Assignment Organizational Policies Practices Development

Developing Organizational Policies and Practices Sample Paper

Walden University

NURS6053C: Interprofessional Organizational and Systems Leadership

June 14, 

Assignment Organizational Policies Practices Development Sample Paper

Escalating health costs is a healthcare stressor that continues to affect the majority of the care facilities in the United States. According to a report published by the Peter G. Peterson Foundation (2019), the United States healthcare system is associated with the highest costs across the globe, and the trend is expected to continue if appropriate strategies are not put in place to address the issue. As at present, the United States spends approximately $11,000 per individuals, with overall expenditure hitting approximately $3.65 trillion in 2018 (Sherman, 2019).

Further, the report also indicates that healthcare expenditure as a percentage of GDP has increased from 5.6% in 1960 to approximately 18% in 2017 (Peter G. Peterson Foundation, 2019). Various factors have been attributed to the increasing costs, including the increasing American population, increased costs of drugs and also advanced disease diagnosis and treatment technologies, which require heavy financial investment and expenditure by the patients during hospital visits (Bradley, Sipsma & Taylor, 2016).

The need for quality, efficient and patient-centric care and the need for maintaining minimum costs are two competing healthcare needs that greatly affect the prevailing trends with respect to healthcare costs.

Competing Needs

The main aim of setting up a care facility is usually to provide the targeted population with quality care services and improve their health outcomes. Over the decades, the UCLA Medical Center has shown commitment towards providing quality patient-centric services, by ensuring that the hospital services are offered in a manner that is safe, efficient, equitable and timely (UCLA Health, 2018).

However, being a not for profit organization, it remains critical for the organization to control its cost and be able to sustain its operations from income generated via government grants, subsidized patient payments, healthcare insurance payments, and charity contributions from well-wishers. Goodpasture (2019) explains that unlike for-profit organizations, non-profit making organizations usually require tight financial management in order to remain operational as they lack profit margins to cushion expenses that are not captured in the base plan.

The limited financial resources by the organization, therefore, necessitate the need for strict control on the various costs, which may have vast adversities on the hospital operations in both short term and long-term. The strict control of the hospital costs often compromise the quality of care, and the organization management has to strike a balance between the quality of care and the expenditure.

According to Reiss-Brennan et al. (2016), healthcare facilities that are characterized by high spending in medical technologies such as the use of electronic health records, telehealth, modern medical equipment and even recruitment of more nursing professionals are more likely to provide quality care as compared to those with little expenditure on vital resources in an effort to reduce costs.

Guven?Uslu and Seal (2018) bring in the concept of costs transfer, whereby the costs incurred by a care facility in acquiring a specific technology, asset, device, medication and even payment of health professionals is directly and indirectly transferred to the patents, partially or wholly. Owing to the fact that individual income and even healthcare covers do not grow at the same rate with the healthcare costs, with time, individuals become incapable of paying for the healthcare services using their own income or through the health covers.

This is well exemplified in the case of insulin, whereby the prices of insulin increased by 12% from 2012 to 2016, making it one of the most expensive drugs to acquires, and which is not even covered under Medicare (Reuters, 2019). Owing to the complexity associated with cost control without comprising the quality of care, UCLA Medical Center management is always looking for innovative ways that can be used to enhance patient care and overall patient experience without necessarily increasing the prices for the care services.

Policy That May Influence Healthcare Stressor

One of the organizational policies that may influence the increasing healthcare costs is the Disclosure of Medical Error Policy (DMEP). DMEP is a policy that is focused on ensuring that every medical error that happens in the care facility is reported and an appropriate action take (Levinson, Yeung, and Ginsburg, 2016).

Essentially, medical errors, directly and indirectly, contribute to increasing costs of care to the patient, the hospital, and the government. For instance, a report by Rodziewicz and Hipskind (2019) shows that medical errors account for approximately $20 billion of the U.S annual healthcare costs, characterized by approximately 100,000 deaths, 400,0000 hospitalizations, and countless missed diagnosis and injuries.

At UCLA Medical Center, various cases of medical errors are often reported and usually account for a significant percentage of the increased costs by the hospital, as such errors make the hospital liable for the treatment of the patient for any injury suffered. Though the hospital encourages the reporting of medical errors through various channels and has an outlined procedure, tit lacks clear and explicit policy to address the occurrence and reporting of medical errors. As such, a significant number of medical errors go unnoticed, an aspect that compromises the patient health outcomes and the quality of care delivered.

DMEP can greatly deter the commission of the medical errors by the nurses and can aid in cutting down the escalating costs. This is because DMEP encourages accountability, dependability, and responsibility by the nurses, hence eliminating chances of negligence as well as uninformed decision-making, which harbor medical errors (Levinson et al., 2016).

Critique of the Policy

Whereas DMEP bears the ability of reducing the healthcare costs, improving the quality of care, and enhancing the patient health outcomes, it also suffers from various limitations. First, it is critical to understand that DMEP is made to foster sound ethical practices by the nurses by ensuring that medical errors that are accidental or deliberate are eliminated and that the nurses are accountable for their actions (Levinson et al., 2016).

However, UCLA Medical Center experiences high patient influx, and more often than not, the nurses are overworked, which results in fatigue, burnouts, and increased stress. This makes nurses prone to making various medical errors. Having a strong policy that restricts the commission of medical errors but does not put in place measures to aid in reducing such error may result in the nurses circumventing the workplace regulations and procedures whenever an error is made (Hutchinson, Jackson & Wilson, 2018).

From an ethical perspective, whereas the nurses are liable for deliberate commission of the medical error, they cannot be held liable in instances whereby the commission of such errors is perpetrated by an existing condition in the organizations, such as the lack of proper process control measures and mechanisms for preventing the errors. For example, according to Provision 1 of the ANA code of ethics, “the nurse promotes, advocates for, and protects the rights, health, and safety of the patient” (VCU Health, 2019).

However, nurses are unable to uphold this provision if the organizational systems in play are incapable of steering the health and safety of the patient. (Olson & Stokes, 2016). A critical strength of the policy is however that, it bears the ability to improve the overall quality of care if the necessary organizational resources are pooled together to promote its implementation, such as the rollout of an integrated Electronic Health Records (EHR) system that provides extremely reliable and relevant clinical data to the nurses, hence promoting  informed decision-making (Levinson et al., 2016).

Recommendations

A nursing practice that can aid in balancing the need to maintain minimum costs and the need to provide quality patient-centric care is the adoption of the Triple Aim Model, developed by the Institute for Healthcare Improvement. According to the Institute for Healthcare Improvement (2019), the triple aim framework seeks to improve the patient experiences, reduce the cost of care, and improve the health of the targeted populations. To successfully implement this framework, UCLA Medical Center, would need to embrace a systematic approach to change.

This change would be focused on improving the existing operations and processes to ensure that they are construed towards high efficiency, while at thesame time identifying the various areas where the organization is underperforming. To achieve this, UCLA Medical Center would need to identify the individuals and families targeted by the care facilities, the health prevention and promotion measures in place, how the primary care structured and services and be redesigned, the cost control approach applicable, and how various changes can be integrated into the hospital curative systems (Institute for Healthcare Improvement, 2019).

The triple aim approach would aid the hospital in achieving quality care, while at the same time reducing the cost and improving patent experiences.

On the same note, process re-engineering techniques can also be applied. Process re-engineering aids in the analysis of a process to identify any area that associated with significant wastes and formulate effective strategies geared towards streamlining such (Musa & Othman, 2016). Process re-engineering and the triple aim framework can aid in identifying defective healthcare policies in place, such as lack of explicit reporting guidelines for medical errors and which promote the ethical cases of deliberately unreported errors.

Secondly, these approaches would ensure that nurses are provided with sufficient resources to perform their duties. For instance, the two approaches would alleviate burnouts, workplace stress, and fatigue, and eliminate the ethical implications of overworked nurses with respect to the occurrence of medical errors.

Assignment Organizational Policies Practices Development References

1. Bradley, E. H., Sipsma, H., & Taylor, L. A. (2016). American health care paradox—High spending on health care and poor health. QJM: An International Journal of Medicine, 110(2), 61-65.
2. Goodpasture, J. E. (2019). Calculation of foregone taxes and community benefit for Florida not-for-profit hospitals. International Journal of Healthcare Management, 12(2), 137-140.
3. Guven?Uslu, P., & Seal, W. (2018). Transfer prices and innovation in public healthcare: Costing and clinical choices in the NHS. Financial Accountability & Management.
4. Hutchinson, M., Jackson, D., & Wilson, S. (2018). Technical rationality and the decentring of patients and care delivery: A critique of ‘unavoidable’in the context of patient harm. Nursing Inquiry, 25(2), e12225.
5. Institute for Healthcare Improvement. (2019). The IHI triple aim. Retrieved from http://www.ihi.org/Engage/Initiatives/TripleAim/Pages/default.aspx
6. Levinson, W., Yeung, J., & Ginsburg, S. (2016). Disclosure of medical error. Jama, 316(7), 764-765.
7. Musa, M. A., & Othman, M. S. (2016). Business Process reengineering in healthcare: a Literature review on the methodologies and approaches. Review of European Studies, 8(1), 20-34.
8. Olson, L. L., & Stokes, F. (2016). The ANA code of ethics for nurses with interpretive statements: Resource for nursing regulation. Journal of Nursing Regulation, 7(2), 9-20.
9. Peter G. Peterson Foundation (2019). Why are Americans paying more for healthcare? Retrieved from https://www.pgpf.org/blog/2019/03/why-are-americans-paying-more-for-healthcare
10. Reiss-Brennan, B., Brunisholz, K. D., Dredge, C., Briot, P., Grazier, K., Wilcox, A. & James, B. (2016). Association of integrated team-based care with health care quality, utilization, and cost. Jama, 316(8), 826-834.
11. Reuters. (2019). U.S. insulin costs per patient nearly doubled from 2012 to 2016, the study finds. NBC News. Retrieved from https://www.nbcnews.com/health/diabetes/u-s-insulin-costs-patient-nearly-doubled-2012-2016-study-n961296
12. Rodziewicz, T. L., & Hipskind, J. E. (2019). Medical error prevention. In StatPearls [Internet]. StatPearls Publishing. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK499956/
13. Sherman, E. (2019). U.S. Health care costs skyrocketed to $3.65 trillion in 2018. Fortune. Retrieved from http://fortune.com/2019/02/21/us-health-care-costs-2/
14. UCLA Health (2018). Cost of care and price transparency. Retrieved from https://www.uclahealth.org/price-transparency
15. VCU Health. (2019). ANA code of ethics. Retrieved from https://www.vcuhealth.org/for-medical-professionals/nursing/about-nursing-at-vcu/ana-code-ethics.

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