Ethical and Policy Factors in Care Coordination

NURS FPX 4050 Assessment 2 Ethical Policy Factors Care Coordination

Care coordination is defined as the process in which the different participants involved in the care of a patient interact and correspond with one another to give better outcomes and quality of services (“Care Coordination,” 2014). There are many different factors that can deter and aid the process of care coordination. The importance of Care Coordination is unequivocal, since the absence of proper cooperation between different participants can lead to destructive results, leaving the patient mentally and physically marred. 

In this paper, the aim is to discuss the effect which ethical factors has on care coordination, and what role government policies play during the process. Ethical factors from the nurse’s perspective are also an aspect of importance in the care continuum and coordination. 

NURS FPX 4050 Assessment 2 Ethical Policy Factors Care Coordination

When providing health care, there are many different ethical factors that come into play. When deciding on which course of action to take, the nurses can practice priority based on age, gender and previously underlying medical condition. It is up to the nurse to conduct an analyses to adequately understand the standing of a number of patients, and to expertly provide healthcare to them in the order required. An example that can be served to delineate this point is if two patients are to simultaneously enter a hospital, only to find one bed to be free, it would resolve to the administration to assess and evaluate the involved ethical factors to decide what course of action to take. These sorts of decisions and responses are governed by the Code of Conduct, which will be discussed in detail in this paper. 

How Governmental Policies Affect Coordination of Care

In the United States, the provision of healthcare and care coordination is vastly governed by governmental policies. There are a number of different policies that are active in the United States as a result of the efforts of the Department of Health and Human Services (Regis College Online, 2021), a couple of which will be described in this paper to portray exactly what effect such policies can have on healthcare. 

Government policies can lay out various guidelines and instructions for institutes and healthcare professionals to follow. The reason behind the enforcement of certain guidelines from the government can be to enhance the provision of healthcare, safeguarding the rights of the patients and so forth. Furthermore, policies can encourage professionals to adopt certain measures when dealing with patients. Similarly, policies can also act as a motivation for professionals to pursue a certain mode of treatment or interaction when dealing with patients.

NURS FPX 4050 Assessment 2 Ethical Policy Factors Care Coordination

To further understand how government policies affect care coordination, the example of the Hospital Readmission Reduction Program can be taken. The main function of the HRRP is to reduce the number of readmissions. This is done by encouraging the healthcare service providers (nurses, doctors etc.) to efficiently and expertly discuss post-discharge plans with patients in order to help them recover better, in turn enabling them to avoid readmissions for problems that are manageable (CMS.gov, n.d.).

The way this policy affects care coordination is that it encourages the different healthcare service providers to actively and expertly communicate with one another, and the patients with the objective of delineating to them the various aspects necessary for the after-discharge recovery and treatment. By keeping the motivation of reduced readmissions, this policy serves to improve the quality of coordination and collaboration between patient and professional.

In light of the above argument and the example stated above, it can be seen that this particular policy reflects positively on coordination of care.

NURS FPX 4050 Assessment 2 Ethical Policy Factors Care Coordination

National, State, or Local Policy Provisions that Raise Ethical Dilemmas

There are a few policy provisions that can raise ethical dilemmas, and create implications for care coordination. The first policy provision that can be scrutinized is the Affordable Care Act of 2010. The essence of the Affordable Care Act was the obligation and enforcement of securing health insurance, the failing of which would culminate in the levying of fines (Regis College Online, 2021). From an unbiased perspective, it is quite apparent what ethical complications and dilemmas the ACA can bring about. The ethical corruption of the ACA can be attributed primarily to the aspect of religion. The concept of insurance is an aspect of prohibition in the fastest growing religion in the world viz. Islam. Since the concept of insurance is subjected to prohibition in the third largest religion in the USA, the ACA which is advocating and stressing upon insurance can be seen as an aspect causing ethical unrest and dilemmas. Coming to the effect this has on care coordination, since the lack of insurance will result in fines and penalties, a person who is not insured will not be able to get treated and medically aided. When such discrepancies can occur on the basis of insurance, it can lead to turbulence in the process of care coordination. It can get exceedingly hard for a person without insurance to get treated. If such a person can get partially treated, he can face complications going forward, based on the lack of insurance.

Another policy that can be enumerated in this regard is the HRRP discussed previously. While the concept behind the HRRP was seen to be advantageous, as it encouraged doctors and nurses to better engage and communicate with the patients (CMS.gov, n.d.), there is the chance of ethical complications erupting from it. The complications that can rise from the HRRP can culminate from the possibility of a patient getting misunderstood, or the condition misdiagnosed, which can lead to denial of admission. 

NURS FPX 4050 Assessment 2 Ethical Policy Factors Care Coordination

Impact of Code of Ethics of Nurses on the Coordination and Continuum of Care

There are four main points of the Nurses’ Code of Ethics. To elaborate the impact of each on the coordination and continuum of care, all four will be enumerated.

Firstly comes the factor of Autonomy. The discretion and the decision-making is to be handed over to the patient as far as deciding between different treatments and medications etcetera is concerned. It is imperative for the nurse to present the viable options to let the patient choose on his or her discretion (Gaines, 2020). This impacts coordination and continuum of care as it helps the patient know all about how he is being treated. Since he is making the decisions, he will be able to properly portray and explain the treatment process to any future doctor.

Then, there is the beneficence factor which helps in creating good relationships between nurses and patients, which in itself is conducive to better cooperation (Gaines, 2020). 

NURS FPX 4050 Assessment 2 Ethical Policy Factors Care Coordination

Then follows the Justice factor. This aspect of the code of ethics demands that the nurses don’t act out of any degree or trace of racism or prejudice. Regardless of age, gender, race and ethnicity, the care given by the nurses must be the same (Gaines, 2020). This helps in care coordination and continuum as better bonds will be formed between the patient and nurse. 

Finally, there is ‘Non-maleficence’ which means to cause no harm (Gaines, 2020). This point means that the nurses must opt for ways which are least deteriorative and harmful to the patient. This helps in the coordination of care as trust will be created between the patient and nurse.

Conclusion

Governmental policies can affect care coordination vastly. In this paper, the purpose was to describe how exactly governmental policies affect coordination of care along with some examples. Policies like the ACA and HRRP were enumerated and elucidated.

Furthermore, the nurses’ code of ethics also features some points and aspects that has an impact on the care coordination. These points, along with the perceived effects, were enumerated.

NURS FPX 4050 Assessment 2 Ethical Policy Factors Care Coordination

References

Care Coordination. (2014). Retrieved from https://www.ahrq.gov/ncepcr/care/coordination.html

CMS.gov. (n.d.). Hospital Readmissions Reduction Program (HRRP). Retrieved from https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/Readmissions-Reduction-Program

Gaines, K. (2020). What is the Nursing Code of Ethics? Retrieved June 18, 2021, from https://nurse.org/education/nursing-code-of-ethics/

NURS FPX 4050 Assessment 2 Ethical Policy Factors Care Coordination

Regis College Online. (2021, April 22). 8 Important Regulations in United States Health Care. Retrieved June 18, 2021, from https://online.regiscollege.edu/blog/8-important-regulations-united-states-health-care/

McDonald, K. M., Sundaram, V., & Bravata, D. M. (2007). Closing the Quality Gap: A Critical Analysis of Quality Improvement Strategies (Vol. 7: Care Coordination). Agency for Healthcare Research and Quality (US).