NURS 6053 Discussion Review of Current Healthcare Issues
Rapidly rising cost of care in developed countries; continue to be a significant national healthcare issue of concern, especially here in the United States. Insurance coverage is among the strongest predictors of access to care and better health outcomes. The uninsured are less likely to receive preventive services and are more likely to delay or forgo care because of cost. They are more likely to have emergency department visits which are less cost-effective, also are more likely to experience potentially avoidable hospitalization than their counterparts with health insurance coverage (Yabroff et al., 2021). While healthcare economics is complex, technological innovation and costs associated with the adoption and use of health technology have become the primary driver of healthcare cost inflation. In the United States, health technology (H.T.) enables the scope and quality of care patients receive. Unfortunately, patients pursue expensive H.T. in response to information asymmetry, which leads them to associate high-tech care with quality and, of course, inefficient or no insurance coverage that shelters them from the actual cost of care. Research has shown lots of evidence relating to ineffective and inappropriate use of H.T. with resultant cost inflation and variable healthcare quality (Hofmann, 2009).
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Staffing shortages in the health care industry has become a significant and stressor all over the nation. Nurses work extremely hard and that is not a secret. With imminent and an increase in the volume of patients seeking care services, patient loads are increasing rapidly, thus making it difficult for nurses already short staff to manage all patient care needs effectively and efficiently (Bakhamis et al.,2019). The United States has a massive nursing shortage, and the problem is only set to grow. Due to an influx of patients into our health system, the retirement of baby boomers, and educational bottlenecks, nursing positions are not being filled fast enough to keep up with demand (Xue et al., 2016 are millions of registered and licensed practical nurses in the United States. Most of these n). Nurses overworked and understaffed on the front lines. There urses, however, are not happy and comfortable in their work, they are stress, overworke, underappreciated, and underutilized leading to significant impact on the delivery of care.
Impact on Work Setting
Workplace quality, productivity, creativity, competitiveness, nursing care outcomes, and patient safety can all suffer as a result of a staffing shortage (Norful et al., 2018). Nurses at my health care organization sometimes work long hours due to staffing shortages, resulting in burnout, injury, fatigue, and job dissatisfaction. Nurses in my health care facility delay treatments and make other errors due to the nurse-to-patient ratio (Xue et al., 2016). As a result, patient quality of care suffers, leading to a variety of complications such as overcrowding in emergency rooms and treatment delays.
Organizational Response and Changes Implemented
Subsidized financing, recruiting new nurses, wage hikes, and contracting with nursing agencies have all been suggested as ways to alleviate the nursing shortage in my health care company. Nurses who wish to further their education can receive financial assistance from the facility where I work. Resources have also been dedicated to raising wages, which has had an effect on both the recruitment and retention of the facility’s existing staff of Registered Nurses.
Nurses should be given scheduling flexibility and coverage as an additional means of addressing the nursing shortage. As a result, nurses are better able to balance their job and home obligations, as well as their pursuit of further education, and they have more time to relax in between emotionally draining shifts and work days.
Accurate staffing, as well as a well-rested and healthy nurse, will have the greatest impact on the nation’s health care system’s overall efficiency and production, while also reducing the amount of errors caused by fatigue or illness on the job (Norful et al., 2018). Not only would we be able to increase the number of health care workers, but we’d also be able to lower the number of nurses who suffer from stress-related illnesses and, as a result, improve patient care and results.
Bottom of Form
Healthcare Cost, Its Impact on Care Access
Rapidly rising cost of care in developed countries; continue to be a significant national healthcare issue of concern, especially here in the United States. Insurance coverage is among the strongest predictors of access to care and better health outcomes. The uninsured are less likely to receive preventive services and are more likely to delay or forgo care because of cost. They are more likely to have emergency department visits which are less cost-effective, also are more likely to experience potentially avoidable hospitalization than their counterparts with health insurance coverage (Yabroff et al., 2021). While healthcare economics is complex, technological innovation and costs associated with the adoption and use of health technology have become the primary driver of healthcare cost inflation. In the United States, health technology (H.T.) enables the scope and quality of care patients receive. Unfortunately, patients pursue expensive H.T. in response to information asymmetry, which leads them to associate high-tech care with quality and, of course, inefficient or no insurance coverage that shelters them from the actual cost of care. Research has shown lots of evidence relating to ineffective and inappropriate use of H.T. with resultant cost inflation and variable healthcare quality (Hofmann, 2009).
Also Read:
With the escalating cost of healthcare and the rise of high deductible health plans, patients are becoming increasingly responsible for significant portions of their bills. The average income of families with employee health insurance rose from $76,000 in 1999 to $99,000 in 2009 but increased spending on health care largely offset this gain. Families’ health insurance premiums rose from $490 to $1115, and out-of-pocket healthcare spending almost doubled. It is no wonder that so many admitted patients pay attention to the bill they will receive on discharge instead of their recovery (Simone, 2011).
Impact of the Increased Healthcare Cost on my Work Setting
I currently work at a hospital that serves a large number of unfunded and undocumented patients; some of these patients are homeless, and others live in living conditions that are hazardous to their health. This exposes my work environment to a high volume and high acuity of critically ill patients, resulting in a high volume and high acuity workplace. The majority of our patients cannot afford preventive care and therefore present in critical conditions. The majority of these patients come from other states, neighboring communities, and not always from the two communities we serve. As a result, my workplace frequently experiences total diversion status. Any nurse working at my workplace is regarded as a super nurse by the community. Most of the time, nurses from my workplace are specifically hired when they leave.
Ways by which my Healthcare Setting has responded to the above Issue of Concern
My healthcare setting is a not-for-profit organization that provides the highest quality of care, leading to the slogan “Atlanta cannot live without Grady.” A recent study found that U.S. health care spending is higher than that of other countries, most likely because of higher prices and perhaps more readily accessible technology; rather than higher-income or an excellent supply of utilization of hospitals and doctors. (Norbeck, 2013). My healthcare setting established a cost-saving policy where unfunded or low-income patients can obtain a “Grady Card” on meeting the essential criteria. However, the patients must be residents of the two communities that we serve.
We have physician advisors, case managers, and utilization review personnel who review patients’ clinical information and follow up appropriately to ensure proper documentation of diagnoses for billing purposes and order of only medically necessary procedures to prevent overbilling (Jackson et al., 2015).
In conclusion, case managers are consistently reviewing charts to ensure that physicians place Medicare patients who meet inpatient criteria on appropriate status, as that would significantly take away or reduce the burden of healthcare costs on patients. The hospital ensures making discharge follow-up calls 2-3 days post-discharge. All arrangements, including transport, were made to ensure patients’ compliance with follow-up visits, reducing the chance of readmission and emergency department utilization. Reducing readmission is a current priority for my health care system, timely outpatient follow-up is promoted as a critical component of transitional care models (Jackson et al., 2015).
References
Hofmann, B.R. (2009). Health care costs. [Electronic resource] : Causes, effects, and control. Nova Science Publishers.
Jackson, C., Shahsahebi, M., Wedlake, T., & DuBard, C. (2015). Timeliness of outpatient follow-up: An evidence-based approach for planning after hospital discharge. Annals of family medicine, 13(2), 115–122.
Norbeck T. B. (2013). Drivers of health care costs. A physician’s foundation white paper – second of a three-part series. Missouri medicine, 110(2), 113–118.
Simone, J. V. (2011). An analysis of the effects and causes of the high cost of health care. Oncology Times, 33(19), 23-24.
Squires, D.A. (2012). Explaining high health care spending in the United States: an international comparison of supply, utilization, prices, and quality. The issue brief, (Commonwealth Fund), 10, 1-14.
By Day 3 of Week 1
Post a description of the national healthcare issue/stressor you selected for analysis, and explain how the healthcare issue/stressor may impact your work setting. Then, describe how your health system work setting has responded to the healthcare issue/stressor, including a description of what changes may have been implemented. Be specific and provide examples.
Staffing Shortages as a National Health are Issue/Stressor
Staffing shortages in the health care industry have become a major issue and source of stress across the country. It is no secret that nurses work extremely hard. Patient loads are rapidly increasing as a result of impending staffing shortages in the health care profession and an increase in the volume of patients seeking care services, making it difficult for nurses who are already understaffed to manage all patient care needs effectively and efficiently (Bakhamis et al.,2019). The United States is experiencing a severe nursing shortage, which is only expected to worsen. Nursing positions are not being filled quickly enough to keep up with demand due to an influx of patients into our health system, the retirement of baby boomers, and educational bottlenecks (Xue et al., 2016).
Impact on Work Setting
Staffing shortages can have a significant impact on the quality of work, on productivity, creativity, competitiveness, nursing care outcomes, and on ensuring patients’ safety (Norful et al., 2018). At my health care organization due to staffing shortage, nurses sometimes work long hours because other nurses calling in sick, running one to four hours late from working under very stressful conditions resulting in burnout, injury, fatigue, and job dissatisfaction. Nurses suffering in my health care facility delay treatments and make other mistakes due to the relationship of the nurse-to-patient ratio (Xue et al., 2016). An unfortunate outcome is that patient quality of care suffers, resulting in a variety of complications including emergency room overcrowding and delay of treatment.
Organizational Response and Changes Implemented
A variety of alternatives have been proposed to address the nursing shortage in my health care organization, including subsidized financing, recruiting new nurses, wage increases, and contracting with nursing agencies for nurses to fill in on a regular basis. My health-care firm offers tuition assistance to nurses who want to further their education. Furthermore, resources have been committed to increasing wages, which has impacted both recruitment and retention of Registered Nurses presently in the facility.
Another significant technique for addressing the nursing shortage is to provide nurses scheduling flexibility and coverage. This helps nurses to balance their hectic work schedule with family life and educational opportunities, as well as decompress between intense, emotionally draining shifts and days of work.
The nation’s health care system, and patients in particular, will benefit the most from adequate staffing and a healthy and well-rested nurse because efficiency and productivity will increase, the number of work-related mistakes will be reduced, sick leaves will be rare and shorter, and burnout will be less common (Norful et al., 2018). By using the aforementioned measures, we would not only boost health-care staffing but also lower the rate of stress-related disease among nurses, as well as considerably improve healthcare quality and patient outcomes.
References
Bakhamis, L., Paul, D.P., Smith, H., & Coustasse, A. (2019). Still an Epidemic: The Burnout
Syndrome in Hospital Registered Nurses. Health Care Manag (Frederick); 38(1):3-10
Norful, A. A., de Jacq, K., Carlino, R., & Poghosyan, L. (2018). Nurse practitioner-physician
comanagement: A theoretical model to alleviate primary care strain. Annals of Family
Xue, Y., Ye, Z., Brewer, C., & Spetz, J. (2016). Impact of state nurse practitioner scope-of-
practice regulation on health care delivery: a systematic review. Nurs Outlook;
64(1):71-85.
By Day 6 of Week 1
Respond to at least two of your colleagues on two different days who chose a different national healthcare issue/stressor than you selected. Explain how their chosen national healthcare issue/stressor may also impact your work setting and what (if anything) is being done to address the national healthcare issue/stressor.
Submission and Grading Information
Grading Criteria
To access your rubric:
Week 1 Discussion Rubric
Post by Day 3 and Respond by Day 6 of Week 1
To participate in this Discussion:
Week 1 Discussion
Module 1: Healthcare Environment (Weeks 1-2)
Laureate Education (Producer). (2018). The Healthcare Environment [Video file]. Baltimore, MD: Author.
Learning Objectives
Students will:
- Analyze current national healthcare issues/stressors
- Analyze the impact of national healthcare issues/stressors on healthcare organizations
- Analyze strategies for addressing national healthcare issues/stressors
| Due By | Assignment |
| Week 1, Days 1–2 | Read the Learning Resources. Compose your initial Discussion post. |
| Week 1, Day 3 | Post your initial Discussion post. Begin to compose your Assignment. |
| Week 1, Days 4-5 | Review peer Discussion posts. Compose your peer Discussion responses. Continue to compose your Assignment. |
| Week 1, Day 6 | Post two peer Discussion responses. |
| Week 2, Days 1–6 | Continue to compose your Assignment. |
| Week 2, Day 7 | Deadline to submit your Assignment. |
Learning Resources
Required Readings
Broome, M., & Marshall, E. S. (2021). Transformational leadership in nursing: From expert clinician to influential leader (3rd ed.). New York, NY: Springer.
- Chapter 2, “Transformational Leadership: Complexity, Change, and Strategic Planning” (pp. 34–62)
- Chapter 3, “Current Challenges in Complex Health Care Organizations and the Quadruple Aim” (pp. 66–97)
Read any TWO of the following (plus TWO additional readings on your selected issue):
Required Media
Laureate Education (Producer). (2015). Leading in Healthcare Organizations of the Future [Video file]. Baltimore, MD: Author.
Rubric Detail
Select Grid View or List View to change the rubric’s layout.
The rising cost of health care has had a massive impact on clinical care. Individuals are avoiding seeking care due to a lack of insurance coverage or financial resources to pay for care. This makes it difficult for clinical providers to prevent illness, resulting in an increase in unhealthy citizens. Furthermore, the rising cost of healthy meal options has resulted in an increase in underlying health conditions such as obesity, diabetes, and heart disease. The United States is the only high-income country that lacks publicly funded universal health care (Bush, 2018). This results in systemic disparities, which lead to poor health and social inequities. Chronic illness is becoming more prevalent in underserved populations, resulting in higher rates of life-threatening illnesses in the hospital setting.
The passage of the Affordable Care Act resulted in some improvements in access to care. It provided insurance to all patients and provided incentives to providers to ensure that patients receive care before their illness requires them to visit the emergency room or be hospitalized (Barkholz and Herman, 2016). Concerns for healthcare employees grew exponentially after the Trump administration worked to repeal these changes. The Affordable Care Act altered financing, opening up new opportunities for nurses (Palumbo et al., 2017). Fear of losing these positions, combined with an increase in the number of uninsured Americans, created a lot of uncertainty among health care workers. The fee-for-service payment system used in US health care exemplifies how volume of service is still deemed more important than value-based care (Park et al., 2018). Nurses in all clinical settings are affected by this.
As a worker at a Minnesota security hospital serving those who have been civilly committed and are deemed “mentally ill and dangerous,” I am directly affected by the fluctuating costs of health care. Patients in my care have no choice but to attend treatment, which means that many of them cannot afford the cost of care. Because they are required by law to be housed in our facility, Minnesota taxpayers pay for a large portion of their care. Because health-care costs are so high, patients are frequently denied adequate care because the government cannot afford it. It is unfortunate that outdated systems and lower quality of care are being seen as a result of state funding. If health-care costs were not increasing so rapidly, mental health facilities like these would likely see higher rates of success and improved patient health.
Working for a state-run facility presents some financial and budgetary challenges. During COVID-19, our facility experienced even larger budget cuts, resulting in changes in staffing and significant layoffs. The majority of the layoffs were in direct care staff, causing safety concerns. Because the cost of care is so high, there are growing concerns about safety in state-run facilities. Time is no longer allotted for shift changes, resulting in inconsistent care and an increased risk of injury on the job. Despite the fact that several staff members approached upper-level management, no changes were made. Staffing remains scarce, and employee injuries are on the rise. It is unfortunate that no changes have been made despite advocation. It has become clear that the costs associated with care are excessive, putting both patients and staff members at risk.
As we can see, universal health care coverage would benefit both health care workers and patients across the board. As the cost of care continues to rise, there has been an increase in chronic illness and death. The number of people who cannot afford health insurance is causing major problems in our society. As we move forward, we must continue to advocate for changes in our health-care system on a political level. America’s health-care industries have largely become for-profit. We must work to change these perceptions and promote health care as a right rather than a privilege.
References
Barkholz, D. & Herman, B. (2016). Threat of ACA repeal fuels angst at hospitals. Modern
Healthcare, 46(46), 19. .
Bush, M. (2018). Addressing the root cause: Rising health care costs and social determinant of
health. North Carolina Medical Journal, 79(1), 26-29. .
Palumbo, M.V., Rambur, B., & Hart, V. (2017). Is health care payment reform impacting nurses’
work settings, roles, and education preparation? Journal of Professional Nursing, 33(6), 400-404. .
Park, B., Gold, S.B., Bazemore, A., & Liaw, W. (2018). How evolving United States payment
models influence primary care and its impact on the quadruple aim. The Journal of the American Board of Family Medicine, 31(4), 588-604. .
A Description of a National Healthcare Issue/Stressor (Nurse Shortage) and How it May Impact My Work Setting
Healthcare facilities must provide high-quality care to improve patient experience, satisfaction, and outcomes (Gray et al., 2018). Several issues/stressors have inhibited the provision of high-quality healthcare services, leading to high costs and unsatisfactory care. Haddad et al. (2020) say healthcare organizations are facing a nurse shortage. The aged population has different health conditions, with some requiring full-time palliative care, thus more nurses are needed to care for them. Pandemics like covid-19 have stretched healthcare institutions due of the growth in patient population, requiring more nurses to provide care.
During covid-19, our patient population increased, thus new staffing models were devised to ensure all patients received high-quality treatment. A study by Drennan & Ross (2019) found that a scarcity of nurses has contributed to increasing nurse burnout. Shortage of nurses affects patients, available nurses, and the healthcare facility owing to nurse burnout. Our healthcare facilities’ management ensures all nurses are covid-19-vaccinated to provide high-quality, safe nursing care. Vaccination is a personal decision, hence the facility faced nurse turnover due to the instruction, leading to a nurse shortage. The unbalanced nurse-to-patient ratio has hampered the delivery of high-quality healthcare.
How my Health System Work Setting Has Responded to the Healthcare Issue/Stressor and What Changes May Have Been Implemented
Our health system work setting is responding to the issue by recruiting more nurses to replace those that quit and the management is making sure that the recruited nurses are all vaccinated. This helps in spreading the virus as well as proving safe healthcare services to patients. Additionally, new staffing models have been developed to allow flexible shifts and appropriate nurse-to-patient ratios, which has greatly improved the quality of healthcare services, patient experience, patient satisfaction, as well as patient outcomes (Marć et al., 2019). As advised by Broome & Marshall (2021), our healthcare system has allowed healthcare providers and nurses to be involved in developing solutions for issues that arise in the facility and this has played a significant role in developing strategies that improve patient care while reducing nurse burnout and turnover.
It is important to understand that nurse shortage leads to nurses doing extra work without rest thus resulting in nurse burnout and most instances, healthcare facilities witness nurse turnover due to burnouts (Drennan & Ross, 2019). Therefore, changes that are being implemented in our healthcare setting include new staffing models that allow flexible shifts and appropriate nurse-to-patient ratios and the employment of nurses that meet the qualifications or standards set by the organization. These changes will greatly help in reducing the nurse shortage issue as well as improving the quality of services provided to patients by providing coordinated and patient-centered care which is the ultimate goal of care facilities.
References
Broome, M., & Marshall, E. S. (2021). Transformational leadership in nursing: From expert clinician to influential leader (3rd ed.).
Drennan, V. M., & Ross, F. (2019). Global nurse shortages: The facts, the impact, and action for change. British medical bulletin, 130(1), 25-37. DOI: 10.1093/bmb/ldz014
Gray, K., Wilde, R., & Shutes, K. (2018). Enhancing nurse satisfaction: an exploration of specialty nurse shortage in a region of NHS England. Nursing Management, 25(1). DOI: 10.7748/nm.2018.e1695
Haddad, L. M., Annamaraju, P., & Toney-Butler, T. J. (2020). Nursing shortage. StatPearls [Internet].
Marć, M., Bartosiewicz, A., Burzyńska, J., Chmiel, Z., & Januszewicz, P. (2019). A nursing shortage–a prospect of global and local policies. International nursing review, 66(1), 9-16.
Content
Name: NURS_6053_Module01_Week01_Discussion_Rubric
| Excellent | Good | Fair | Poor | ||
| Main Posting | Points Range: 45 (45%) – 50 (50%)
Answers all parts of the discussion question(s) expectations with reflective critical analysis and synthesis of knowledge gained from the course readings for the module and current credible sources.
Supported by at least three current, credible sources.
Written clearly and concisely with no grammatical or spelling errors and fully adheres to current APA manual writing rules and style. |
Points Range: 40 (40%) – 44 (44%)
Responds to the discussion question(s) and is reflective with critical analysis and synthesis of knowledge gained from the course readings for the module.
At least 75% of post has exceptional depth and breadth.
Supported by at least three credible sources.
Written clearly and concisely with one or no grammatical or spelling errors and fully adheres to current APA manual writing rules and style. |
Points Range: 35 (35%) – 39 (39%)
Responds to some of the discussion question(s).
One or two criteria are not addressed or are superficially addressed.
Is somewhat lacking reflection and critical analysis and synthesis.
Somewhat represents knowledge gained from the course readings for the module.
Post is cited with two credible sources.
Written somewhat concisely; may contain more than two spelling or grammatical errors.
Contains some APA formatting errors. |
Points Range: 0 (0%) – 34 (34%)
Does not respond to the discussion question(s) adequately.
Lacks depth or superficially addresses criteria.
Lacks reflection and critical analysis and synthesis.
Does not represent knowledge gained from the course readings for the module.
Contains only one or no credible sources.
Not written clearly or concisely.
Contains more than two spelling or grammatical errors.
Does not adhere to current APA manual writing rules and style. |
|
| Main Post: Timeliness | Points Range: 10 (10%) – 10 (10%)
Posts main post by day 3. |
Points Range: 0 (0%) – 0 (0%) | Points Range: 0 (0%) – 0 (0%) | Points Range: 0 (0%) – 0 (0%)
Does not post by day 3. |
|
| First Response | Points Range: 17 (17%) – 18 (18%)
Response exhibits synthesis, critical thinking, and application to practice settings.
Responds fully to questions posed by faculty.
Provides clear, concise opinions and ideas that are supported by at least two scholarly sources.
Demonstrates synthesis and understanding of learning objectives.
Communication is professional and respectful to colleagues.
Responses to faculty questions are fully answered, if posed.
Response is effectively written in standard, edited English. |
Points Range: 15 (15%) – 16 (16%)
Response exhibits critical thinking and application to practice settings.
Communication is professional and respectful to colleagues.
Responses to faculty questions are answered, if posed.
Provides clear, concise opinions and ideas that are supported by two or more credible sources.
Response is effectively written in standard, edited English. |
Points Range: 13 (13%) – 14 (14%)
Response is on topic and may have some depth.
Responses posted in the discussion may lack effective professional communication.
Responses to faculty questions are somewhat answered, if posed.
Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited. |
Points Range: 0 (0%) – 12 (12%)
Response may not be on topic and lacks depth.
Responses posted in the discussion lack effective professional communication.
Responses to faculty questions are missing.
No credible sources are cited. |
|
| Second Response | Points Range: 16 (16%) – 17 (17%)
Response exhibits synthesis, critical thinking, and application to practice settings.
Responds fully to questions posed by faculty.
Provides clear, concise opinions and ideas that are supported by at least two scholarly sources.
Demonstrates synthesis and understanding of learning objectives.
Communication is professional and respectful to colleagues.
Responses to faculty questions are fully answered, if posed.
Response is effectively written in standard, edited English. |
Points Range: 14 (14%) – 15 (15%)
Response exhibits critical thinking and application to practice settings.
Communication is professional and respectful to colleagues.
Responses to faculty questions are answered, if posed.
Provides clear, concise opinions and ideas that are supported by two or more credible sources.
Response is effectively written in standard, edited English. |
Points Range: 12 (12%) – 13 (13%)
Response is on topic and may have some depth.
Responses posted in the discussion may lack effective professional communication.
Responses to faculty questions are somewhat answered, if posed.
Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited. |
Points Range: 0 (0%) – 11 (11%)
Response may not be on topic and lacks depth.
Responses posted in the discussion lack effective professional communication.
Responses to faculty questions are missing.
No credible sources are cited. |
|
| Participation | Points Range: 5 (5%) – 5 (5%)
Meets requirements for participation by posting on three different days. |
Points Range: 0 (0%) – 0 (0%) | Points Range: 0 (0%) – 0 (0%) | Points Range: 0 (0%) – 0 (0%)
Does not meet requirements for participation by posting on 3 different days. |
|
| Total Points: 100 | |||||
Name: NURS_6053_Module01_Week01_Discussion_Rubric
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