Advocacy For Equitable Health Care Discussion Paper.docx
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74J Adv Pract Oncol AdvancedPractitioner.comSection Editor.docx
74J Adv Pract Oncol AdvancedPractitioner.com
Section Editors: Heather M. Hylton and Wendy H. Vogel
PRACTICE MATTERS
Barriers to Practice and the Impact on
Health Care: A Nurse Practitioner Focus
MARY E. PETERSON, MS, APRN, AOCNP®
From St. David’s South Austin Medical Center,
Austin, Texas
Author’s disclosures of potential conflicts of
intersst are found at the end of this article.
Correspondence to: Mary E. Peterson, MS, APRN,
AOCNP®, HCA Physician Services Group, 4700
James Casey, Suite B-149, Austin, TX 78704.
E-mail: [email protected]
https://doi.org/10.6004/jadpro.2017.8.1.6
© 2017 Harborside Press®
In 1965, in answer to the growing demand for primary care, nurs-ing pioneer Loretta Ford, along with Dr. Henry Silver, created
the first certificate program that pro-
vided nurses with the skills to provide
primary care to underserved popula-
tions. Since the inception of that first
program, the field has grown to include
adult/gerontology, women’s health,
neonatal, and other specialty roles,
with minimum requirements for edu-
cation at the master’s/doctoral level.
The growth of nurse practitioners
(NPs) across all 50 states is unsur-
prising given the current landscape
of health care, yet barriers that limit
practice need action at both the state
and national levels. Access to care is a
significant challenge for patients. This
access is negatively impacted when
qualified NPs are willing and able to
deliver quality, cost-effective care, yet
governmental bodies continue to ig-
nore legislation that would update the
laws and modernize health care.
IDENTIFYING RESTRICTIONS
Individual states regulate NP practice.
Currently, 22 states and the District of
Columbia, or 44%, have adopted full
practice authority licensure and prac-
tice laws for NPs. Full practice author-
ity is defined by the American Associ-
ation of Nurse Practitioners (AANP)
as follows: “State practice and licen-
sure law provides for all nurse practi-
tioners to evaluate patients, diagnose,
order and interpret diagnostic tests,
initiate and manage treatments—in-
cluding prescribe medications—un-
der the exclusive licensure authority
of the state board of nursing.” The
remaining states are categorized as
either “reduced practice” (17 states,
or 34%) or “restricted practice” (12
states, or 24%). The AANP further
defines these categories as follows
(AANP, 2016):
• Reduced Practice: The NP has the
ability to engage in at least one element
of the NP practice and is regulated
through a collaborative agreement
with an outside health discipline to
provide patient care.
• Restricted Practice: The NP has
the ability to engage in at least one
element of NP practice and requires
supervision, delegation, or team
management by an outside health
discipline to provide patient care.
In 2010, the Institute of Medicine
(IOM), with the Robert Wood John-
son Foundation (RWJF), published a
landmark report titled, “The Future J Adv Pract O.
Running Head OPEN COMMENT LETTER1OPEN COMMENT LETTER5Open.docx
Running Head: OPEN COMMENT LETTER 1
OPEN COMMENT LETTER 5
Open Comment Letter – Draft Copy
[NAME]
[ADDRESS]
[DATE]
[THE COUNCIL AUTHORS OF LEGISLATION]
[ADDRESS]
Dear Sir/Madam,
I am writing to address issues that are related to health disparities as well as the legislation that can be implemented to help in dealing with the vice.
Overview
Health disparities refer to the differences that may arise in the health status of different groups of persons. Factors such as race, gender, social class, disability, and sexual orientation may contribute to health disparities. The issue of racial discrimination has been a major contributor of health disparities across the U.S., with 47% of individuals from the African American and Latina population complaining of poor medical care and treatment. The aged population has also been affected directly by the issue of health disparity, with most of them having to face the challenges of poor medical care. In the quest of dealing with the issue of health disparities, it is vital to employ the use of the health equity legislation act. The Health Equity and Accountability Act of 2014 was passed by the Congress to help in addressing the issues of health disparities across the U.S.
Intended Consequences of the Legislation
The implementation of the Health Equity and Accountability Act of 2014 will help in addressing the issue of health disparity across the U.S. First and foremost, the legislative act will call for the equal medical care and treatment to all individuals, irrespective of their gender, race, and social class. The piece of legislation will call for the medical practitioners to be on the frontline in providing the necessary treatments to these vulnerable groups (Braveman et al., 2011). Moreover, it will be a requirement for all the healthcare organizations across the U.S. to come up with healthcare disparities programs that will aim at educating the medical practitioners in providing equal treatments to all individuals. Specific medical attention will be provided to the elderly, to help them lead normal lives.
Interpretation of the Major Tenets of Legislation
As for the health practitioners, it will be a requirement for them to ensure that they provide equal medical care to all the patients. Moreover, the health equality act will help the health practitioners come up with suitable decisions on how to handle all patients equally without discriminating against them (Laurencin, 2014). As for the consumers of the healthcare services, by having an idea of the legislation, they will be able to fight for their rights. In the event of health disparities, they will have an idea of how to handle the issue, as well as the personnel that they will be able to approach and address their issues.
Summary of the Logical Interpretation of the Legislation
The Health Equity and Accountability Act will aim at addressing the issues of health disparities within the health organizations across the U.S. The member of the ...
Running head A REVIEW OF KEY CURRENT HEALTHCARE ISSUES QUALITY A.docx
Running head: A REVIEW OF KEY CURRENT HEALTHCARE ISSUES: QUALITY AND VALUE IN THE U.S’S HEALTHCARE SYSTEM 1
A REVIEW OF KEY CURRENT HEALTHCARE ISSUES: QUALITY AND VALUE IN THE U.S’S HEALTHCARE SYSTEM
A Review of Key Current Healthcare Issues: Quality and Value in the U.S's Healthcare System
Student's Name
Institution Affiliation
Date
A Review of Key Current Healthcare Issues: Quality and Value in the U.S's Healthcare System
Healthcare regulations, funds, workload, and technology continue to complicate and inconvenient the U.S healthcare system. However, the quality and value of care tops. In the United States of America, despite significant healthcare transformation efforts, poor care lingers a considerable concern.
America is second to none in terms of healthcare expenditure across the globe. Ironically, evidence shows that its citizens do not receive the most appropriate care, or at least, which they need. For instance, Graban (2018) documents that preventive care is underutilized in the country, which is escalating the budget of managing advanced diseases. On the other hand, patients of chronic ailments such as diabetes, hypertension, and cardiac complications, do not also usually get treatments that are proven and effective (Wiler, Pines, & Ward, 2019). According to Strome (2019), this case is particularly true and event rampant to the persons that insured, uninsured, or under-insured. The lack of proper coordination of chronic diseases patients' care would only source more or exuberate poor healthcare. The unsurprising healthcare system's underlying fragmentation only fuels the issue given that many health care providers hardly have the payment support such related gears, necessary for effective communication and coordination to improve patient care.
While a significant number of patients miss medically necessary care, other clients get unnecessary or even unsafe attention. Research depicts terrific variations in hospital inpatient lengths of stay, specialists' visits, testing and procedures, and costs — not just by United States' unalike geographic areas, but from one health institution to another in the same town (Wiler, Pines, & Ward, 2019). Though limited, evidence on the most effective treatments and procedures, on the best way of informing providers about the efficacy of different treatments, and on the failures of detecting and reducing errors further underwrite the gaps care's quality and effectiveness (Strome, 2019). The concerns are especially pertinent to the Americans of the lower social classes as well as to those from diverse demographic and ethnic groups are usually frequent victims of a lot of incongruences in health and health care.
The implication of Poor Patient Care
Poor quality care impacts both patients and providers negatively. For patients, it reduces their survival changes, aggravates illnesses, and leads to unnecessary mortalities (Graban, 2018). To providers, such issu.
Running head A REVIEW OF KEY CURRENT HEALTHCARE ISSUES QUALITY A.docx
Running head: A REVIEW OF KEY CURRENT HEALTHCARE ISSUES: QUALITY AND VALUE IN THE U.S’S HEALTHCARE SYSTEM 1
A REVIEW OF KEY CURRENT HEALTHCARE ISSUES: QUALITY AND VALUE IN THE U.S’S HEALTHCARE SYSTEM
A Review of Key Current Healthcare Issues: Quality and Value in the U.S's Healthcare System
Student's Name
Institution Affiliation
Date
A Review of Key Current Healthcare Issues: Quality and Value in the U.S's Healthcare System
Healthcare regulations, funds, workload, and technology continue to complicate and inconvenient the U.S healthcare system. However, the quality and value of care tops. In the United States of America, despite significant healthcare transformation efforts, poor care lingers a considerable concern.
America is second to none in terms of healthcare expenditure across the globe. Ironically, evidence shows that its citizens do not receive the most appropriate care, or at least, which they need. For instance, Graban (2018) documents that preventive care is underutilized in the country, which is escalating the budget of managing advanced diseases. On the other hand, patients of chronic ailments such as diabetes, hypertension, and cardiac complications, do not also usually get treatments that are proven and effective (Wiler, Pines, & Ward, 2019). According to Strome (2019), this case is particularly true and event rampant to the persons that insured, uninsured, or under-insured. The lack of proper coordination of chronic diseases patients' care would only source more or exuberate poor healthcare. The unsurprising healthcare system's underlying fragmentation only fuels the issue given that many health care providers hardly have the payment support such related gears, necessary for effective communication and coordination to improve patient care.
While a significant number of patients miss medically necessary care, other clients get unnecessary or even unsafe attention. Research depicts terrific variations in hospital inpatient lengths of stay, specialists' visits, testing and procedures, and costs — not just by United States' unalike geographic areas, but from one health institution to another in the same town (Wiler, Pines, & Ward, 2019). Though limited, evidence on the most effective treatments and procedures, on the best way of informing providers about the efficacy of different treatments, and on the failures of detecting and reducing errors further underwrite the gaps care's quality and effectiveness (Strome, 2019). The concerns are especially pertinent to the Americans of the lower social classes as well as to those from diverse demographic and ethnic groups are usually frequent victims of a lot of incongruences in health and health care.
The implication of Poor Patient Care
Poor quality care impacts both patients and providers negatively. For patients, it reduces their survival changes, aggravates illnesses, and leads to unnecessary mortalities (Graban, 2018). To providers, such issu ...
The Barriers that Prevent Certified Nurse Practitioner (CNP) Practice
Review the shortage of medical professionals and the increasing need for advanced practitioners to serve in primary care roles
Identify the current barriers that prevent CNP from practicing to the full extent of their education, scope and training
Outline concrete ways in which these barriers can be effectively removed so as to improve autonomy for CNP’s and quality of care for patients.
EvelinAccording to the last report of the American Association o.docx
Evelin
According to the last report of the American Association of Nurse Practitioners, the scope of the nurses' practices is not limited by their titles. On the contrary, advanced nursing practice allows nurses to actively participate in clinical diagnoses, interventions, treatment monitoring, prescribing, and examinations physical (Batey & Holland, 2018). At present, the concept of advanced practice nurses has achieved worldwide development, for this reason, the health system prefers advanced practice nurses because they are trained professionals to meet the needs of patients and meet the administrative requirements of the system sanitary (Coulehan & Sheedy, 2017).
Prescribing for advanced practice nurses (APRNs) is a new integration to their responsibilities and duties with the health of patients. The prescribing of these nurses, has demonstrated effectiveness and efficacy, and allows APRNs to approach the integral and efficient management of patients from the viewpoint of other nurses, given that, according to each state, APRNs have the power to prescribe, that is, if APRNs have experience in prescribing, each state can limit this practice (Scudder, 2016).
Regarding the education of APRNs, these nurses should be specially educated to formulate prescription medications, to train about safe practices based on formulas and the combination of controlled medications. On the other hand, the limited APRNs for the formulation of medications, have the option of working interdisciplinary with other professionals to participate in the prescription, this ensures that nurses know the risks and benefits of the prescription (Coulehan & Sheedy, 2017). However, this seems to be a barrier, like the laws in each state, since it does not allow trained APRNs to exercise their knowledge and skills in this regard. Although this practice aims to protect the integrity of patients, it limits the experience and autonomy of nurses with the knowledge and certified education (Batey & Holland, 2018).
Finally, another barrier faced by nurses trained and endorsed by the state, are the regulations of each health institution, since, each hospital can determine the scope of APRNs, that is, hospitals can limit the APRNs to formulate prescriptions of medications, even if, they are accredited and allowed by the state, since, federal and state laws give hospitals autonomy to determine the competencies and functions of each of their workers (Jiao & Murimi, 2018). Likewise, it is possible to affirm that the main consequence of these barriers affects the quality and effective care of patients, since, in some cases, there may be delays in medical care until a certified physician supervises the activities of APRNs, increasing health costs and decreasing patient satisfaction (Batey & Holland, 2018).
Guillermo
The Role of Advanced Practice Nursing in Safe Prescribing
APRNs consist of nurse midwives, nurse anesthetists, clinical nurse specialists, and nurse practitioners. They are all ...
Recommended
74J Adv Pract Oncol AdvancedPractitioner.comSection Editor.docx
74J Adv Pract Oncol AdvancedPractitioner.com
Section Editors: Heather M. Hylton and Wendy H. Vogel
PRACTICE MATTERS
Barriers to Practice and the Impact on
Health Care: A Nurse Practitioner Focus
MARY E. PETERSON, MS, APRN, AOCNP®
From St. David’s South Austin Medical Center,
Austin, Texas
Author’s disclosures of potential conflicts of
intersst are found at the end of this article.
Correspondence to: Mary E. Peterson, MS, APRN,
AOCNP®, HCA Physician Services Group, 4700
James Casey, Suite B-149, Austin, TX 78704.
E-mail: [email protected]
https://doi.org/10.6004/jadpro.2017.8.1.6
© 2017 Harborside Press®
In 1965, in answer to the growing demand for primary care, nurs-ing pioneer Loretta Ford, along with Dr. Henry Silver, created
the first certificate program that pro-
vided nurses with the skills to provide
primary care to underserved popula-
tions. Since the inception of that first
program, the field has grown to include
adult/gerontology, women’s health,
neonatal, and other specialty roles,
with minimum requirements for edu-
cation at the master’s/doctoral level.
The growth of nurse practitioners
(NPs) across all 50 states is unsur-
prising given the current landscape
of health care, yet barriers that limit
practice need action at both the state
and national levels. Access to care is a
significant challenge for patients. This
access is negatively impacted when
qualified NPs are willing and able to
deliver quality, cost-effective care, yet
governmental bodies continue to ig-
nore legislation that would update the
laws and modernize health care.
IDENTIFYING RESTRICTIONS
Individual states regulate NP practice.
Currently, 22 states and the District of
Columbia, or 44%, have adopted full
practice authority licensure and prac-
tice laws for NPs. Full practice author-
ity is defined by the American Associ-
ation of Nurse Practitioners (AANP)
as follows: “State practice and licen-
sure law provides for all nurse practi-
tioners to evaluate patients, diagnose,
order and interpret diagnostic tests,
initiate and manage treatments—in-
cluding prescribe medications—un-
der the exclusive licensure authority
of the state board of nursing.” The
remaining states are categorized as
either “reduced practice” (17 states,
or 34%) or “restricted practice” (12
states, or 24%). The AANP further
defines these categories as follows
(AANP, 2016):
• Reduced Practice: The NP has the
ability to engage in at least one element
of the NP practice and is regulated
through a collaborative agreement
with an outside health discipline to
provide patient care.
• Restricted Practice: The NP has
the ability to engage in at least one
element of NP practice and requires
supervision, delegation, or team
management by an outside health
discipline to provide patient care.
In 2010, the Institute of Medicine
(IOM), with the Robert Wood John-
son Foundation (RWJF), published a
landmark report titled, “The Future J Adv Pract O.
Running Head OPEN COMMENT LETTER1OPEN COMMENT LETTER5Open.docx
Running Head: OPEN COMMENT LETTER 1
OPEN COMMENT LETTER 5
Open Comment Letter – Draft Copy
[NAME]
[ADDRESS]
[DATE]
[THE COUNCIL AUTHORS OF LEGISLATION]
[ADDRESS]
Dear Sir/Madam,
I am writing to address issues that are related to health disparities as well as the legislation that can be implemented to help in dealing with the vice.
Overview
Health disparities refer to the differences that may arise in the health status of different groups of persons. Factors such as race, gender, social class, disability, and sexual orientation may contribute to health disparities. The issue of racial discrimination has been a major contributor of health disparities across the U.S., with 47% of individuals from the African American and Latina population complaining of poor medical care and treatment. The aged population has also been affected directly by the issue of health disparity, with most of them having to face the challenges of poor medical care. In the quest of dealing with the issue of health disparities, it is vital to employ the use of the health equity legislation act. The Health Equity and Accountability Act of 2014 was passed by the Congress to help in addressing the issues of health disparities across the U.S.
Intended Consequences of the Legislation
The implementation of the Health Equity and Accountability Act of 2014 will help in addressing the issue of health disparity across the U.S. First and foremost, the legislative act will call for the equal medical care and treatment to all individuals, irrespective of their gender, race, and social class. The piece of legislation will call for the medical practitioners to be on the frontline in providing the necessary treatments to these vulnerable groups (Braveman et al., 2011). Moreover, it will be a requirement for all the healthcare organizations across the U.S. to come up with healthcare disparities programs that will aim at educating the medical practitioners in providing equal treatments to all individuals. Specific medical attention will be provided to the elderly, to help them lead normal lives.
Interpretation of the Major Tenets of Legislation
As for the health practitioners, it will be a requirement for them to ensure that they provide equal medical care to all the patients. Moreover, the health equality act will help the health practitioners come up with suitable decisions on how to handle all patients equally without discriminating against them (Laurencin, 2014). As for the consumers of the healthcare services, by having an idea of the legislation, they will be able to fight for their rights. In the event of health disparities, they will have an idea of how to handle the issue, as well as the personnel that they will be able to approach and address their issues.
Summary of the Logical Interpretation of the Legislation
The Health Equity and Accountability Act will aim at addressing the issues of health disparities within the health organizations across the U.S. The member of the ...
Running head A REVIEW OF KEY CURRENT HEALTHCARE ISSUES QUALITY A.docx
Running head: A REVIEW OF KEY CURRENT HEALTHCARE ISSUES: QUALITY AND VALUE IN THE U.S’S HEALTHCARE SYSTEM 1
A REVIEW OF KEY CURRENT HEALTHCARE ISSUES: QUALITY AND VALUE IN THE U.S’S HEALTHCARE SYSTEM
A Review of Key Current Healthcare Issues: Quality and Value in the U.S's Healthcare System
Student's Name
Institution Affiliation
Date
A Review of Key Current Healthcare Issues: Quality and Value in the U.S's Healthcare System
Healthcare regulations, funds, workload, and technology continue to complicate and inconvenient the U.S healthcare system. However, the quality and value of care tops. In the United States of America, despite significant healthcare transformation efforts, poor care lingers a considerable concern.
America is second to none in terms of healthcare expenditure across the globe. Ironically, evidence shows that its citizens do not receive the most appropriate care, or at least, which they need. For instance, Graban (2018) documents that preventive care is underutilized in the country, which is escalating the budget of managing advanced diseases. On the other hand, patients of chronic ailments such as diabetes, hypertension, and cardiac complications, do not also usually get treatments that are proven and effective (Wiler, Pines, & Ward, 2019). According to Strome (2019), this case is particularly true and event rampant to the persons that insured, uninsured, or under-insured. The lack of proper coordination of chronic diseases patients' care would only source more or exuberate poor healthcare. The unsurprising healthcare system's underlying fragmentation only fuels the issue given that many health care providers hardly have the payment support such related gears, necessary for effective communication and coordination to improve patient care.
While a significant number of patients miss medically necessary care, other clients get unnecessary or even unsafe attention. Research depicts terrific variations in hospital inpatient lengths of stay, specialists' visits, testing and procedures, and costs — not just by United States' unalike geographic areas, but from one health institution to another in the same town (Wiler, Pines, & Ward, 2019). Though limited, evidence on the most effective treatments and procedures, on the best way of informing providers about the efficacy of different treatments, and on the failures of detecting and reducing errors further underwrite the gaps care's quality and effectiveness (Strome, 2019). The concerns are especially pertinent to the Americans of the lower social classes as well as to those from diverse demographic and ethnic groups are usually frequent victims of a lot of incongruences in health and health care.
The implication of Poor Patient Care
Poor quality care impacts both patients and providers negatively. For patients, it reduces their survival changes, aggravates illnesses, and leads to unnecessary mortalities (Graban, 2018). To providers, such issu.
Running head A REVIEW OF KEY CURRENT HEALTHCARE ISSUES QUALITY A.docx
Running head: A REVIEW OF KEY CURRENT HEALTHCARE ISSUES: QUALITY AND VALUE IN THE U.S’S HEALTHCARE SYSTEM 1
A REVIEW OF KEY CURRENT HEALTHCARE ISSUES: QUALITY AND VALUE IN THE U.S’S HEALTHCARE SYSTEM
A Review of Key Current Healthcare Issues: Quality and Value in the U.S's Healthcare System
Student's Name
Institution Affiliation
Date
A Review of Key Current Healthcare Issues: Quality and Value in the U.S's Healthcare System
Healthcare regulations, funds, workload, and technology continue to complicate and inconvenient the U.S healthcare system. However, the quality and value of care tops. In the United States of America, despite significant healthcare transformation efforts, poor care lingers a considerable concern.
America is second to none in terms of healthcare expenditure across the globe. Ironically, evidence shows that its citizens do not receive the most appropriate care, or at least, which they need. For instance, Graban (2018) documents that preventive care is underutilized in the country, which is escalating the budget of managing advanced diseases. On the other hand, patients of chronic ailments such as diabetes, hypertension, and cardiac complications, do not also usually get treatments that are proven and effective (Wiler, Pines, & Ward, 2019). According to Strome (2019), this case is particularly true and event rampant to the persons that insured, uninsured, or under-insured. The lack of proper coordination of chronic diseases patients' care would only source more or exuberate poor healthcare. The unsurprising healthcare system's underlying fragmentation only fuels the issue given that many health care providers hardly have the payment support such related gears, necessary for effective communication and coordination to improve patient care.
While a significant number of patients miss medically necessary care, other clients get unnecessary or even unsafe attention. Research depicts terrific variations in hospital inpatient lengths of stay, specialists' visits, testing and procedures, and costs — not just by United States' unalike geographic areas, but from one health institution to another in the same town (Wiler, Pines, & Ward, 2019). Though limited, evidence on the most effective treatments and procedures, on the best way of informing providers about the efficacy of different treatments, and on the failures of detecting and reducing errors further underwrite the gaps care's quality and effectiveness (Strome, 2019). The concerns are especially pertinent to the Americans of the lower social classes as well as to those from diverse demographic and ethnic groups are usually frequent victims of a lot of incongruences in health and health care.
The implication of Poor Patient Care
Poor quality care impacts both patients and providers negatively. For patients, it reduces their survival changes, aggravates illnesses, and leads to unnecessary mortalities (Graban, 2018). To providers, such issu ...
The Barriers that Prevent Certified Nurse Practitioner (CNP) Practice
Review the shortage of medical professionals and the increasing need for advanced practitioners to serve in primary care roles
Identify the current barriers that prevent CNP from practicing to the full extent of their education, scope and training
Outline concrete ways in which these barriers can be effectively removed so as to improve autonomy for CNP’s and quality of care for patients.
EvelinAccording to the last report of the American Association o.docx
Evelin
According to the last report of the American Association of Nurse Practitioners, the scope of the nurses' practices is not limited by their titles. On the contrary, advanced nursing practice allows nurses to actively participate in clinical diagnoses, interventions, treatment monitoring, prescribing, and examinations physical (Batey & Holland, 2018). At present, the concept of advanced practice nurses has achieved worldwide development, for this reason, the health system prefers advanced practice nurses because they are trained professionals to meet the needs of patients and meet the administrative requirements of the system sanitary (Coulehan & Sheedy, 2017).
Prescribing for advanced practice nurses (APRNs) is a new integration to their responsibilities and duties with the health of patients. The prescribing of these nurses, has demonstrated effectiveness and efficacy, and allows APRNs to approach the integral and efficient management of patients from the viewpoint of other nurses, given that, according to each state, APRNs have the power to prescribe, that is, if APRNs have experience in prescribing, each state can limit this practice (Scudder, 2016).
Regarding the education of APRNs, these nurses should be specially educated to formulate prescription medications, to train about safe practices based on formulas and the combination of controlled medications. On the other hand, the limited APRNs for the formulation of medications, have the option of working interdisciplinary with other professionals to participate in the prescription, this ensures that nurses know the risks and benefits of the prescription (Coulehan & Sheedy, 2017). However, this seems to be a barrier, like the laws in each state, since it does not allow trained APRNs to exercise their knowledge and skills in this regard. Although this practice aims to protect the integrity of patients, it limits the experience and autonomy of nurses with the knowledge and certified education (Batey & Holland, 2018).
Finally, another barrier faced by nurses trained and endorsed by the state, are the regulations of each health institution, since, each hospital can determine the scope of APRNs, that is, hospitals can limit the APRNs to formulate prescriptions of medications, even if, they are accredited and allowed by the state, since, federal and state laws give hospitals autonomy to determine the competencies and functions of each of their workers (Jiao & Murimi, 2018). Likewise, it is possible to affirm that the main consequence of these barriers affects the quality and effective care of patients, since, in some cases, there may be delays in medical care until a certified physician supervises the activities of APRNs, increasing health costs and decreasing patient satisfaction (Batey & Holland, 2018).
Guillermo
The Role of Advanced Practice Nursing in Safe Prescribing
APRNs consist of nurse midwives, nurse anesthetists, clinical nurse specialists, and nurse practitioners. They are all ...
THIS IS THE FEEDBACK I RECEEIVED. Only one patient responded to my.docx
THIS IS THE FEEDBACK I RECEEIVED. Only one patient responded to my post. Hope this helps
Ryan,
Inadequate levels of nursing professionals were first discussed more than 80 years ago (Whelan, n.d.). Recently, scholars have opined many reasons for the shortage of nurses. Factors such as work stress, burnout, violence against healthcare professionals, a lack of qualified nursing instructors, and nurses unable to adapt to changing technology or clinical environments have been addressed (Haddad & Toney-Butler, 2019). As many nurses may attest, doing more with less can lead to mistakes and dissatisfaction with a nursing career. Ultimately, patient care suffers.
Organizations employ various tactics to help strengthen nurse retention. Halter et al. (2017) suggest strong nursing leadership and assigning preceptors to new nurses can help minimize nursing resignation rates. At the writer’s employment, hospital administrators use several ways to retain nurses. Each quarter, a nurse is recognized for outstanding achievement by receiving a certificate, gift card, and editorial mention on the hospital’s intranet. Moreover, the hospital caters lunch for all employees, dayside and nighttime staff, twice a year for meeting quality targets. Also, the hospital uses various national celebration days such as ice cream, donuts, coffee, bagels, and candy to reward all employees. Creating a level of goodwill and institutional collaboration can help retain nurses and improve job satisfaction (Kurnat-Thoma et al., 2017).
Reference
Haddad, L.M., & Toney-Butler, T.J. (2019). Nursing shortage. StatPearls Publishing.
Halter, M., Pelone, F., Boiko, O., Beighton, C., Harris, R., Gale, J., Gourlay, S., & Drennan, V. (2017). Interventions to reduce adult nursing turnover: A systematic review of systematic reviews. The Open Nursing Journal, 11, 108-123. https://doi.org/10.2174/1874434601711010108
Kurnat-Thoma, E., Ganger, M., Peterson, K., & Channell, L. (2017). Reducing annual hospital and registered nurse staff turnover: A 10-element onboarding program intervention. SAGE Open Nursing, 3. https://doi.org/10.1177/2377960817697712
Whelan, J.C. (n.d.). Where did all the nurses go? Retrieved from https://www.nursing.upenn.edu/nhhc/workforce-issues/where-did-all-the-nurses-go/
By Thomas C. Ricketts and Erin P. Fraher
Reconfiguring Health Workforce
Policy So That Education,
Training, And Actual Delivery
Of Care Are Closely Connected
ABSTRACT There is growing consensus that the health care workforce in
the United States needs to be reconfigured to meet the needs of a health
care system that is being rapidly and permanently redesigned.
Accountable care organizations and patient-centered medical homes, for
instance, will greatly alter the mix of caregivers needed and create new
roles for existing health care workers. The focus of health system
innovation, however, has largely been on reorganizing care delivery
processes, reengineering workflows, and adopting electronic technolo ...
Running Head HEALTHCARE STAKEHOLDER CONFLICTS1HEALTHCARE .docx
Running Head: HEALTHCARE STAKEHOLDER CONFLICTS
1
HEALTHCARE STAKEHOLDER CONFLICTS
5
Stakeholder Conflicts in Healthcare Visions
Kendra Smith
Grand Canyon University: HCA 675
Introduction
The stakeholders in the healthcare service in any jurisdiction entail the government, the healthcare providers or the physicians, the payers, the patients as well as healthcare professional organizations.
These stakeholders work hand in hand to ensure efficiency and professionalism in healthcare delivery (Blair et al, 1988). They do this by developing succinct policies and effectively implement them for the sole purpose of improving healthcare services. However, there have been serious conflicts in opinion regarding enhancing healthcare service practices and proper administrative mechanisms for the achievement of better services, among the stakeholders.
Conflicts in Health Vision
One of the major health reform visions which have generated considerable debate concerns the accommodation of evidence-driven healthcare service practice, which the government of the United States has instructed all healthcare service providers or organizations to adopt. The major emphasis on this aspect of medicine is the requirement by the government that all healthcare service providers or organizations should document which healthcare services they provide and why they provide such healthcare services to the communit
y.
The argument behind this requirement is that it will enable the government, or it will be generally helpful in gauging the benefits the community gains from such healthcare services. In addition, establishing evidence-driven healthcare practice according to healthcare practitioners will help in identifying specific health problems within a community, and subsequently, design the most appropriate medical response. Some healthcare stakeholders also believe that this is an avenue that the government intends to use in creating and forging a closer working relationship between private and public healthcare providers. However much most stakeholders, both private and public, appreciate this evidence-based healthcare practice, as a vital component in improving healthcare services, the major concern is about how such data should be obtained. Some healthcare providers have reasoned that these data should be generated from the already existing data, due to the costs associated with activities that may lead to acquiring and establishing sound data or information domain. In response to this requirement, most of the healthcare organizations have established community-based information or data collection and management mechanisms, which enable them to collect data concerning community health concerns and threats, then define effective ways of response.
With the introduction and implementation of a series of healthcare reforms in the United States, such as the Obamacare and Trumpcare, there is general expectation that there will be enhanced access to healthcare service ...
Advocating Through PolicyAs noted by Dr. Stanley and Dr. W
Advocating Through Policy
As noted by Dr. Stanley and Dr. White in this week’s media presentation, professional nurses should be engaging in advocacy efforts to improve health and nursing practice through involvement in the policy process at the institutional, local, state, or federal levels. This array of possibilities for involvement provides opportunities for all nurses, regardless of time, or other possible constraints. Successful policy making is a collaborative effort, and one that commands mutual respect from all involved. Your involvement in policy making can lead to expanded opportunities as both a nurse leader and as a respected member of an interprofessional health care team.
Note
: This Discussion provides a forum for discussing advocacy opportunities and honing your presentation skills in a small group setting.
To prepare:
Reflect on the insights offered by Dr. Stanley and Dr. White on engaging in advocacy through the policy process.
Identify a practice issue that is of interest to you and that could benefit from advocacy efforts through the policy process.
Consider the stakeholders and any special interest or professional organizations that would support your issue.
Develop a short, yet persuasive PowerPoint (up to 3 slides IN APA FORMAT) as follows:
1) Identify the practice issue that would benefit from being addressed through the policy process
2) Represent the key stakeholders (i.e. use graphical images when possible)
3) Propose one strategy for how a nurse could advocate for this issue
The PowerPoint should be succinct, visually appealing, and effective.
By Tuesday 5/8/18 6pm
Post
your PowerPoint presentation.
Required Readings
Bodenheimer, T., & Grumbach, K. (2016).
Understanding health policy: A clinical approach
(7th ed.). New York, NY: McGraw-Hill Medical.
Chapter 17, “Conclusion: Tensions and Challenges”
This chapter concludes with final thoughts on the challenge of providing quality health care and controlling health care costs. The solution is likely to be resolved only by a collaborative approach, involving all health care stakeholders, and by health professionals taking the lead.
Howard, J., Levy, F., Mareiniss, D. P., Craven, C. K., McCarthy, M., Epstein-Peterson, Z. D., & et al. (2010). New legal protections for reporting patient errors under the Patient Safety and Quality Improvement Act: A review of the medical literature and analysis.
Journal of Patient Safety, 6
(3), 147-152
.
The authors studied the dissemination of information on the Patient Safety and Quality Improvement Act (PSQIA), a federal act that affords protection to those reporting medical errors. They found medical literature to be inadequate in this regard, and as a result, medical personnel were uninformed on their legal protections. This lack of information has become a barrier to policy implementation.
Jacobson, N., Butterill, D., & Goering, P. ...
HeadnoteGovernments with universal healthcare systems are increa.docx
Headnote
Governments with universal healthcare systems are increasingly bemoaning the costs of their systems and the need to contain these costs if affordable healthcare services are to be sustained into the future. In a bid to reduce the costs of healthcare, politicians and bureaucrats have championed the need for reform. Although avoiding the language of rationing, the kinds of 'reforms' being championed (eg. greater government regulation of universal health coverage, reducing reimbursement for medical costs, cutting funding to public hospitals) seem however, to be more concerned with restricting universal healthcare coverage, rather than reforming it.
The rhetoric of healthcare reforms has also had a political ideological objective shifting the provision of and accountability for public healthcare services to private sector providers. This objective has been pursued despite experts warning that such a shift will ultimately lead (and in some cases has already led) to inequities and unjust disparities in access to healthcare and related health outcomes, especially in vulnerable populations who cannot afford private health insurance.
Australia has not been immune from ideologically driven machinations about the sustainability of its universal healthcare scheme, ie. Medicare. Despite health expenditure in Australia reportedly reaching a record low for the period 2012-2013, there has been a political campaign of spreading false and misleading information about Medicare's sustainability (Keast 2015).This misinformation has included 'blaming' vulnerable populations (eg. an ageing demographic, the 'undeserving poor') for their allegedly disproportionate over-utilisation of public healthcare services and the need to curb this costly 'wanton' demand. What has been overlooked in this situation, however, is that a key driver of the spiraling costs of healthcare is not the over-utilisation of services by people in need, but rather 'the use of wasteful tests and treatments' prescribed by doctors (Tilburt & Cassel, 2013) together with the rising costs of drugs (driven by the business behaviours of the pharmaceutical industry) and medical technology, particularly in hospitals. Also overlooked is the problem of language and the tendency to treat the terms 'healthcare', 'hospital care', and 'medical care' as being synonymous, when they are not. Failure to distinguish what each of these terms refers to unnecessarily muddles debate about what healthcare reforms are needed as well as where and how these should occur.
Question of nursing ethics
The ethics of healthcare rationing has been the subject of debate for decades. This debate has primarily rested on the issue of whether it is ever acceptable to ration healthcare and, if so, on what grounds. It has also prompted unresolved controversies about the interests of individuals versus the collective interests of society in accessing limited healthcare resources and how best to balance these competing inter.
4 replies one for each claudiamajor disasters and eme
4 replies one for each claudiamajor disasters and eme
Running Head LIMITED ACCESS TO HEALTHCARE1LIMITED ACCESS TO.docx
Running Head: LIMITED ACCESS TO HEALTHCARE1
LIMITED ACCESS TO HEALTHCARE6
Limited Access to Healthcare
Arnaldo Perez-Frometa
Capella University
Developing a Health Care Perspective
Access to healthcare services is very essential for sustainable level of living and good health. Several scholars have described access as “the timely use of personal health services to achieve the best possible health outcomes”. One of the issues facing many countries across the world including those with systems for universal healthcare is providing appropriate and timely healthcare access for deprived patients. Currently there is limited information on how those patients living in a context of social and material deprivation perceive obstructions in the system of healthcare. In this paper we shall discuss several resources addressing the issue of access to services in the healthcare system.
According to Andersen, Davidson, & Baumeister (2014), in their article titled “improving the access to care”, access refers to the actual utility of individual services for heath as well as everything else that can facilitate or impede their use. In this article they present research and policy issues as well as basic trends which are related to evaluating and monitoring the access to healthcare services. They show how evaluating and monitoring offers the platform for the prediction of health services, promotion of social justice and the improvement of efficiency and effectiveness for the delivery of health services. They analyzed access and healthcare outcomes using a behavioral model which provides a systematic framework of individual and contextual framework
They expanded the behavioral model by emphasizing on two new aspects. They include the life quality as an input and healthcare outcome and genetics as a factor for predisposing. They also examined some examples of access indicators which include efficiency and effectiveness measures, utilization, potential access and healthcare needs. Changes that occurred in these indicators over time were tracked using trend data. Finally they did observations on access and the present status as well as new areas of improving access via ACA which has played a big role in improving access to health care.
Next we are going to analyze the article written by Acharya et al., (2017) titled “Partnerships in mental healthcare service delivery in low-resource settings: developing an innovative network in rural Nepal”. This article provides an understanding on the contribution of mental illness on the worldwide burden diseases which are non communicable. However, the authors note that there has been an extremely limited access to ethnically sensitive, appropriately contextual and high quality service for mental healthcare. Despite the availability for interventions to improve outcomes for the patients, this situation still persists. The authors suggest that there is need for the development of partnerships network for adaptation.
Chapter 4 Where Do We Want to BePrevious sectionNext section
Chapter 4 Where Do We Want to Be?
Previous section
Next section
Chapter 4
Where Do We Want to Be?
Even in a country that lacks an overall, cohesive health policy, it is useful to ask: How unhappy are we with our health care, and what do we want to change? Do not expect consistent responses from the American public. When the nation was debating the Clinton health plan, a number of organizations surveyed the public. Respondents reported they believed that the health care system was in trouble. At the same time, they expressed satisfaction with their own largely employer-financed health care programs. Public support for universal coverage was strong, but individuals did not want to pay higher taxes to support it (Peterson, 1995). An ABC New/Washington Post poll in October 1993 showed the following (Schick, 1995):
• 51% of the public favored the Clinton health plan.
• 59% thought that it was better than the existing system.
• Only 19% thought that their care would get better under it, and 34% thought worse care would result.
• However, 57% were against tax increases to pay for it, whereas 40% would be willing to pay.
The American public also appears to be split over the Patient Protection and Affordable Care Act (ACA) as a whole. Data about opposition to the act can be misleading, with a significant portion of opposition coming from people who believe the ACA did not go far enough. They would prefer a public option, for example, or a single-payer system. Overall, the public is
negative about the individual mandate and the employer mandate, but is much in favor of the insurance changes that have been implemented. People are confused about the insurance exchange provisions of the act as well. An April 2013 tracking poll found that “about half the public says they do not have enough information about the health reform law to understand how it will impact their own family, a share that rises among the uninsured and low-income households” (Kaiser Family Foundation, 2013). The same poll reported that 42% of respondents did not know that the ACA was still the law of the land. Twelve percent believed it had been repealed by Congress, 7% believed it had been overturned by the Supreme Court, and 23% didn’t know whether it was still in effect or not.
Americans report being in good health more than any other OECD country. Their complaints are mostly about financial risks and to some extent access and waiting. A 2010 study of six developed countries showed that Americans were satisfied with their doctors and the availability of effective care, but were also more likely to report that the system needed to be completely rebuilt (Papanicolas, Cylus, & Smith, 2013).
4.1 Alignment with the Rest of Society
Previous section
Next section
4.1 ALIGNMENT WITH THE REST OF SOCIETY
The democratic process is likely to generate many policy experiments as we cope with advancing technology, changing demographics, political pressures, and economic fluctuations. These exper ...
Unintended Consequences of Health Care ReformThe PPACA of .docx
Unintended Consequences of Health Care Reform
The PPACA of 2010 fostered new provisions for health care and the structure of health care delivery. The individual mandate to obtain insurance is one provocative provision. While this provision attempts to increase access to health care, it raises questions on how the existing system could sustain the potentially large influx of newly insured individuals.
Another provision calls for new models of health care provider organizations to ensure delivery efficiency and continuity of care. In this week’s media presentation, Dr. Kathleen White discusses the accountable care organization, which comprises a group of providers coordinating care across a variety of institutional settings. Yet becoming an accountable care organization may present a number of challenges.
This week’s Discussion builds on Week 1, continuing the examination of those societal and organizational contexts that influence health care reform. The unintended consequences of reform policy on the health care system are also considered.
To prepare:
Review this week’s media presentation and the other Learning Resources focusing on how reform may lead to improved quality, greater access, and reduced cost of care. Also think about the unintended consequences that may arise as a result.
Consider the information presented about the individual mandate and accountable care organizations. What are some questions or concerns you might have regarding the individual mandate? What are the pros and cons associated with becoming an accountable care organization?
With posting instructions in mind, select either the individual mandate or accountable care organizations as the focus of your Discussion this week.
By tomorrow Wednesday 03/07/18 BY 12pm, write a minimum of 550 words in APA format with a minimum of
THREE
scholarly references from the list of required readings below. Include the level one headers as numbered below:
Post
a cohesive response that addresses the following:
1) In the first line of your posting, identify the topic you have selected—either the individual mandate or accountable care organizations. With regard to this topic, describe one or more positive results that could be achieved, and one or more unintended consequence(s) that organizations or individuals may experience.
2) Briefly evaluate issues on the topic that may be a consideration for the organization you work in and the nursing profession ( I WORK I A HOSPITAL SETTING).
Required Readings
Bodenheimer, T., & Grumbach, K. (2016). Understanding health policy: A clinical approach (7th ed.). New York, NY: McGraw-Hill Medical.
Chapter 5, “How Health Care is Organized – I: Primary, Secondary, and Tertiary Care”
Chapter 6, “How Health Care is Organized – II: Health Delivery Systems”
McClellan, M. (2010). Accountable care organizations in the era of health care reform. American Health & Drug Benefits, 3 ...
More Related Content
Similar to Advocacy For Equitable Health Care Discussion Paper.docx
THIS IS THE FEEDBACK I RECEEIVED. Only one patient responded to my.docx
THIS IS THE FEEDBACK I RECEEIVED. Only one patient responded to my post. Hope this helps
Ryan,
Inadequate levels of nursing professionals were first discussed more than 80 years ago (Whelan, n.d.). Recently, scholars have opined many reasons for the shortage of nurses. Factors such as work stress, burnout, violence against healthcare professionals, a lack of qualified nursing instructors, and nurses unable to adapt to changing technology or clinical environments have been addressed (Haddad & Toney-Butler, 2019). As many nurses may attest, doing more with less can lead to mistakes and dissatisfaction with a nursing career. Ultimately, patient care suffers.
Organizations employ various tactics to help strengthen nurse retention. Halter et al. (2017) suggest strong nursing leadership and assigning preceptors to new nurses can help minimize nursing resignation rates. At the writer’s employment, hospital administrators use several ways to retain nurses. Each quarter, a nurse is recognized for outstanding achievement by receiving a certificate, gift card, and editorial mention on the hospital’s intranet. Moreover, the hospital caters lunch for all employees, dayside and nighttime staff, twice a year for meeting quality targets. Also, the hospital uses various national celebration days such as ice cream, donuts, coffee, bagels, and candy to reward all employees. Creating a level of goodwill and institutional collaboration can help retain nurses and improve job satisfaction (Kurnat-Thoma et al., 2017).
Reference
Haddad, L.M., & Toney-Butler, T.J. (2019). Nursing shortage. StatPearls Publishing.
Halter, M., Pelone, F., Boiko, O., Beighton, C., Harris, R., Gale, J., Gourlay, S., & Drennan, V. (2017). Interventions to reduce adult nursing turnover: A systematic review of systematic reviews. The Open Nursing Journal, 11, 108-123. https://doi.org/10.2174/1874434601711010108
Kurnat-Thoma, E., Ganger, M., Peterson, K., & Channell, L. (2017). Reducing annual hospital and registered nurse staff turnover: A 10-element onboarding program intervention. SAGE Open Nursing, 3. https://doi.org/10.1177/2377960817697712
Whelan, J.C. (n.d.). Where did all the nurses go? Retrieved from https://www.nursing.upenn.edu/nhhc/workforce-issues/where-did-all-the-nurses-go/
By Thomas C. Ricketts and Erin P. Fraher
Reconfiguring Health Workforce
Policy So That Education,
Training, And Actual Delivery
Of Care Are Closely Connected
ABSTRACT There is growing consensus that the health care workforce in
the United States needs to be reconfigured to meet the needs of a health
care system that is being rapidly and permanently redesigned.
Accountable care organizations and patient-centered medical homes, for
instance, will greatly alter the mix of caregivers needed and create new
roles for existing health care workers. The focus of health system
innovation, however, has largely been on reorganizing care delivery
processes, reengineering workflows, and adopting electronic technolo ...
Running Head HEALTHCARE STAKEHOLDER CONFLICTS1HEALTHCARE .docx
Running Head: HEALTHCARE STAKEHOLDER CONFLICTS
1
HEALTHCARE STAKEHOLDER CONFLICTS
5
Stakeholder Conflicts in Healthcare Visions
Kendra Smith
Grand Canyon University: HCA 675
Introduction
The stakeholders in the healthcare service in any jurisdiction entail the government, the healthcare providers or the physicians, the payers, the patients as well as healthcare professional organizations.
These stakeholders work hand in hand to ensure efficiency and professionalism in healthcare delivery (Blair et al, 1988). They do this by developing succinct policies and effectively implement them for the sole purpose of improving healthcare services. However, there have been serious conflicts in opinion regarding enhancing healthcare service practices and proper administrative mechanisms for the achievement of better services, among the stakeholders.
Conflicts in Health Vision
One of the major health reform visions which have generated considerable debate concerns the accommodation of evidence-driven healthcare service practice, which the government of the United States has instructed all healthcare service providers or organizations to adopt. The major emphasis on this aspect of medicine is the requirement by the government that all healthcare service providers or organizations should document which healthcare services they provide and why they provide such healthcare services to the communit
y.
The argument behind this requirement is that it will enable the government, or it will be generally helpful in gauging the benefits the community gains from such healthcare services. In addition, establishing evidence-driven healthcare practice according to healthcare practitioners will help in identifying specific health problems within a community, and subsequently, design the most appropriate medical response. Some healthcare stakeholders also believe that this is an avenue that the government intends to use in creating and forging a closer working relationship between private and public healthcare providers. However much most stakeholders, both private and public, appreciate this evidence-based healthcare practice, as a vital component in improving healthcare services, the major concern is about how such data should be obtained. Some healthcare providers have reasoned that these data should be generated from the already existing data, due to the costs associated with activities that may lead to acquiring and establishing sound data or information domain. In response to this requirement, most of the healthcare organizations have established community-based information or data collection and management mechanisms, which enable them to collect data concerning community health concerns and threats, then define effective ways of response.
With the introduction and implementation of a series of healthcare reforms in the United States, such as the Obamacare and Trumpcare, there is general expectation that there will be enhanced access to healthcare service ...
Advocating Through PolicyAs noted by Dr. Stanley and Dr. W
Advocating Through Policy
As noted by Dr. Stanley and Dr. White in this week’s media presentation, professional nurses should be engaging in advocacy efforts to improve health and nursing practice through involvement in the policy process at the institutional, local, state, or federal levels. This array of possibilities for involvement provides opportunities for all nurses, regardless of time, or other possible constraints. Successful policy making is a collaborative effort, and one that commands mutual respect from all involved. Your involvement in policy making can lead to expanded opportunities as both a nurse leader and as a respected member of an interprofessional health care team.
Note
: This Discussion provides a forum for discussing advocacy opportunities and honing your presentation skills in a small group setting.
To prepare:
Reflect on the insights offered by Dr. Stanley and Dr. White on engaging in advocacy through the policy process.
Identify a practice issue that is of interest to you and that could benefit from advocacy efforts through the policy process.
Consider the stakeholders and any special interest or professional organizations that would support your issue.
Develop a short, yet persuasive PowerPoint (up to 3 slides IN APA FORMAT) as follows:
1) Identify the practice issue that would benefit from being addressed through the policy process
2) Represent the key stakeholders (i.e. use graphical images when possible)
3) Propose one strategy for how a nurse could advocate for this issue
The PowerPoint should be succinct, visually appealing, and effective.
By Tuesday 5/8/18 6pm
Post
your PowerPoint presentation.
Required Readings
Bodenheimer, T., & Grumbach, K. (2016).
Understanding health policy: A clinical approach
(7th ed.). New York, NY: McGraw-Hill Medical.
Chapter 17, “Conclusion: Tensions and Challenges”
This chapter concludes with final thoughts on the challenge of providing quality health care and controlling health care costs. The solution is likely to be resolved only by a collaborative approach, involving all health care stakeholders, and by health professionals taking the lead.
Howard, J., Levy, F., Mareiniss, D. P., Craven, C. K., McCarthy, M., Epstein-Peterson, Z. D., & et al. (2010). New legal protections for reporting patient errors under the Patient Safety and Quality Improvement Act: A review of the medical literature and analysis.
Journal of Patient Safety, 6
(3), 147-152
.
The authors studied the dissemination of information on the Patient Safety and Quality Improvement Act (PSQIA), a federal act that affords protection to those reporting medical errors. They found medical literature to be inadequate in this regard, and as a result, medical personnel were uninformed on their legal protections. This lack of information has become a barrier to policy implementation.
Jacobson, N., Butterill, D., & Goering, P. ...
HeadnoteGovernments with universal healthcare systems are increa.docx
Headnote
Governments with universal healthcare systems are increasingly bemoaning the costs of their systems and the need to contain these costs if affordable healthcare services are to be sustained into the future. In a bid to reduce the costs of healthcare, politicians and bureaucrats have championed the need for reform. Although avoiding the language of rationing, the kinds of 'reforms' being championed (eg. greater government regulation of universal health coverage, reducing reimbursement for medical costs, cutting funding to public hospitals) seem however, to be more concerned with restricting universal healthcare coverage, rather than reforming it.
The rhetoric of healthcare reforms has also had a political ideological objective shifting the provision of and accountability for public healthcare services to private sector providers. This objective has been pursued despite experts warning that such a shift will ultimately lead (and in some cases has already led) to inequities and unjust disparities in access to healthcare and related health outcomes, especially in vulnerable populations who cannot afford private health insurance.
Australia has not been immune from ideologically driven machinations about the sustainability of its universal healthcare scheme, ie. Medicare. Despite health expenditure in Australia reportedly reaching a record low for the period 2012-2013, there has been a political campaign of spreading false and misleading information about Medicare's sustainability (Keast 2015).This misinformation has included 'blaming' vulnerable populations (eg. an ageing demographic, the 'undeserving poor') for their allegedly disproportionate over-utilisation of public healthcare services and the need to curb this costly 'wanton' demand. What has been overlooked in this situation, however, is that a key driver of the spiraling costs of healthcare is not the over-utilisation of services by people in need, but rather 'the use of wasteful tests and treatments' prescribed by doctors (Tilburt & Cassel, 2013) together with the rising costs of drugs (driven by the business behaviours of the pharmaceutical industry) and medical technology, particularly in hospitals. Also overlooked is the problem of language and the tendency to treat the terms 'healthcare', 'hospital care', and 'medical care' as being synonymous, when they are not. Failure to distinguish what each of these terms refers to unnecessarily muddles debate about what healthcare reforms are needed as well as where and how these should occur.
Question of nursing ethics
The ethics of healthcare rationing has been the subject of debate for decades. This debate has primarily rested on the issue of whether it is ever acceptable to ration healthcare and, if so, on what grounds. It has also prompted unresolved controversies about the interests of individuals versus the collective interests of society in accessing limited healthcare resources and how best to balance these competing inter.
4 replies one for each claudiamajor disasters and eme
4 replies one for each claudiamajor disasters and eme
Running Head LIMITED ACCESS TO HEALTHCARE1LIMITED ACCESS TO.docx
Running Head: LIMITED ACCESS TO HEALTHCARE1
LIMITED ACCESS TO HEALTHCARE6
Limited Access to Healthcare
Arnaldo Perez-Frometa
Capella University
Developing a Health Care Perspective
Access to healthcare services is very essential for sustainable level of living and good health. Several scholars have described access as “the timely use of personal health services to achieve the best possible health outcomes”. One of the issues facing many countries across the world including those with systems for universal healthcare is providing appropriate and timely healthcare access for deprived patients. Currently there is limited information on how those patients living in a context of social and material deprivation perceive obstructions in the system of healthcare. In this paper we shall discuss several resources addressing the issue of access to services in the healthcare system.
According to Andersen, Davidson, & Baumeister (2014), in their article titled “improving the access to care”, access refers to the actual utility of individual services for heath as well as everything else that can facilitate or impede their use. In this article they present research and policy issues as well as basic trends which are related to evaluating and monitoring the access to healthcare services. They show how evaluating and monitoring offers the platform for the prediction of health services, promotion of social justice and the improvement of efficiency and effectiveness for the delivery of health services. They analyzed access and healthcare outcomes using a behavioral model which provides a systematic framework of individual and contextual framework
They expanded the behavioral model by emphasizing on two new aspects. They include the life quality as an input and healthcare outcome and genetics as a factor for predisposing. They also examined some examples of access indicators which include efficiency and effectiveness measures, utilization, potential access and healthcare needs. Changes that occurred in these indicators over time were tracked using trend data. Finally they did observations on access and the present status as well as new areas of improving access via ACA which has played a big role in improving access to health care.
Next we are going to analyze the article written by Acharya et al., (2017) titled “Partnerships in mental healthcare service delivery in low-resource settings: developing an innovative network in rural Nepal”. This article provides an understanding on the contribution of mental illness on the worldwide burden diseases which are non communicable. However, the authors note that there has been an extremely limited access to ethnically sensitive, appropriately contextual and high quality service for mental healthcare. Despite the availability for interventions to improve outcomes for the patients, this situation still persists. The authors suggest that there is need for the development of partnerships network for adaptation.
Chapter 4 Where Do We Want to BePrevious sectionNext section
Chapter 4 Where Do We Want to Be?
Previous section
Next section
Chapter 4
Where Do We Want to Be?
Even in a country that lacks an overall, cohesive health policy, it is useful to ask: How unhappy are we with our health care, and what do we want to change? Do not expect consistent responses from the American public. When the nation was debating the Clinton health plan, a number of organizations surveyed the public. Respondents reported they believed that the health care system was in trouble. At the same time, they expressed satisfaction with their own largely employer-financed health care programs. Public support for universal coverage was strong, but individuals did not want to pay higher taxes to support it (Peterson, 1995). An ABC New/Washington Post poll in October 1993 showed the following (Schick, 1995):
• 51% of the public favored the Clinton health plan.
• 59% thought that it was better than the existing system.
• Only 19% thought that their care would get better under it, and 34% thought worse care would result.
• However, 57% were against tax increases to pay for it, whereas 40% would be willing to pay.
The American public also appears to be split over the Patient Protection and Affordable Care Act (ACA) as a whole. Data about opposition to the act can be misleading, with a significant portion of opposition coming from people who believe the ACA did not go far enough. They would prefer a public option, for example, or a single-payer system. Overall, the public is
negative about the individual mandate and the employer mandate, but is much in favor of the insurance changes that have been implemented. People are confused about the insurance exchange provisions of the act as well. An April 2013 tracking poll found that “about half the public says they do not have enough information about the health reform law to understand how it will impact their own family, a share that rises among the uninsured and low-income households” (Kaiser Family Foundation, 2013). The same poll reported that 42% of respondents did not know that the ACA was still the law of the land. Twelve percent believed it had been repealed by Congress, 7% believed it had been overturned by the Supreme Court, and 23% didn’t know whether it was still in effect or not.
Americans report being in good health more than any other OECD country. Their complaints are mostly about financial risks and to some extent access and waiting. A 2010 study of six developed countries showed that Americans were satisfied with their doctors and the availability of effective care, but were also more likely to report that the system needed to be completely rebuilt (Papanicolas, Cylus, & Smith, 2013).
4.1 Alignment with the Rest of Society
Previous section
Next section
4.1 ALIGNMENT WITH THE REST OF SOCIETY
The democratic process is likely to generate many policy experiments as we cope with advancing technology, changing demographics, political pressures, and economic fluctuations. These exper ...
Unintended Consequences of Health Care ReformThe PPACA of .docx
Unintended Consequences of Health Care Reform
The PPACA of 2010 fostered new provisions for health care and the structure of health care delivery. The individual mandate to obtain insurance is one provocative provision. While this provision attempts to increase access to health care, it raises questions on how the existing system could sustain the potentially large influx of newly insured individuals.
Another provision calls for new models of health care provider organizations to ensure delivery efficiency and continuity of care. In this week’s media presentation, Dr. Kathleen White discusses the accountable care organization, which comprises a group of providers coordinating care across a variety of institutional settings. Yet becoming an accountable care organization may present a number of challenges.
This week’s Discussion builds on Week 1, continuing the examination of those societal and organizational contexts that influence health care reform. The unintended consequences of reform policy on the health care system are also considered.
To prepare:
Review this week’s media presentation and the other Learning Resources focusing on how reform may lead to improved quality, greater access, and reduced cost of care. Also think about the unintended consequences that may arise as a result.
Consider the information presented about the individual mandate and accountable care organizations. What are some questions or concerns you might have regarding the individual mandate? What are the pros and cons associated with becoming an accountable care organization?
With posting instructions in mind, select either the individual mandate or accountable care organizations as the focus of your Discussion this week.
By tomorrow Wednesday 03/07/18 BY 12pm, write a minimum of 550 words in APA format with a minimum of
THREE
scholarly references from the list of required readings below. Include the level one headers as numbered below:
Post
a cohesive response that addresses the following:
1) In the first line of your posting, identify the topic you have selected—either the individual mandate or accountable care organizations. With regard to this topic, describe one or more positive results that could be achieved, and one or more unintended consequence(s) that organizations or individuals may experience.
2) Briefly evaluate issues on the topic that may be a consideration for the organization you work in and the nursing profession ( I WORK I A HOSPITAL SETTING).
Required Readings
Bodenheimer, T., & Grumbach, K. (2016). Understanding health policy: A clinical approach (7th ed.). New York, NY: McGraw-Hill Medical.
Chapter 5, “How Health Care is Organized – I: Primary, Secondary, and Tertiary Care”
Chapter 6, “How Health Care is Organized – II: Health Delivery Systems”
McClellan, M. (2010). Accountable care organizations in the era of health care reform. American Health & Drug Benefits, 3 ...
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Chapter 4 Where Do We Want to BePrevious sectionNext section
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