NURS FPX 4050 Assessment 2: Ethical and Policy Factors in Care Coordination

Peeches Headlam

Capella University

30 June 2021
Ethical and Policy Factors in Care Coordination 2

Ethical and Policy Factors in Care Coordination

Care coordination is defined as the process in which the different participants involved in

the care of a patient interact and correspond with one another to give better outcomes and quality

of services (“Care Coordination,” 2014). There are many different factors that can deter and aid

the process of care coordination. The importance of Care Coordination is unequivocal, since the

absence of proper cooperation between different participants can lead to destructive results,

leaving the patient mentally and physically marred.

In this paper, the aim is to discuss the effect which ethical factors has on care

coordination, and what role government policies play during the process. Ethical factors from the

nurse’s perspective are also an aspect of importance in the care continuum and coordination.

When providing health care, there are many different ethical factors that come into play.

When deciding on which course of action to take, the nurses can practice priority based on age,

gender and previously underlying medical condition. It is up to the nurse to conduct an analyses

to adequately understand the standing of a number of patients, and to expertly provide healthcare

to them in the order required. An example that can be served to delineate this point is if two

patients are to simultaneously enter a hospital, only to find one bed to be free, it would resolve to

the administration to assess and evaluate the involved ethical factors to decide what course of

action to take. These sorts of decisions and responses are governed by the Code of Conduct,

which will be discussed in detail in this paper.

How Governmental Policies Affect Coordination of Care

In the United States, the provision of healthcare and care coordination is vastly governed

by governmental policies. There are a number of different policies that are active in the United

States as a result of the efforts of the Department of Health and Human Services (Regis College
Ethical and Policy Factors in Care Coordination 3

Online, 2021), a couple of which will be described in this paper to portray exactly what effect

such policies can have on healthcare.

Government policies can lay out various guidelines and instructions for institutes and

healthcare professionals to follow. The reason behind the enforcement of certain guidelines from

the government can be to enhance the provision of healthcare, safeguarding the rights of the

patients and so forth. Furthermore, policies can encourage professionals to adopt certain

measures when dealing with patients. Similarly, policies can also act as a motivation for

professionals to pursue a certain mode of treatment or interaction when dealing with patients.

To further understand how government policies affect care coordination, the example of

the Hospital Readmission Reduction Program can be taken. The main function of the HRRP is to

reduce the number of readmissions. This is done by encouraging the healthcare service providers

(nurses, doctors etc.) to efficiently and expertly discuss post-discharge plans with patients in

order to help them recover better, in turn enabling them to avoid readmissions for problems that

are manageable (CMS.gov, n.d.).

The way this policy affects care coordination is that it encourages the different healthcare

service providers to actively and expertly communicate with one another, and the patients with

the objective of delineating to them the various aspects necessary for the after-discharge

recovery and treatment. By keeping the motivation of reduced readmissions, this policy serves to

improve the quality of coordination and collaboration between patient and professional.

In light of the above argument and the example stated above, it can be seen that this

particular policy reflects positively on coordination of care.

National, State, or Local Policy Provisions that Raise Ethical Dilemmas

Ethical and Policy Factors in Care Coordination 4

There are a few policy provisions that can raise ethical dilemmas, and create implications

for care coordination. The first policy provision that can be scrutinized is the Affordable Care

Act of 2010. The essence of the Affordable Care Act was the obligation and enforcement of

securing health insurance, the failing of which would culminate in the levying of fines (Regis

College Online, 2021). From an unbiased perspective, it is quite apparent what ethical

complications and dilemmas the ACA can bring about. The ethical corruption of the ACA can be

attributed primarily to the aspect of religion. The concept of insurance is an aspect of prohibition

in the fastest growing religion in the world viz. Islam. Since the concept of insurance is subjected

to prohibition in the third largest religion in the USA, the ACA which is advocating and stressing

upon insurance can be seen as an aspect causing ethical unrest and dilemmas. Coming to the

effect this has on care coordination, since the lack of insurance will result in fines and penalties,

a person who is not insured will not be able to get treated and medically aided. When such

discrepancies can occur on the basis of insurance, it can lead to turbulence in the process of care

coordination. It can get exceedingly hard for a person without insurance to get treated. If such a

person can get partially treated, he can face complications going forward, based on the lack of

insurance.

Another policy that can be enumerated in this regard is the HRRP discussed previously.

While the concept behind the HRRP was seen to be advantageous, as it encouraged doctors and

nurses to better engage and communicate with the patients (CMS.gov, n.d.), there is the chance

of ethical complications erupting from it. The complications that can rise from the HRRP can

culminate from the possibility of a patient getting misunderstood, or the condition misdiagnosed,

which can lead to denial of admission.

Impact of Code of Ethics of Nurses on the Coordination and Continuum of Care

Ethical and Policy Factors in Care Coordination 5

There are four main points of the Nurses’ Code of Ethics. To elaborate the impact of each

on the coordination and continuum of care, all four will be enumerated.

Firstly comes the factor of Autonomy. The discretion and the decision-making is to be

handed over to the patient as far as deciding between different treatments and medications

etcetera is concerned. It is imperative for the nurse to present the viable options to let the patient

choose on his or her discretion (Gaines, 2020). This impacts coordination and continuum of care

as it helps the patient know all about how he is being treated. Since he is making the decisions,

he will be able to properly portray and explain the treatment process to any future doctor.

Then, there is the beneficence factor which helps in creating good relationships between

nurses and patients, which in itself is conducive to better cooperation (Gaines, 2020).

Then follows the Justice factor. This aspect of the code of ethics demands that the nurses

don’t act out of any degree or trace of racism or prejudice. Regardless of age, gender, race and

ethnicity, the care given by the nurses must be the same (Gaines, 2020). This helps in care

coordination and continuum as better bonds will be formed between the patient and nurse.

Finally, there is ‘Non-maleficence’ which means to cause no harm (Gaines, 2020). This

point means that the nurses must opt for ways which are least deteriorative and harmful to the

patient. This helps in the coordination of care as trust will be created between the patient and

nurse.

Conclusion

Governmental policies can affect care coordination vastly. In this paper, the purpose was

to describe how exactly governmental policies affect coordination of care along with some

examples. Policies like the ACA and HRRP were enumerated and elucidated.
Ethical and Policy Factors in Care Coordination 6

Furthermore, the nurses’ code of ethics also features some points and aspects that has an

impact on the care coordination. These points, along with the perceived effects, were

enumerated.
Ethical and Policy Factors in Care Coordination 7

References

Care Coordination. (2014). Retrieved from https://www.ahrq.gov/ncepcr/care/coordination.html

CMS.gov. (n.d.). Hospital Readmissions Reduction Program (HRRP). Retrieved from

https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/

Readmissions-Reduction-Program

Gaines, K. (2020). What is the Nursing Code of Ethics? Retrieved June 18, 2021, from

https://nurse.org/education/nursing-code-of-ethics/

Regis College Online. (2021, April 22). 8 Important Regulations in United States Health Care.

Retrieved June 18, 2021, from https://online.regiscollege.edu/blog/8-important-

regulations-united-states-health-care/

McDonald, K. M., Sundaram, V., & Bravata, D. M. (2007). Closing the Quality Gap: A Critical

Analysis of Quality Improvement Strategies (Vol. 7: Care Coordination). Agency for

Healthcare Research and Quality (US).