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Ethical and Policy Factors in Care Coordination

Rafael Cirino

NURS-FPX-4050

Professor Hope Taylor

May 2023
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Ethical and Policy Factors in Care Coordination

Hi, my name is Rafael Cirino, I would like to present to you a recording of some of the

ethical and policy considerations involved in care coordination.

Care coordination has been heavily impacted by many medical legal and ethical

considerations. The nursing home industry has been significantly impacted. Nonetheless,

understanding how to promote public awareness of critical ethical and policy concerns has been

critical. RNs have a moral duty to care for their patients for the whole of their treatment.

Electronic health records (EHRs) are likely to enhance the range of coordination of care in an

interdisciplinary medical setting. Care coordination may be challenging during hospital stays

that need participation from multiple departments, and appointments with outpatients.

Integrated care aims to improve how satisfied patients are with treatment, minimize readmission

rates, and shorten hospital stays.

Ethical and Policy Factors in Care Coordination

Care coordination has been profoundly affected by many challenges arising from the

intersection between healthcare law and ethics. The nursing home industry has been deeply

impacted by the ethical and regulatory difficulties that have been plaguing the healthcare sector

as a whole. But it is been crucial to figure out how to get the word out to the public about

pressing policy and ethical issues. A healthcare practitioner's ethical obligations extend

throughout the whole scope of patient care. Giving patients access to their electronic health

records (EHRs) is often all that is required for effective care coordination in today's modern,

multidisciplinary healthcare setting. Many disorders, however, need the involvement of several

services and insurance companies, making it challenging to organize treatment. The purpose of

integrated care is to improve outcomes like patient satisfaction, readmission rates, and duration

of stay.

Health Policy Issues that Influence the Coordination of Care

There is a possibility that EHRs may cause issues with care coordination. Healthcare

mistakes are caused by communication failures. Healthcare practitioners sometimes make

mistakes when it comes to patient records. Healthcare personnel that are unable to communicate

may make errors and disrupt patient care. To provide care of the highest possible standard,

nurses must adhere to a set of ethical guidelines, regulatory procedures, and professional

standards. The purpose is to keep hospital and nursing care workers healthy. Patient welfare and

charity are prioritized in ethics. Residents in nursing homes rely on nurses for care, prevention,

and recuperation. Care coordination may be hampered by health insurance arrangements. As a

result, minorities and the poor may have reduced access to medical care. Uninsured people will

have more difficulties. Without insurance, rising healthcare expenses may make treatment

impossible. Its effects on the effectiveness of patient treatment are evident right away.

Beneficence, nonmaleficence, autonomy, and justice are the cornerstones of care ethics. These

concepts assist nurse practitioners in making clinical decisions under pressure. Care

coordination and insurance go hand in hand. Patients who are not covered by the legislation,

particularly non-citizens, may have difficulty obtaining health insurance in the United States.

Undocumented immigrants may have difficulty affording medical treatment. It will alter the

way healthcare is delivered.

Policies affecting care coordination

The health and wellbeing of American citizens is the government's primary priority. The

authorized policies are essential because of the dramatic effect they have on the therapeutic

continuum. One of the HHS's main responsibilities is keeping patient information private.

Health care professionals and community organizations may now share patient information

thanks to HIPAA (Kaufman, 2022). Disclosure of a patient's (PHI) might undermine their

privacy and disrupt treatment coordination efforts.

Potentially far-reaching consequences for inter-facility medical record sharing may

result from the HIPAA law. With the passage of HIPAA, clinicians are now free to freely

discuss patient records between themselves. Throughout the coordination of care, PHI may not

be shared with parties unrelated to patient care. HIPAA allows a patient's closest personal
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associates to see their medical records (Oyeleye, 2021). The importance of the patient's bad

decisions, if any, increases. As a result, HIPAA is seen as critical to the open flow of health

information from patients for the sake of making decisions based on research.

Policies that raise Ethical Questions for Coordination of Care

The health and general fulfilment of patients are enhanced by the requirements placed

on nurses. HHS does a great job of achieving the federal government's healthcare objective.

Care coordination has suffered from the expanding national debt brought on by the Affordable

Care Act. Health insurance assistance is limited by legislation. Since Medicare and Medicaid do

not help non-taxpayers, many charity groups, like as homeless shelters, are typically overlooked

when creating criteria for excellent treatment and coordination. If a profession is considered

seriously, it must follow conventional education and regulating practices. Nursing ethics have

been impacted by laws aimed to safeguard nurses and their clients during decision-making.

Nurses may have to decide whether to disclose patient health information despite national

privacy regulations.

Nursing Ethics' Impact on Healthcare Delivery

The code of ethics may guide nurses on community service and evidence-based

practicing. All nurse practitioners, no matter their education level, region, or cultural

upbringing, are bound by the same code of ethics. Using the ANA code of ethics as a guide,

nurses may make moral decisions while caring for patients. Nurses who follow a code of ethics

may ensure that all patients get care (Hajiaghamohsen et al., 2022). Ethics may arise during

treatment. Nurses may consult the ANA's code of ethics for ethical assistance during patient

care. Nurses are responsible for making independent decisions on patient care. While healthcare

technology has reduced ethical grey areas, it may disrupt patient care. Care coordination may

raise moral discomfort and uneasiness. You might be fined, sued, suspended, or fired for

violating the code of ethics. A set of ethical standards to help professionals towards better

judgment is essential in the ever-changing nursing industry. It is imperative that nurses

consistently adhere to ANA ethics. Patients have to be treated the same way since there are not
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enough resources. On the other hand, medical professionals who violate the ethical code will be

held accountable for their actions.

Nursing Homes and Health Policies

Since HIPAA, people in places like nursing homes are safer and healthier than they

were before since providers may more easily access their medical data. The doctor-patient bond

strengthens. Following HIPAA regulations, Lum et al. (2020) sit is vital for nursing homes to

preserve the well-being and health of their patients since the availability of data encourages the

deployment of care coordination solutions. Healthcare policy has a major effect on nursing

home patients' standard of life and their security. Nursing home residents' lifespan and quality

of life are directly impacted by their health and happiness.

Ethical and Policy Issues Affecting the Continuum and Coordination of Care

Healthy People 2030 states the advantages of incorporating social variables, such as

physical relationships to enhance public care, are outlined in depth. The ACA safeguards

nursing home patients' privacy by promoting care ongoing in tandem (Houghton et al., 2022).

Care coordination and end-of-life choices are influenced by patients' rights to privacy about

their medical information. The financial impact of therapy on patients must be considered by all

medical providers. The quality of clinical care provided by nursing homes is subpar. There have

been a number of attempts to improve the law's implementation, but so far they have all failed.

Patients in nursing homes should not suffer because doctors and nurses do not know the rules

and guidelines.

Care Coordination and Policies in Nursing Homes

Healthcare coordination standards, such as the Affordable Care Act (ACA), have been

critical for the nursing home business since nursing homes typically assist patients with chronic

health conditions (Kotcher et al, 2023). Nursing home care may be covered by the patient's

health insurance at a reasonable premium. Patients may have peace of mind knowing that the

HIPAA standards will be adhered to regarding the confidentiality of their medical data. Family

members may rest certain that their loved ones are safe in a nursing home environment
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throughout the clock, every day of the week. However, in the United States, consumers may

choose from a number of health insurance policies that ensure they will get medical care in the

event of an illness or injury. The Patient Protection and Affordable Care Act ensures that those

who are already residing in nursing homes will have the opportunity to receive health care at a

lower cost to them. According to Kotcher et al. (2022), residents of nursing homes who have

access to comprehensive resident injury insurance are more likely to have a consistent sense of

safety. Constant care coordination in nursing homes is provided without jeopardizing the

privacy of patients' medical data. As a result of HIPAA and the Affordable Treatment Act,

patients residing in nursing homes now get treatment that is more coordinated and more

consistent with their needs.

HIPAA Policy Contribution to Nursing Home Coordination of Care

HIPAA's stringent restrictions have decreased the possibility of fraud and misuse

involving nursing home patients' sensitive health information. Despite the community

organization's concern about patient safety, HIPAA has protected the home care recipients'

bank accounts. Even if a patient withdraws consent for the release of their PHI, it must be

preserved for as long as is required by law. HIPAA has made it possible for residents of nursing

homes receiving coordinated and continuous care to access their medical records (Dineen-

Griffin et al., 2019). Nursing home residents may rest comfortably knowing that their personal

health information will be safeguarded in accordance with HIPAA regulations. It is probable

that those who live in nursing homes will profit quite a bit from the recently enacted legislation.

Encrypting personal health information and creating effective government and privacy breach

reporting processes are two major advantages.

Conclusion

Nursing homes are an essential community resource for those who need medical care

but cannot get it in their own homes or hospitals. There are a number of policy and ethical

issues that need to be discussed by the society at large. Patients now have easier access to

continuous, coordinated treatment as a result of HIPAA and the Affordable Treatment Act.
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Having a solid understanding of healthcare ethics and policy may increase one's capacity to

tackle clinical difficulties. Despite the constraints imposed by ethical concerns, the community

setting provides major advantages in terms of continuity and integrated care. The federal

government is responsible for addressing any moral and policy concerns that arise.
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