Ethical and Policy Factors in Care Coordination
Hello everyone. I thank you for being part of this session. I am Nilsa Salmon-Graham. This presentation focuses on care coordination and relationship with ethical aspects and health policies. The goal is to identify evidence-based and patient-centered practices that influence the quality and safety of patient care across continuum. For instance, care coordination allows different healthcare professionals to share insights into the best ways to optimize care outcomes (Izumi et al., 2018). Nursing homes are among healthcare facilities that encourage well-coordinated and collaborative practices to optimize care outcomes. Nurses, nurse aides, and others within the facilities are responsible for sharing knowledge, skills, and experiences on evidence-based strategies for responding to patients’ demands (Buljac-Samardžić & van Woerkom, 2018). Complexities within the settings remind the care team about collective obligations and commitment to using team-based functions to make a difference in the lives of clients. This presentation enhances familiarity with ethical aspects and health policies such as the Affordable Care Act that help create the best clinical environment for the workforce and patients.
Objectives
- To discuss the roles of nursing homes in improving health and quality of life.
- To describe ethical aspects essential for promoting quality and safe care within nursing homes.
- To discuss the Affordable Care Act as a policy that supports well-coordinated care across the continuum.
- To discuss the relationship between ethical aspects, health policies, and care coordination.
The objectives identify the need for complete understanding of ethical aspects and health policies that influence health and quality of life. This way, healthcare professionals are responsible for adhering to values, beliefs, and behaviors that make them responsive to patients’ needs and expectations. For instance, nurses and nurse aides within nursing homes could play vital roles in establishing a clinical environment that makes it easier for the care team and patients to navigate complexities within the facilities (Buljac-Samardžić & van Woerkom, 2018). With care coordination, nurses direct the care process, make accurate and complete community needs assessment, and determine the level of care necessary to improve quality of life. Nurses and the rest of the care team also initiate an organized care plan with detailed information about services necessary to meet individuals’ health needs. Thus, one element of success in nursing homes is the ability to organize activities and share information to achieve strategic priorities.
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Care Coordination in Nursing Homes
Care coordination in nursing homes involves directing the care process, assessing community needs, organizing care plan, and monitoring patients’ progress. The care team including, primary care providers, physical therapists, mental and behavioral health counselors, and specialists collaborate to meet patients’ needs (Lewis, 2023). The team organizes care plan meetings and briefings. The sessions allow the care team to evaluate a patient’s treatment and new concerns. Similarly, care coordination promotes proactive patient and family engagement to ensure the plan is fulfilling. As such, nurses and aides should embrace care coordination as a means of assisting patients with activities of daily living such as medications (Lewis, 2023). Strong relationships among primary care providers and specialists improve the quality of rehabilitation, physical and speech therapies, diabetes management, and hospice care. The goal is to ensure fewer emergency room visits, reduced medication costs, fewer hospital readmissions, patient satisfaction, and improved quality of life.
Ethical Aspects in Nursing Homes
Ethical aspects are vital considerations for nurses, aides, and other professionals to improve health and quality of life. Primary care providers, physical therapists, mental health counselors, specialists, and other professionals should uphold compassion, respect, and dignity when handling patients (Toumova et al., 2021). The aim is to respond adequately to patients’ values and preferences. The care team also aim to reduce health disparities through unbiased and non-discriminatory service delivery. Patients need services such as dressing, bathing, feeding, medications, speech therapies, and physical therapies (Buljac-Samardžić & van Woerkom, 2018). Excellent communication is necessary to respond to the identified health needs. Similarly, the care team provides nutritional counseling, social support, hospice care, and end-of-life care while encouraging excellent interpersonal relations. Ethical principles of autonomy, justice, beneficence, and non-maleficence also remind healthcare professionals about their roles in improving health and quality of life.
Magelssen et al. (2018) identified informed consent as a means for patients to participate in shared decision-making about treatment pathways. Further, clinical and related activities should protect patients from emotional, physical, and psychological distress. Responding to patients’ best interests is also crucial to create the right environment and encourage positive health-seeking behaviors and attitudes. Justice is another principle that promotes health equity across the care continuum (Toumova et al., 2021). The care team delivers culturally and linguistically appropriate care to ensure that everyone benefits from different health care services. Patients in low-income communities benefit from increased availability and access to essential health services, social supports, and others appropriate for improving health and quality of life.
The Affordable Care Act and Care Coordination in Nursing Homes
The Affordable Care Act responds to the needs of low-income people within communities. Qualifying for incentives such as Medicaid enhances access to activities of daily living such as bathing, eating, or therapies. Collins and Saylor (2018) associated ACA with enhanced access to community-based and long-term care in nursing homes. The emphasis is on patient-centered and evidence-based care that brings together multiple primary care providers and specialists. The different healthcare professionals collaborate in identifying individualized care plans for improving the quality, cost, and safety of patient care. Medicaid and Medicare help improve patient experiences by linking individuals with primary care providers and specialists (Garfield et al., 2023). For instance, nursing homes could benefit from community health teams responsible for coordinating disease prevention and management. The teams coordinate with nurses, nurse aides, and others to design and implement interdisciplinary plans.
Collaborative efforts enhance access to quality-driven, cost-effective, and culturally and linguistically appropriate care. The aim is to ensure that nursing homes provide integrated primary, acute, behavioral health and long-term care to patients with varying needs and expectations. The Center for Medicare & Medicaid Innovation is a vital aspect of the Affordable Care Act. The element makes it easier for the care team to interact and discuss pathways for optimizing care outcomes. As such, high-risk patients such as those with cognitive decline and pre-existing conditions like diabetes benefit from real-time monitoring of symptoms and progress (Garfield et al., 2023). Accountable Care Organizations are another component of the Affordable Care Act that help reduce health disparities. Different healthcare providers are responsible for care coordination, improving quality of care, and coordinating care. The aim is to reduce care fragmentation and safeguard patients from unnecessary costs.
Questions about Viability of the Affordable Care Act
The Affordable Care makes nursing homes more responsive to patients’ needs and expectations. Low-income people benefit from enhanced availability and access to essential health services. Patients are likely to overcome the challenges of a fragmented healthcare system. However, questions arise over viability and sustainability of the intervention. Rising health burden and increased government spending increase the risk of budget cuts. Medicaid and Medicare may become unsustainable if the government decides to reduce spending on health care incentives (Garfield et al., 2023). Patients may be ineligible for ACA’s incentives due to failure to meet financial requirements and functional criteria.
Individuals in low-income may be eligible for ACA’s provisions but not aware that they qualify for Medicaid. Further, patients may have challenges navigating the application process (Garfield et al., 2023). The various limitations remind nursing homes about their roles in understanding determinants of health and responding adequately to patients’ demands. Sustainable measures means streamlining ACA’s application process, protecting patients from out-of-pocket expenses, and enhancing health education and promotion to make more people aware about qualification for Medicaid.
As I conclude, care coordination is an important consideration for nursing homes. The concept makes it easier for the care team to help patients navigate the healthcare system. Ethical aspects and health policies are also relevant for healthcare providers to respond to patients with complex care needs. The care team embraces respects, compassion, and dignity when handling patients. Increased awareness about the criteria for qualifying for ACA and the application process will ensure that more patients enroll for Medicaid and other incentives available to reduce out-of-pocket expenses.
References
Buljac-Samardžić, M., & van Woerkom, M. (2018). Improving quality and safety of care in nursing homes by team support for strengths use: A survey study. PLoS ONE, 13(7), 1-14. https://doi.org/10.1371/journal.pone.0200065
Collins, B. L., & Saylor, J. (2018). The Affordable Care Act: 8 years later. Nursing Management, 49(8), 42-48. https://pubmed.ncbi.nlm.nih.gov/30063509/
Garfield, R., Musumeci, M., Reaves, E., & Damico, A. (2023). Medicaid’s role for people with dementia. Kaiser Family Foundation. https://www.kff.org/medicaid/issue-brief/medicaids-role-for-people-with-dementia/
Izumi, S., Barfield, P., Basin, B., Mood, L., Tadesse, R., Bradley, K., & Tanner, C. (2018). Care coordination: Identifying and connecting the most appropriate care to the patients. Research in Nursing and Health, 41(1), 49-56. https://onlinelibrary.wiley.com/doi/10.1002/nur.21843
Lewis, K. (2023). How care coordination promotes senior health and longevity. A Place for Mom. https://www.aplaceformom.com/caregiver-resources/articles/care-coordination-for-senior-health
Magelssen, M., Gjerberg, E., Lillemoen, L., Førde, R., Pedersen, R. (2018). Ethics support in community care makes a difference for practice. Nursing Ethics, 25(2), 165-173. https://pubmed.ncbi.nlm.nih.gov/27664037/
Toumová, K., Havierniková, L., Kimmerová, J., Hellerová, V., Tóthová, V., & Chloubová, I. (2021). The importance of ethical codes in nursing care. Journal of Nursing and Social Sciences Related to Health and Illness. 84-90. https://kont.zsf.jcu.cz/pdfs/knt/2021/02/05.pdf