NURS 6053- Week 1 Discussion Review of Current Healthcare Issues
NURS 6053- Week 1 Discussion Review of Current Healthcare Issues
NURS 6053- Week 1 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).
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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).
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).
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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 nurses from my workplace are specifically hired when they transfer to other hospitals because it is assumed that if you can care for Grady patients, you can care for any patient anywhere.
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Methods by which my Healthcare Setting has responded to the aforementioned Concern
My healthcare facility is a non-profit organization that provides the highest quality of care, prompting the slogan “Atlanta cannot live without Grady.” According to a recent study, the United States’ health-care spending is higher than that of other countries, most likely due to higher prices and possibly more easily accessible technology, rather than higher income or an abundance of hospitals and doctors. Norbeck (2013) My healthcare setting implemented a cost-cutting policy in which uninsured or low-income patients can obtain a “Grady Card” if they meet the essential criteria. Patients must, however, be residents of one of the two communities we serve.
We have physician advisors, case managers, and utilization review personnel who review patients’ clinical information and follow up as needed to ensure proper diagnosis documentation for billing purposes and the ordering of only medically necessary procedures to avoid overbilling (Jackson et al., 2015).
Finally, case managers are constantly reviewing charts to ensure that physicians place Medicare patients who meet inpatient criteria on appropriate status, as this significantly reduces or eliminates the burden of healthcare costs on patients. The hospital ensures that discharge follow-up calls are made within 2-3 days of discharge. All arrangements, including transportation, were made to ensure patients’ compliance with follow-up visits, lowering the likelihood of readmission and ER utilization. Reducing readmissions is a current priority for my health-care system, and timely outpatient follow-up is emphasized as an essential component of transitional care models (Jackson et al., 2015).
If you were to ask 10 people what they believe to be the most significant issue facing healthcare today, you might get 10 different answers. Escalating costs? Regulation? Technology disruption?
These and many other topics are worthy of discussion. Not surprisingly, much has been said in the research, within the profession, and in the news about these topics. Whether they are issues of finance, quality, workload, or outcomes, there is no shortage of changes to be addressed.
In this Discussion, you examine a national healthcare issue and consider how that issue may impact your work setting. You also analyze how your organization has responded to this issue.
To Prepare:
Review the Resources and select one current national healthcare issue/stressor to focus on.
Reflect on the current national healthcare issue/stressor you selected and think about how this issue/stressor may be addressed in your work setting.
Also Check Out: NURS 6053- Week 3 Discussion Organizational Policies and Practices to Support Healthcare Issues
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The national healthcare issue that I want to bring to attention is nursing shortages. Nursing shortages have been around for a long time, but they have now reached critical levels in many countries including the US. Nursing shortages have been affecting the whole country, there are currently 7.3 million nurse shortages globally. The 2020 State of the World’s Nursing report by the World Health Organization evidenced that, by 2030, there will be a critical global shortage of 5.7 million nurses. To help all countries deal with nursing shortages by 2030, the WHO estimates that 8% more nurses need to graduate annually and be supported to be employed and retained in the profession (Marc, 2021). Many nurses are burnt out and exhausted by their work, and the threat of greater attrition is real because of the pandemic.
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 experienced higher mortality and failure-to-rescue rates than in facilities with lower patient-to-nurse ratios (Heinz, 2018). shortage of nurses leads to an increase in the workload of the existing workforce, which results in a predictable increase in medication errors. Close to half of all nurses employed have admitted to committing a medication error in the past year.
Errors may range from infusing medicines at the wrong rate (most common) to giving the wrong medicine or mixing up medicines between patients, which easily can result in fatal consequences (Ghafoor et al., 2021). I work in a behavioral health facility, and we are faced with staff shortages daily leaving the whole team with an extra workload, leaving the house supervisor to multitask pretty much doing two people’s work. This causes a delay in medication administration, delays in sending patients to lunch on time, delays in activity, and group which affects all the units in the hospital.
Our hospital changed the shift schedule, we used to have 12 hours shift now the facility is offering eight hours and 12 hours shifts making it durable for nurses and aims to reduce burnout. The organization is also offering bonuses to those individuals who sign on to become nurses and to pick up shifts in case of shortages. Major investment in nursing by governments needs to occur to enable millions more nurses to graduate and to ensure positions for them are established and sustained. Nurses around the world need to collaborate and work closely across borders and regions to gather evidence about the profession to inform policy and investment decisions. Nursing leaders and educators have key roles to play to help overcome nursing shortages. Many nursing organizations, scholars, and leaders have recognized the ongoing and deleterious effects of nursing shortages on positive patient outcomes and health service provision, as well as the potential to further exacerbate shortfalls in the profession (Bourgault, 2022). Quite simply, if nurses must work in situations of nursing shortages, they are more likely to be overworked, exhausted and leave nursing.
References
Bourgault, A. M. (2022). The Nursing Shortage and Work Expectations Are in Critical Condition: Is Anyone Listening? Critical Care Nurse, 42(2), 8–11. https://doi.org/10.4037/ccn2022909
Ghafoor, Y., Yaqoob, M. A., Bilal, M. A., & Ghafoor, M. S. (2021). Impact of nurse shortage on patient care. Saudi J Nurs Heal Care, 4(4), 114-9. https:// 10.36348/sjnhc.2021.v04i04.003114-9. https:// 10.36348/sjnhc.2021.v04i04.003
Heinz, D. (2018). Hospital nurse staffing and patient outcomes: a review of current literature. Dimensions of Critical Care Nursing, 23(1), 44-50. Retrieved from https://search-ebscohost-com.ezp.waldenulibrary.org/login.aspx?direct=true&db=rzh&AN=106723823&site=ehost-live&scope=site
Marc, M., Bartosiewicz, A., Burzynska, J., Chmiel, Z., & Januszewicz, P. (2021). A nursing shortage – a prospect of global and local policies. International Nursing Review, 66(1), 9 16. Retrieved from http://dx.doi.org/http://dx.doi.org.ezp.waldenulibrary.org/10.1111/inr.12473
Nurses work in different settings with varying work demands, support mechanisms, and approaches to work. Regardless of these differences, healthcare stressors are part of everyday work. These stressors are usually workplace challenges widespread in the United States that hamper nurses’ ability to deliver timely and effective care (Rose et al., 2021). The nursing shortage is a prevalent national stressor with far-reaching effects on patient care. It is characterized by higher demand for nurses than the current supply.
The effects of the nursing shortage witnessed in other organizations may be experienced in my work setting. As Shah et al. (2021) explained, the nursing shortage is a leading cause of burnout among nurses. It increases the nurse-patient ratio implying that nurses are overworked and may lack time for self-care and other activities that enhance commitment to work. Shah et al. (2021) further observed that nurses experiencing burnout are more likely to commit medical errors than nurses working within the standard nurse-patient ratios. Errors risk patient safety and damage patients’ trust in healthcare providers. Burnout triggers turnover and increases an organization’s management costs since replacing nurses is costly.
To avert the damaging effects of the nursing shortage, healthcare organizations should implement robust strategies, both staff-centered and organization-wide. My healthcare setting has responded to the nursing shortage through continuous supervision of staff, motivation programs, and formulating policies that prevent work overload. As Lee and Lee (2022) noted, nurse motivation is critical to creating a positive work atmosphere and retaining nurses. The same perspective guides the management when developing and implementing motivation programs. Regarding the changes that may have been implemented, nurses need mental strength to cope with the increasing workload. As a result, the management should invest more in coping programs and organize appropriate training initiatives to improve nurses’ resilience.
References
Lee, J. Y., & Lee, M. H. (2022). Structural model of retention intention of nurses in small-and medium-sized hospitals: Based on Herzberg’s Motivation-Hygiene theory. Healthcare, 10(3), 502. https://doi.org/10.3390/healthcare10030502
Rose, S., Hartnett, J., & Pillai, S. (2021). Healthcare worker’s emotions, perceived stressors and coping mechanisms during the COVID-19 pandemic. PLoS One, 16(7), e0254252. https://doi.org/10.1371/journal.pone.0254252
Shah, M. K., Gandrakota, N., Cimiotti, J. P., Ghose, N., Moore, M., & Ali, M. K. (2021). Prevalence of and factors associated with nurse burnout in the US. JAMA Network Open, 4(2), e2036469-e2036469. doi:10.1001/jamanetworkopen.2020.36469
Mod 1 WK 1 Initial Post
Healthcare Stressor
There is a multitude of factors influencing and challenging the healthcare industry in today’s world, including legislation, public policy, and the
needs of consumers (Broome & Sorenson Marshall, 2020). Veterans Administration (VA) is facing a shortage of healthcare providers as one of its
national healthcare issues/stressors. Staffing shortages have plagued the VA system for years, leaving patients waiting for long periods and
healthcare providers overwhelmed (Doyle & Streeter, 2017).
Impact Workplace
Healthcare provider shortages may harm the overall quality of care for our veterans. Physicians may struggle to provide high-quality care
when fewer providers are available, causing veterans who require healthcare services to suffer adverse effects. There may be a delay in getting
necessary care due to fewer physicians available to see patients. As a result, wait times for appointments may increase. When there are not
enough physicians to meet the demand for care, those working may suffer burnout and increased stress. As a result, their job satisfaction and
the quality of their patient care may be negatively affected. Healthcare costs may be affected negatively overall (Zhang et al., 2020).
Social Determinants Affected
A social determinant affecting the VA’s physician shortage is its geographical location. Attracting and retaining healthcare providers in many
VA facilities in remote areas are challenging. Quality of life, career advancement opportunities, and higher salaries in urban areas may make
healthcare providers prefer to practice there. A rural community’s distance and population define its social connections and cultural norms.
Resources are often limited in rural areas, salaries may be lower, and it is challenging to recruit healthcare providers. As a result of a shortage of
physicians in rural areas, patients may need more access to healthcare, have longer wait times for appointments, and have an increased burden
on remaining healthcare providers(Doyle & Streeter, 2017).
Veterans Affairs Responds to Provider Shortage Along with Changes Implemented
As a result of the VA’s physician shortage, various measures have been put in place to address the issue. The medical education expansion
program at the VA is expanding residency and fellowship programs. It also invests in research and innovation and provides funding for medical
education. (Klink et al., 2022). The VA has also expanded the implementation of resident, fellowship, education, training programs, and funding
for medical education. Telemedicine and telehealth services to improve access to care for remote veterans are also offered. By implementing
these initiatives, the VA intends to improve the quality of care provided to veterans and address the growing demand for healthcare providers
(Klink et al., 2022).
In response to the growing need for physicians, advanced practice registered nurses (APRNs) are providing more patient services. There is a
low risk of the quality of care being compromised or costs being raised by relying more heavily on nonphysician clinicians when receiving their
care (Auerbach et al., 2018).
References
Auerbach, D. I., Staiger, D. O., & Buerhaus, P. I. (2018). Growing ranks of advanced practice clinicians — implications for the physician workforce.
New England Journal of Medicine, 378(25), 2358–2360. https://doi.org/10.1056/nejmp1801869
Broome, M. E., & Sorenson Marshall, E. (Eds.). (2020). Transformational leadership in nursing (3rd ed.). Springer Publishing.
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