Capella 4050 Assessment 2 Ethical and Policy Factors in Care Coordination NURS-FPX 4050 Coord Patient-Centered Care ​​​​​​​Introduction 

Moving forward some of you here are care coordinators and may have an idea about the concept of care coordination while others who are frontline nurses might have this knowledge gap. So let us first understand the concept so that we can build an equal pace of this presentation. According to the Agency for Healthcare Research and Quality (AHRQ), care coordination is defined as a thoughtful organization of activities related to patient care and the distribution of sensitive patient information with concerned individuals in an appropriate manner so that patient’s health and safety are maintained and healthcare providers can deliver effective care (Agency for Healthcare Research and Quality, 2018).

To ensure that patient/resident care is coordinated appropriately, the U.S. government has established various policies which are essential for healthcare organizations to follow so that effective, equitable, and safe healthcare is provided. 

Governmental Policies Affecting the Coordination of Care

The Affordable Care Act (ACA) is one of the most relatable governmental policies for residents in nursing homes. The Patient Protection and Affordable Care Act which is widely known as ACA is a reform act signed in 2010 that has major 3 goals related to healthcare; 1) an affordable health insurance policy, 2) a Medicaid program that covers low-income individuals, and 3) innovative medical care methods to lower the costs of healthcare (McIntyre & Song, 2019). This act, for instance, proposes the obligation of providing accessible and affordable care to those who are deprived of quality healthcare.

Moreover, ACA creates opportunities to innovate new care models which improve care coordination among healthcare providers, leading to enhanced healthcare quality. A study suggested that with the help of ACA in long-term care settings (nursing homes), the quality of care is improved which is evident by the decreased number of readmissions, and reduced incidences of adverse events like falls and pressure ulcers (Walker et al., 2020). 

Another policy that applies to the health and safety of residents in nursing homes and covers the second half of care coordination’s definition is related to protected health information (PHI). This policy falls under the Health Insurance Portability and Accountability Act (HIPAA) which was established in 1996. It is a federal law that entails healthcare organizations to follow standard guidelines for the protection of patient’s health information (Moore & Frye, 2019).

Capella 4050 Assessment 2

For example, HIPAA policy impacts care coordination in a way that healthcare providers follow appropriate channels to reveal patient information with informed consent and coordinate among themselves to maintain the confidentiality and privacy of information. Most of the community care centers and nursing homes use electronic residents’ records too which adds another responsibility of care providers to ensure information is secured and saved in encrypted software. 

Let’s discuss another national-level policy that is particular to nursing homes. The Nursing Homes Reform Act (NHRA) was established with the purpose to provide quality care by preparing individualized care plans for the residents addressing their rights of freedom and dignity (Werner et al., 2022). This act also relies on monitoring the actions of healthcare providers for the provision of quality care. Thus, provoking healthcare providers to coordinate patient care and work collaboratively to ensure residents’ health and safety is a priority. This law prepares healthcare providers to meet the standards of care through planning and executing safe practices for quality healthcare. 

All of these governmental policies advocate that healthcare providers especially nurses should coordinate with other team members to provide safe and quality healthcare. Care coordinators play a vital role in monitoring and evaluating the care that is being provided. I hope everything is clear to you all, if you have any questions, please park them for a Q&A session at the end. 

Policies that Raise Ethical Dilemmas for Care Coordination

Implementation of any policy requires healthcare providers to ensure that ethical principles are being followed. These principles include autonomy (right of freedom and choice), beneficence (right of benefit), non-maleficence (to not harm consumers), and justice (equality and equitability). Most of the time healthcare policies give birth to ethical dilemmas which are situations in which healthcare providers are stuck between legal or ethical perspectives. Ethical decision-making models help in these regards which are not a part of today’s presentation, however, we will be discussing so