Healthcare Ethics and Equity
Would a bedside nurse know the difference between these two patients’ payor arrangements?
A bedside nurse may not essentially know specifically the details of RT and FS’s payor arrangements. Nurses primarily focus on clinical care, such as monitoring health status, administering medication, and educating patients on disease management. They barely focus on being heavily involved in the financial aspects of care. Nurses might be aware that both patients are covered under Medicare, the nuances of RT’s Fee-for-Service (FFS) model and FS’s involvement in an Accountable Care Organization (ACO) are more expected to be understood by administrative staff or care coordinators (Norman, 2022). However, subtle differences in the availability of resources may alert nurses to the differences between the two patients’ financial models. These differences may include FS having access to more integrated care services among others.
Should nursing be aware?
Yes, nursing staff should be aware of payor arrangements. This is under consideration that these can significantly influence patient outcomes, care access, and the overall care plan. For instance, understanding that FS is part of an ACO may help nurses ensure FS receives coordinated care (Fitzpatrick & Alfes, 2022). This also includes smoking cessation programs and follow-up services; that main aim is to prevent hospital readmissions. Conversely, a knowledge on the fact that RT is under FFS could prompt nurses to advocate for additional resources. This will help ensure that RT doesn’t experience fragmented care or frequent hospitalizations. Awareness of these arrangements allows nurses to tailor their care approaches and advocate effectively for equitable resources.
Should nursing continue to educate both patients on their disease?
Yes, regardless of their payor arrangements, nurses should absolutely continue to educate both RT and FS about their disease. Education is central in managing chronic conditions like COPD. It is also necessary that both patients need guidance on ways to improve their outcomes. This applies basically in areas like smoking cessation, medication adherence, and managing oxygen therapy (Norman, 2022). Despite unalike financial models, both patients face similar health risks due to their smoking and COPD stages. Consistent education from nurses will therefore ensure that both patients can take appropriate steps to manage their conditions. This training will also help in preventing exacerbations and reduce the risk of hospital readmission.
What if these patients were in the same nursing unit? Would there be a concern that these patients were being offered different levels of support at home?
If RT and FS were in the same nursing unit, there could be concerns about equity in the care provided. This is especially regarding the levels of support offered at home. Under the ACO model, FS may have access to more comprehensive services, such as home care, respiratory therapy, and smoking cessation support. These aspects are designed to reduce readmissions and improve outcomes. In contrast, RT’s FFS arrangement may not provide the same level of coordinated care. Here, RT leaves them more vulnerable to gaps in home support and follow-up services. This discrepancy certainly creates ethical concerns about whether both patients are receiving the same standard of care and necessary resources for managing their COPD at home.
Clinically, what is the better way to care for the patient? Does that match the payor payment?
Clinically, the best approach for both patients is a coordinated care model that includes smoking cessation, medication adherence, and regular follow-up to prevent exacerbations of COPD (Fitzpatrick & Alfes, 2022). This holistic model of care focuses on prevention and management that aligns well with FS’s ACO arrangement. This is where the healthcare system is incentivized to keep the patient healthy and out of the hospital. However, RT’s FFS model does not align as well with these clinical goals, as it reimburses based on services provided rather than outcomes, potentially leading to fragmented care. In an ideal world, both patients would receive care that emphasizes prevention, but the payor systems in place may not equally support this approach.
Discussion Question 2 (C):
Telehealth presents both significant opportunities and potential risks that nursing leaders must carefully navigate. Here are some key considerations and tactics for addressing them:
Opportunities:
Telehealth can dramatically improve access to care. This is especially for patients in rural or underserved areas. It allows patients to link up with specialists and receive consultations that may have been previously difficult or impossible. Telehealth enables more frequent check-ins and monitoring without requiring in-person visits (Schweickert & Rutledge, 2024). This actually applies mostly for patients with chronic conditions like COPD. This can lead to better management of conditions and potentially reduce hospitalizations.
Telehealth also offers opportunities for more efficient care delivery. Virtual visits can reduce absentee rates, thus allowing providers to see more patients. Remote patient monitoring using connected devices can provide continuous data on patients’ conditions. Such probable actions enable earlier interventions when needed. Telehealth can additionally facilitate better care coordination between different providers and specialties.
Risks:
However, telehealth also comes with potential risks. There are concerns about data security and patient privacy. Such risk occurs especially when transmitting sensitive medical information over digital platforms. When certain populations lack access to the necessary technology or internet connectivity, there is a risk of exacerbating health disparities. Care quality may also be compromised in some cases. This potentially happens when providers cannot perform physical examinations or if technical issues interfere with communication (Schweickert & Rutledge, 2024).
Another risk is the potential for overutilization of healthcare services. The risk might be due to the convenience of telehealth, thus leading to unnecessary consultations. There are also concerns about the impact on the provider-patient relationship and whether the quality of interactions may suffer in a virtual setting.
Addressing Risks and Capitalizing on Opportunities:
There are several strategies that we as nurses can apply to address these risks and maximize opportunities. First, implementation of robust security measures and ensuring HIPAA compliance can be necessary. Such measures would be crucial for protecting patient data. We should also advocate for policies and initiatives that improve broadband access in underserved areas. This would reduce disparities in telehealth access.
To be able to maintain quality of care, developing clear guidelines for when telehealth is appropriate versus when in-person care is necessary. There would be a need of investing in high-quality telehealth technology and providing thorough training for staff (Schweickert & Rutledge, 2024). These educational platforms would generally minimize technical issues and improve the virtual care experience.
Tactics to Engage Nursing Employees:
To engage nursing employees in utilizing telehealth, several tactics can be effective:
1. Education and training: Provide comprehensive training on telehealth technologies and best practices. This should include technical skills and more so how to effectively communicate and build rapport with patients in a virtual setting.
2. Highlight benefits: Clear and concise communication of the benefits of telehealth for both patients and nurses. This could include improved work-life balance through potential remote work opportunities and the ability to reach and help more patients.
3. Address concerns: Actively listen to and address nurses’ concerns about telehealth. This might involve fears about job security and changes in workflow. It might also involve concerns about quality of care.
4. Involve nurses in implementation: When selecting and implementing telehealth solutions, there is a need to include nurses. Their front-line experience provides valuable insights into what features are most important and most important is how to integrate telehealth into existing workflows.
5. Provide support: Ensure that nurses have unlimited access to technical support and resources when using telehealth technologies (Norman, 2022). Consider entitling telehealth victors who can provide peer support and guidance.
6. Recognize and reward adoption: Recognize nurses who effectively incorporate telehealth into their practice. This could be through formal recognition programs or by highlighting success stories.
By addressing both the opportunities and risks of telehealth, and actively engaging nursing staff in its implementation, we can harness the power of this technology to improve patient care and nursing practice.