Ethical and Policy Factors in Care Coordination.
Cleveland Clinic Care Community.
Cleveland Clinic Care Community is a health unit that started in 2017 to help patients at high risk. The unit covers home therapeutic care, express clinic care, pediatric care, and primary care for adults across all its major centers. The unit has 50 leading care coordinators involved in primary care practices, which are essential in the Cleveland Clinic Care Community’s services. The care coordinators central role is to minimize patient utilization by;
- Bettering care is involved in a specific disease.
- Making community resources available to patients
- Maintaining healthcare coordination routine
- Assisting patients to maintain their care
How safety and health government policies affect care coordination.
Healthcare policy concerning making and implementing regulations, rules, and laws to manage the healthcare system. United States healthcare system involves in sectors such as health information technology, pharmaceutical, and insurance (Yousefi et al., 2019). Community government policies related to safety and health may affect aftercare coordination; examples of such policies are universal health coverage involving affordable care, Medicare, prison healthcare policy, American Recovery and Reinvestment Act, and Health Insurance Portability and Accountability Act (HIPPA).
All the above policies have a potential impact on coordination care; an example is the Health Insurance Portability and Accountability Act (HIPPA), which involves privacy rules and administrative simplification designed to increase the effectiveness of the system of healthcare through standardizing electronic data transfer and protecting privacy and security of member’s data. This policy affects the care coordination process where coordinators are limited to sharing patient information, which is sometimes affecting their effectiveness.
Policy provisions that raise ethical questions or dilemmas for care coordination.
Local, state, and national policy provisions may raise dilemmas and ethical questions for coordination of care. Such policy provisions are insurance and affordability of health care services in the United States system of health face care coordination ethical issues where health professionals face most issues. One of the moral questions and dilemmas is the issue of poor people’s access to health care. The problem still exists even when there is the establishment of generic drugs because the prices of medicines are still high, with a report showing 20% of the drug spending. The Affordable Care Act provides a chance for insurance opportunities, which comes with complexity and revisions annually, making it hard to appreciate poor people. There is an issue in the United States on medical and employee insurance, which raises ethical issues where employers refuse to give employees a chance for better health care.
Assess the impact of the code of ethics for nurses on the coordination and continuum of care.
Some of the factors involved in access to health services and health disparities are geographical location of the patient, social, economic status, disabilities, patient age, the sexual identity of the patient, ethnicity, and race. Social determinants are situations that individuals are involved in their society and are shaped by the allocation of resources such as power and finances.
For example, when a society has limited access to hospitals and other health care services, it corresponds with the health situation of that society. A potential impact of health care policy is affordable care. The government creates cost-sharing subsidies and establishes new law for health insurance companies to develop lower cost-effective care to its citizens. The logical consequences that would result in the provision of affordable care policy are that more people would be able to get quality health care services, and the country’s health status would improve (Santana et al., 2018).
Ethical and policy factors to consider in care coordination.
- Justice and fairness – When coordination care is being distributed by nurses, ethics demands that justice and fairness be observed (Boonstra & Broekhuis, 2020). Right means that there must be equity such that no patient is given priority on other bases outside medical reasons.
- Beneficence – Nurses and other individuals involved in coordination care must be open to doing good. The willingness to sacrifice to do the best thing at the right time satisfies the principle of beneficence. In coordination care, no one may supervise the group of caregivers, but they have to be governed by the will to do good. An example of beneficence is when one of the caregivers decides to remove his/her sweater to cover the patience when the latter is in unfavorable cold weather.
- Accountability – Everyone involved in care coordination must be accountable for their actions when dealing with a patient. The law holds everyone responsible, so physicians are called upon to guide the other untrained individuals involved in care coordination when handling a patient. The implication of this is that each person is keen enough to avoid going against the physician’s directions
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- The patient’s autonomy – The patient does not lose his/her ability to make decisions unless in the state of unconsciousness or insanity. Patients must be treated as unique and allowed to retain their beliefs, opinions, and values. These are to be respected even if they are interfering with the recovery process. Care coordination individuals should not coerce patients to make certain decisions.
- Veracity – Everyone involved in care coordination should not hide any truth from the patient regardless of who they are. Patients have the right to be told the truth regarding the details of their sickness. The information must not be withheld, even if it will cause psychological distress regarding both positive and negative information.
- Staffing policy – The qualifications of care coordinators should be set so that there is no quality variation when patients are attended. A care coordinator should have at least a bachelor’s degree in social work, nursing, or any other related service field. Care coordinators should have a professional certification allowing them to practice. Interdisciplinary teams should be engaged in care coordination so that they be effective enough in addressing various challenges.
- There should be a high degree of interaction and communication between the care coordinators and the physicians allocated to different cases. Face to face interaction should be facilitated such that the physicians and the care coordinators meet. There should also be at least one care coordinator for every physician responsible for all the patients programmed under that particular physician.
- Targeting policy – The care coordination program and activities should be made more specific. This is through targeting the patients at substantial risk of hospitalization (Randel et al., 2017). These patients should be given priority. The other individuals who are not at risk of hospitalization should be considered later, depending on the available resources.
- Access to timely information – Information regarding admissions to the hospital and emergency room should be relayed to the care coordination team as fast as possible. Individuals who had been hospitalized and admitted are vulnerable and may need readmissions. Constant watch and follow up are needed through better adherence and self-care. This implies that the care coordination team must give instructions to be followed at home while on bed rest.
- In-person Contact – In-person contact is necessary for any successful intervention to take place. The care coordination team must work closely with individual patients. The designated care coordination team should be interacting face to face with patients. The patients should visit the physician at the clinical office, or the physician sees them at home.
In conclusion, the care coordinator needs to follow ethical and policy factors as healthcare professionals. Fairness and justice should be observed for the patient; nurses should be accountable for their actions.
References
Boonstra, A., & Broekhuis, M. (2020). Barriers to the acceptance of electronic medical records by physicians from systematic review to taxonomy and interventions. BMC health services research, 10 (1), 231.
Randel, L., Pearson, S. D., Sabin, J. E., Hyams, T., & Emanuel, E. J. (2017). How managed care can be ethical. Health Affairs, 20 (4), 43-56.
Santana, M. J., Manalili, K., Jolley, R. J., Zelinsky, S., Quan, H., & Lu, M. (2018). How to practice person-centered care: A conceptual framework. Health Expectations, 21(2), 429-440.
Yousefi Nooraie, R., Khan, S., Gutberg, J., & Baker, G. R. (2019). A network analysis perspective to implementation: the example of health links to promote coordinated care. Evaluation & the health professions, 42(4), 395-421.