NURS FPX 4050 Assessment 2 Ethical and Policy Factors in Care Coordination

Name

Capella university

NURS-FPX 4050 Coord Patient-Centered Care

Prof. Name

Date

Ethical and Policy Factors in Care Coordination

Greetings! I am Nathalie, a community care coordinator in Oregon, United States. It is a privilege to speak before the esteemed members of the American Nurses Association (ANA). In this presentation, I will explore the impact of ethical considerations and healthcare policies on care coordination, with an emphasis on the ANA’s role. My presentation will focus on how ethical standards and policy outlines influence the practices used to coordinate patient care in the healthcare continuum.

Care Coordination and Continuum

Coordinated patient care involves the systematic planning and management of patient-related activities within healthcare and in external settings. According to Bardhan et al. (2020), coordinated care includes various aspects, including interdisciplinary collaboration, patient-centered care, self-management, disease prevention, primary care, and constant follow-up. Meanwhile, the continuum of care represents a holistic, unified approach to healthcare that ensures patients receive seamless and consistent care at every stage of their health journey.

Role of ANA in Providing Coordinated Care

In the U.S, registered nurses are represented by ANA, an organization dedicated to enhancing patient care and promoting the role of nurses within the healthcare system. The ANA works to strengthen the nursing profession by supporting nurses, setting practice standards, promoting nursing education, and influencing healthcare policy (ANA, n.d.-b). The emphasis on nurse-led care coordination is vital to its mission. Healthcare experts are essential in managing and integrating healthcare across diverse healthcare settings.

The ANA underscores the importance of nurses in developing patient care plans, coordinating discharges, and ensuring seamless care transitions (ANA, n.d.-a). The ANA contributes to the strengthening of the continuum of care by advocating policies that prioritize patient-centered care, care transitions, and interdisciplinary teamwork. Additionally, through its educational resources, certification programs, and research initiatives, the ANA equips nurses with the necessary skills for successful care coordination, improving patient outcomes, and lowering healthcare costs.

Governmental Policies that Impact Care Coordination

Several constitutional policies in the U.S. significantly impact care coordination, promote public health, and ensure community safety. These include the Health Insurance Portability and Accountability Act (HIPAA), the Affordable Care Act (ACA), and the Medicare Access and CHIP Reauthorization Act (MACRA). These policies play a crucial role in shaping healthcare practices and improving the coordination of care across the system.

Health Insurance Portability and Accountability Act (HIPAA)

The strategy mandates that healthcare organizations protect patient privacy and ensure the secure transfer of health information (Oyeleye, 2021). These regulations enhance care coordination by requiring healthcare providers, including nurses, to handle patient health data securely, enabling more coordinated and systematic care. The ANA endorses the principles of HIPAA, acknowledging that the protection of patient data is crucial for upholding trust and confidentiality. The ANA provides guidelines to healthcare organizations and professionals on best practices for secure data storage and transmission based on evidence-based methods.

Affordable Care Act (ACA)

This policy significantly impacts care coordination by encouraging integrated care models and initiatives centered around patient needs. The ACA promotes the use of Accountable Care Organizations (ACOs), which prioritize collaboration among healthcare experts to improve care quality and reduce costs (Glied et al., 2020). The ANA supports these efforts by emphasizing the critical role of nurses in managing care transitions and maintaining continuity within these models. Additionally, the policy’s emphasis on preventive measures strengthens the role of nurses in management care across the continuum, enhancing health results.

Medicare Access and CHIP Reauthorization Act (MACRA)

This policy influences care coordination by promoting value-based care, where reimbursement from the government is built on the value of care provided relatively than the amount of services delivered. According to MACRA’s guidelines, healthcare providers are encouraged to prioritize patient-centered approaches, which are crucial for care coordination and improving outcomes, particularly for individuals with chronic conditions (Jella et al., 2021). The ANA endorses MACRA’s focus on quality and recognizes the pivotal role of nurses in meeting care coordination objectives. Nurses are vital in managing care plans, collaborating with interdisciplinary teams, and ensuring that patients receive essential follow-up care. This supports the ANA’s dedication to enhancing healthcare quality and safety through robust care coordination.

Ethical Dilemmas Related to Policy Provisions

Healthcare policies at national, state, and local levels present substantial ethical challenges that result in ineffective care coordination and adversely affect patient outcomes.

National Policy

As discussed earlier, the ACA enhances care coordination through integrated care models, aiming to deliver optimal, patient-centered care. Additionally, it introduced Value-Based Purchasing (VBP) programs that emphasize delivering high-quality care in a cost-effective manner. However, these provisions can lead to ethical concerns about equitable access and the allocation of resources. There is a risk that these policies unintentionally restrict resources for marginalized and underserved communities, resulting in disparities in care coordination (Kim et al., 2023). These moral issues challenge the principle of fairness, as not all patients benefit equally from coordinated care. The ANA is vital in tackling these issues by advocating for policies that promote fair access to care and supporting nurse-led initiatives to enhance care coordination for every patient.

State Policy

The Oregon Health Plan 1115 Demonstration Waiver is a state-level initiative designed to reduce health disparities by 2030, boosting the state’s Coordinated Care Organizations (CCOs) (Oregon Health Authority, n.d.). Although this waiver aims to enhance care coordination for Medicaid recipients through service integration and cost management. It can create ethical issues, particularly for populations in rural regions who encounter difficulties accessing coordinated care. At the state level, ANA is vital in supporting fair healthcare plans and offering guidance on merging care coordination with social determinants of health. It supports laws that address healthcare disparities. Additionally, the ANA can form partnerships to ensure that all communities, especially those in underserved areas, benefit from coordinated care initiatives.

Local Policy

Diverse regions within states have unique zoning regulations that influence healthcare accessibility and care coordination by determining the locations of healthcare facilities. These regulations pose ethical challenges by concentrating healthcare resources in wealthier areas while leaving low-income or rural communities with inadequate access to essential services. For instance, restrictive zoning rules impede the establishment of necessary clinics or pharmacies in underserved areas, impacting residents’ ability to receive timely and well-coordinated care.

Research indicates that more inclusive zoning practices can help mitigate healthcare disparities by safeguarding the entire community. Irrespective of their financial rank, have approach to the infrastructure needed for comprehensive and coordinated care (Jones et al., 2021). Therefore, the ANA can support zoning policies that address the healthcare needs of all communities, highlighting the importance of equitable access to healthcare services as a key component of care coordination.

Code of Ethics and Factors Contributing to Coordination of Care

The Code of Ethics for Nurses directs nurses in delivering equitable, patient-focused care, influencing both care coordination and the continuum of care. This code underscores key values such as respect for patients, advocacy, and a dedication to social justice. It is crucial for addressing health inequities and improving access to care services (ANA, n.d.-c). Social determinants of health (SDOH), highlighted in Healthy People 2030, include factors like financial constancy, instruction, healthcare approach, area conditions, and community background, which show a vital role in determining health outcomes.

Ethical principles require nurses to incorporate these SDOHs into their care coordination practices, ensuring that care is not only clinically effective but also equitable and accessible (Flaubert, 2021). Additionally, the Code of Ethics encourages nurses to support policies and practices that address these determinants, aiming to minimize health disparities. Nurses adhering to these ethical standards ensure a thorough continuum of care. This approach considers the broader social setting of patients’ lives, which is essential for achieving optimal health outcomes across diverse groups.

Conclusion

The integration of ethical considerations and healthcare policies is pivotal in shaping care coordination and improving patient outcomes. The American Nurses Association is instrumental in advocating for fair practices and embedding ethical principles into care models. By addressing disparities and emphasizing social determinants of health, nurses can enhance care coordination, ensuring that all patients receive quality care. This comprehensive approach is crucial for achieving optimal health outcomes across diverse populations.

References

ANA. (n.d.-a). Care coordination and the essential role of nurses. ANA. https://www.nursingworld.org/practice-policy/health-policy/care-coordination/

ANA. (n.d.-b). Nursing: Scope and standards of practice. nursingworld.org. https://www.nursingworld.org/~4af71a/globalassets/catalog/book-toc/nssp3e-sample-chapter.pdf

ANA. (n.d.-c). Ethics and human rights. ANA.

https://www.nursingworld.org/practice-policy/nursing-excellence/ethics/

Bardhan, I., Chen, H., & Karahanna, E. (2020). Connecting systems, data, and people: A multidisciplinary research roadmap for chronic disease management. MIS Quarterly: Management Information Systems, 44(1), 185–200. https://doi.org/10.25300/MISQ/2020/14644

Flaubert, J. L. (2021). The role of nurses in improving health care access and quality. In www.ncbi.nlm.nih.gov. National Academies Press (US). https://www.ncbi.nlm.nih.gov/books/NBK573910/

Glied, S. A., Collins, S. R., & Lin, S. (2020). Did The ACA lower Americans’ financial barriers to health care? Health Affairs, 39(3), 379–386. https://doi.org/10.1377/hlthaff.2019.01448

Jella, T. K., Desai, A., Cwalina, T. B., Acuña, A. J., Huang-Wright, C., & Wright, J. (2021). Post-Medicare Access and CHIP Reauthorization Act of 2015 Trends in lumbar magnetic resonance imaging use for patients with low back pain at 1373 hospitals. World Neurosurgery, 154, e147–e154. https://doi.org/10.1016/j.wneu.2021.06.144