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ORGANIZATIONAL POLICIES AND PRACTICES TO SUPPORT HEALTHCARE ISSUES
First discussion
Competing needs profoundly influence policy development within the healthcare sector, necessitating strategic responses to address multifaceted care delivery challenges. Crafting organizational policies becomes pivotal in standardizing practices and ensuring effective healthcare interventions (Kelly & Porr, 2018). Specifically, in home health nursing, competing needs, such as the strain on the workforce versus ensuring patient safety, significantly impact policy formulation and implementation, directly influencing patient outcomes (Milliken, 2018; Moore et al., 2023).
In the home health setting, the competition between nurses’ overwhelming workload and the imperative of maintaining patient safety, quality care, and overall satisfaction presents a critical challenge. Home Health nurses navigate a multitude of responsibilities, including traveling between patient homes, carrying out orders, managing communications, and handling complex familial dynamics alongside direct patient care. The exhaustive documentation requirements also exacerbate their workload, demanding meticulous attention and time (Head et al., 2019).
The repercussions of this imbalance are far-reaching. Overwhelmed nurses may feel pressured and rushed, compromising their ability to offer comprehensive care and fulfill administrative duties promptly. This not only affects patient satisfaction but also poses risks to patient safety. Inadequate or delayed documentation might lead to misunderstandings in care continuity, potentially resulting in adverse patient outcomes due to missing or outdated information for subsequent visits (Russell et al., 2021).
The gravity of this issue extends beyond organizational efficiency; it directly impacts patient safety and care quality. According to Ellenbecker et al. (2018), the Centers for Medicare and Medicaid Services (CMS) estimates that 8,090 home health care agencies in the United States provide care for more than 2.4 million elderly and disabled people annually. Medicare beneficiaries who are in poor health, have low incomes, and are 85 years of age or older have relatively high rates of home health care use. The vulnerability of the patient population, often comprising the elderly or chronically ill individuals without robust support networks, intensifies the responsibility of ensuring meticulous and timely care delivery.
Addressing these competing needs through policy interventions involves optimizing workforce management, reassessing nurse workload by considering patient acuity, providing adequate resources and accessible administrative and clinical support to nurses, streamlining documentation processes, and implementing strategies that prioritize patient care without compromising safety or quality. For instance, establishing enforceable documentation standards and advocating for technology integration can mitigate risks associated with delayed or incomplete charting (Maglalang et al., 2021). Moreover, policies promoting training, education, and workload management for home health nurses can enhance their efficiency without compromising patient care (Garcia et al., 2019).
A balanced policy framework is crucial, emphasizing labor efficiency while upholding patient safety and care standards. This strategic policy approach aims to foster a healthcare system that equally prioritizes patient care and operational efficiency by aligning the demands of patients, staff, and resources.
In conclusion, effective policy development in the home health sector must recognize and reconcile these competing needs to ensure optimal care delivery. Integrating these strategies into policy frameworks aligns with the broader context of social determinants of health and ethical obligations within healthcare delivery, ultimately enhancing patient outcomes and care quality in home health settings.
Second discussion
Competing needs are when the needs of the patients and the working staff do not align with the healthcare organization. These needs affect patient care and the nursing staff resulting in decreased patient satisfaction and nurse burnout. (Kelly, P., Porr, C., 2018) “Delivery Within the past few decades of healthcare reform we have witnessed healthcare organizations shift from a treat-heal-care model to a more corporate or business paradigm, with emphasis on efficiency and cost outcomes as opposed to patient outcomes. This shift occurred in response to various challenges, namely the mandate for public administrators to maintain an efficient, effective, and equitable healthcare system.” With these changes, patient satisfaction is still the goal of the healthcare organization. The bottom line for most hospitals, including nonprofit hospitals, is making money. This is very frustrating for everyone nurses and patients. As caregivers in health care today, nurses have a diverse list of responsibilities. competing priorities is a cause of burnout. Origination should aid the staff in this because it negatively affects care for patients. It has been my experience over the last 25 years of being a nurse that there are very few outlets for nurses to help with the feeling of being spread too thin or that they cannot keep up with the needs of their patients and all the requirements of the hospital such as ever-changing policies, education requirements, and never-ending charting. With everything that is required from the nursing staff very few rewards are offered, such as pay raises or cost-effective benefit packages. A lot is expected from the nurses, and little is given back which makes for unhappy, burnout nurses. In turn, many nurses are leaving the workforce or changing hospitals in search of a better job. (Jean, Y. 2023) “Nursing shortages lead to errors, higher morbidity, and mortality rates. In hospitals with high patient-to-nurse ratios, nurses experience burnout and dissatisfaction, and the patients experience higher mortality and failure-to-rescue rates than facilities with lower patient-to-nurse ratios. Some states have begun to pass legislation to limit patient-to-nurse ratios. Despite this, when staffing is short, ratios go up to meet the need.” The nurses are always expected to accept the assignments they are given, no matter what legislation states. Hospitals will always sacrifice the nurses to fill every bed in the hospital regardless of the stress it causes.
(aha.org 2022) “The AHA urges Congress and the Biden Administration to prioritize funding that supports the health care workforce needs of the country in the wake of the COVID-19 pandemic and into the future.” There are many needs facing the healthcare workforce such as schools turning away over 80,000 qualified applicants from baccalaureate and graduate programs in nursing in 2019 alone due to a lack of qualified faculty, availability of clinical sites and preceptors. Low salaries are one of the main reasons for the lack of nurse educators. Something must be done to provide funding for education and to provide ways to stop staffing shortages or there will be no qualified nurses left to care for the patients. (aha.org 2022) “Rising clinician burnout — accelerated by the pandemic — calls for national support. A recent National Academy of Medicine report suggests that between 35% and 54% of U.S. nurses and physicians have symptoms of burnout, which it characterizes as high emotional exhaustion, high depersonalization (i.e. cynicism), and a low sense of personal accomplishment from work. Hospitals and health systems are deploying a range of programs and interventions to assist their workforce. However, given the financial pressures posed by the pandemic, Congress should provide additional funding to support national research and demonstration programs related to clinician well-being. The AHA supported the passage of the Dr. Lorna Breen Health Care Provider Protection Act, which aims to prevent suicide, burnout, and behavioral health disorders among health care professionals.” I have yet to see any programs in my area that address mental health issues other than personal enrollment in counseling which sometimes is paid for by private insurance. I hope in the future to see programs that are offered by healthcare organizations to promote mental health and personal well-being.
