Discussion: Organizational Policies Outline

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Organizational Policies and Practices to Support Healthcare Issues

Post an explanation of how competing needs, such as the needs of the workforce, resources, and patients, may impact the development of policy.

Health care policies are vital for many aspects of healthcare delivery, including: (1) screening for prevention of disease; (2) early diagnosis and care; (3) long-term control of chronic diseases and disabilities; and (4) setting-up guidelines (Basdekis et al 2019). Competing needs among stakeholders can slow the development of policies, as all parties need to uphold similar ideations to be successful. The outlining of a problem forms the way in which a policy issue is seen (Katrakazas et al 2019). So, when developing policies, it is best to consider all involved and open ones-self up to ideas from all stakeholders and study all avenues. Considering competing needs of the workforce, the patients and the available resources is vital to ensure stability within the policy made. The resources needed, the workforce and the patients will all have different points of view regarding what needs to be considered when making a policy. It is not until one comes to a resolution that all can agree on, that a new policy will be successful and followed by all.

Then, describe any specific competing needs that may impact the national healthcare issue/stressor you selected.

Competing needs of the insured versus the uninsured is a huge issue. Policies made to benefit the uninsured can make the insured patient wonder why they even try to maintain insurance. According to Seo and fellow authors, individuals with gaps in insurance were more likely than those with uninterrupted Medicaid to admit prices or insurance-linked reasons for not following up with their care (2017). Healthcare is expensive, and unfortunately costs are not going to diminish any time soon. The uninsured need health care just as much as the insured, but who will pay for services given to the uninsured patient? Will organizations be forced to eat the costs? Competing needs? Yes. The need for affordable care for everyone is the goal, but obtainable? I don’t know.

What are the impacts, and how might policy address these competing needs? Be specific and provide examples.

Policies that address the needs of the uninsured as well as the insured would be ideal. Making a way for healthcare to be more affordable overall would be even better. Overhauling the entire insurance system is a bit unrealistic, but it is what needs to be done. Policies should be in place for those in between jobs that are affordable and not out of reach (like COBRA insurance). Those responsible enough to carry insurance should get discounts. Those who go without insurance because of mental health conditions should have less expensive insurance included with the Social Security Disability (SSD) that stays intact regardless of the patient’s mindset or condition. Those under the average income level should be provided with insurance based on their income, while those who choose not to work should be made to work for the county they reside in to pay for any medical treatment given. I realize that this is not something that can be fixed with a simple wave of a wand, but it is a topic that needs to be addressed. Our population has health care needs that they cannot afford to treat. One should not be afraid to get health care treatment just because of a bill that may not get paid.

References

Basdekis, I.; Pozdniakov, K.; Prasinos, M.; Koloutsou, K. (2019). Evidence Based Public Health Policy Making: Tool Support. IEEE World Congress on Services.

Katrakazas, P.; Manta, O.; Koutsouris, D.; Dimakopoulos, N.; Giotis, G.; Tzoannos, E. (2019). The Need of Social Campaigning in Public Health Policy Decision Making. IEEE World Congress on Services

Seo, V.; Baggett, T.P.; Thorndike, A.N.; Hull, P.; Hsu, J.; Newhouse, J.P.; Fung, V. (2019). Access to care among Medicaid and uninsured patients in community health centers after the Affordable Care Act. BMC health services research. 19(1), 291.

Hello Youland,

Youland, you are astute. There are always competing interests in every organization that must be addressed to ensure efficiency in operational processes. Particularly in healthcare institutions involving the development and implementation of various policies, there are always competing needs that must be fully addressed by management or policymakers. Competing needs arise within any organization as healthcare workers strive to meet their goals and hospital leaders strive to meet hospital objectives (Minvielle, 2018). Leaders and employees in every healthcare organization often have specific goals. Differences in objectives or goals may result in competing needs. There are always priorities when leaders and workers set their goals; additionally, there is always the need to consider the available resources that may facilitate processes and procedures toward meeting these goals. A policy addressing adequate nurse staffing is required to meet the needs of patients and employees while minimizing hospital costs. However, increased nursing staff utilization may result in economic inefficiencies as well as misallocated resources (Wicks & St Clair, 2017).

Before allocating resources, healthcare management must always consider their priorities in order to address competing needs. Most healthcare institutions consider their priorities before allocating resources to various processes. Management must involve nurses and other healthcare professional teams in order to effectively formulate policies that ensure the incorporation of best practices as well as the efficiency of general operational processes (Park & Yu, 2019). To put it another way, deciding where to allocate resources should involve the entire workforce. A policy could address these competing needs by ensuring an optimal nurse-to-patient ratio, improving patient care outcomes, and ensuring patient safety. Furthermore, a policy can be developed and sufficient resources allocated to ensure a significant decrease in the number of healthcare-acquired infections and an improvement in patient outcomes.

References

Minvielle, E. (2018). Toward Customized Care: Comment on”(Re) Making the Procrustean Bed? Standardization and Customization as Competing Logics in Healthcare”. International journal of health policy and management, 7(3), 272.

Park, H., & Yu, S. (2019). Effective policies for eliminating nursing workforce shortages: A systematic review. In Health Policy and Technology, 8(3), 296-303.

Wicks, A. M., & St Clair, L. (2017). Competing values in healthcare: balancing the (un) balanced scorecard. Journal of Healthcare Management, 52(5).

Competing Needs and Impact of Policy

Policies are made to govern a certain practice and are necessary to hold persons accountable for their actions. Registered nurses (RNs) are constantly challenged to provide quality nursing care while resources are chipped away, sometimes along with their energy, pride, and ability to provide holistic patient care (Kelly & Porr, 2018), but are still expected to  promote beneficence and avoid maleficence in all circumstances.  Nurses and nurse leaders must establish policies that are ethical and just and not waver in the presence of competing needs.  Policies and procedures provide a road map for day-to-day operations and are put in place to be followed for the betterment of the organization and improve practices. For example, a policy that focuses on staffing for nurses and nurse assistants is necessary to ensure that adequate staffing is available. The policy should provide parameters for nurse to patient ratio and a list of resources, steps, and protocols to assist where needed. The development of a policy in regards to the use of resources and being economical can also help to diffuse the fight between the need for staff versus the need for personal protective equipment (PPE).

The Impact of Organizational budget on the Nursing Shortage

I am constantly reminded that healthcare is a business just like any other and organization leaders are always trying to find new ways and ideas to satisfy the consumer but save the company money. Unfortunately, Health care is not like other businesses because people’s lives are at stake and when healthcare is faced with competing needs, one is likely to surpass the other and the other just might be as valuable as someone’s life. The shortage of nurses has a tremendous impact of any healthcare organization and can directly attack healthcare budget in more ways than one. For example, the shortage of nurse’s force countless hours in overtime to ensure that shifts are adequately covered to ensure patients receive the treatment that they need, because after all, patient satisfaction, safety, and best outcomes are the goal. On the contrary, these nurses who overwork themselves are more likely to perform at a level that is below satisfactory eventually resulting in mediocre patient care, documentation errors, medication errors and many other patient delivery errors. Researchers has suggested that overworked health care providers have reported a decline in mental and physical state, demonstrated inadequate patient care and nurse leaving/shortage (Leineweber et al., 2014).  A study conducted on Nurses’ practice in relation to burnout concludes that adequate staffing and leadership and support for nurses are crucial for nurses wellbeing and mental health. (Leineweber et al., 2014).

To paint a picture; at my organization, if a patient has a complaint or is not satisfied with the delivery of care they received, often times letters are written to the CEO or Hospital’s president and they are forced to discount patient’s hospital bills to regain consumer satisfaction and prevent any contamination to the reputation of the Organization. Organizational budgets can force decisions between paying nurses or providing necessities needed for adequate patient care delivery such as PPE’s that as necessary for minimizing the risk of health care providers contracting diseases. If nurses do not feel safe, they may opt to leave their jobs, creating a bigger deficit for the organization, therefore a balance must be found between competing needs.

References

Alyahya, M. S., Hijazi, H. H., Al Qudah, J., AlShyab, S., & AlKhalidi, W. (2018). Evaluation of

infection prevention and control policies, procedures, and practices: An ethnographic

study. AJIC: American Journal of Infection Control, 46(12), 1348–1355. https://doi-org.ezp.waldenulibrary.org/10.1016/j.ajic.2018.05.023

Kelly, P., Porr, C. (2018) Ethical Nursing Care Versus Cost Containment: Considerations to

Enhance RN Practice

Leineweber, C., Westerlund, H., Chungkham, H. S., Lindqvist, R., Runesdotter, S., &

Tishelman, C. (2014). Nurses’ practice environment and work-family conflict in relation to burn out: A multilevel modelling approach. PLoS ONE, 9(5). https://doi-org.ezp.waldenulibrary.org/10.1371/journal.pone.0096991

Hello Rashae,

This is insightful Rashae; healthcare is a business just like any other and organization. As a result, healthcare leaders are always trying to find new ways and ideas to satisfy the consumer but save the company money. As a result, there are always planning processes meant to ensure effective utilization of resources and ensure effective patient outcomes. In the process of planning, there is always the need to consider priorities (Ansmann & Pfaff, 2018). For instance, a healthcare organization may be faced with different needs; however, through planning and setting priorities, they will be able to utilize their resources in a more profitable way.

Nurse shortage has been a critical issue in most healthcare institutions. Researchers have suggested that overworked health care providers have reported a decline in mental and physical state, demonstrated inadequate patient care, and nurse leaving/shortage. Therefore, allocating more resources towards employing more nurses is always a priority (Hovland & Moltu, 2019). However, other priorities such as the reduction of medication errors may set in. Medication errors have been considered one of the major factors that contribute to low patient satisfaction and negative patient outcome.

Therefore, healthcare management may weigh their priorities before engaging in allocating resources (Kelly, 2018). To effectively formulate policies that would ensure incorporation of the best practices as well as the efficiency in the general operational processes, the management needs to involve nurses and other healthcare professional teams. With proper planning and allocation of resources, healthcare institutions are able to generate more profits and enhance operational processes in addition to meeting the needs of patients. Setting priories may help in the budgeting processes for the entire institution.

References

Ansmann, L., & Pfaff, H. (2018). Providers and Patients Caught Between Standardization and Individualization: Individualized Standardization as a Solution: Comment on”(Re) Making the Procrustean Bed? Standardization and Customization as Competing Logics in Healthcare”. International journal of health policy and management, 7(4), 349.

Hovland, R. T., & Moltu, C. (2019). Making way for a clinical feedback system in the narrow space between sessions: navigating competing demands in complex healthcare settings. International journal of mental health systems, 13(1), 1-11.

Kelly, P., Porr, C. (2018). Ethical Nursing Care Versus Cost Containment: Considerations to

Enhance RN Practice.

Competing Needs and its Impact on Policy Development

            Various aspects go into the formation of healthcare. Healthcare involves not only the direct patient care and its care providers but how that care is provided, with what resources and the overarching goals determine how it is all played out. Sometimes these topics compete and make it difficult in creating a policy that serves the needs of the organization, but also of the patients and the care team. Sometimes the answer is simple, but most often it is complicated as each piece has a different need that may adversely affect the other. The care team may have concerns regarding missed breaks; not getting enough breaks due to high acuity and their patient’s immediate needs. The patients have their own personal needs and desires that may need to be met and yet they may not agree with the health care decision that ethically would need to be made. The organization is concerned regarding the missed break law and their legal requirements to ensure their staff is complying (U.S. Department of Labor, 2021). These all impact how a policy is created, as the organization must bring all of these needs under one policy to create direction for their staff to abide by.

Competing Needs Impacting Nursing Shortage and How Those Needs Impact

            There are some competing needs involving most areas in nursing. Within the current healthcare issue of the nursing shortage – controlling costs, the mental health of staff, and the necessity for safe patient care are involved. Throughout a business and organization, the cost must be a major focus and the key component would be deciphering how to contain those costs as much as possible. Organizations find ways to cut their budget by reducing resources, increasing staffing ratios, and limiting extra pay (Kelly & Porr, 2018). Nurses are being expected to work harder and longer hours when there are an insufficient number of care providers which is contributing to poor mental health and increasing levels of burnout (Suhonen, 2018). Another major concern is the need for safe patient care. Patient care is shown to be compromised when there is a decrease in staffing and more specifically, education and times to plan and calm were decreased – leading to most likely higher readmission numbers (Blouin & Podjasek, 2019).

How Policy can Address these Competing Needs

            There are several ways that policy can influence these competing needs in association with the nursing shortage. Organizations take all the data and discuss strategies to help ensure all areas of concern are being met. The policy can be utilized to create incentives for nurses to work extra hours, hopefully boosting morale as it’s their choice versus mandatory overtime. This could assist in the patient care concern, however with nurses working increased hours that can also stimulate mental exhaustion. Management, that has the appropriate credentials, could be part of the policy developed to ensure appropriate patient care as well as decreasing costs. They could help in sharing the load with their staff and ultimately help the nurses feel supported (Blouin & Pokjasek, 2019).

References

Blouin, A.S., & Podjasek, K. (2019). The continuing saga of nurse staffing: historical and emerging challenges. The Journal of Nursing Administration, 49(4), 221-227.

Kelly, P., & Porr, C. (2018). Ethical nursing care versus cost containment: considerations to enhance rn practice. OJIN: Online Journal of Issues in Nursing, 23(1), Manuscript 6.

Suhonen, R., Stolt, M., Habermann, M., Hjaltadottir, I., Vryonides, S., Tonnessen, S., Halvorsen, K., Harvey, C., Toffoli, L., & Scott, P.A. Ethical elements in priority setting in nursing care: a scoping review, 88, 25-42.

U.S. Department of Labor. (2021, January 1). Minimum length of meal period required under state law for adult employees in private sector 1.