice. OJIN: Online Journal of Issues in Nursing, 23(1), Manuscript 6. doi:10.3912/OJIN.Vol23No01Man06. Retrieved from http://ojin.nursingworld.orgLinks to an external site.
