Developing Organizational Policies and Practices

Developing Organizational Policies and Practices

The high cost of healthcare is a significant national issue. It is impacted by the need for technical innovation and administrative complexity (Chen et al., 2020). On one hand, there is a continuous search for advanced technology and innovative treatments. New investigative and diagnostic tools, enhanced surgical procedures, and breakthrough pharmaceuticals are usually costly. This is because of research and development expenditures and costs associated with integrating new technologies into healthcare systems. On the other hand, the administrative complexity of the healthcare system adds to the budgetary burden. The complex web of insurance standards, billing methods, and regulatory compliance necessitates significant administrative support, which raises operational expenses. These competing needs create a paradox in which efforts to improve patient care and system efficiency unintentionally contribute to an overall increase in healthcare expenditures. This exacerbates the national issue of healthcare affordability.

In our organization, we introduced value-based care (VBC) to address the high cost of healthcare. VBC prioritizes patient outcomes and cost-effectiveness (Teisberg et al., 2020). It’s different from the fee-for-service model, which puts quantity over quality. In the VBC model, providers are encouraged to provide whole care to patients. The treatment improves patient health and reduces costs to the organization. This is achieved through integrated care, preventive interventions, and chronic disease management. The goal is to decrease hospital readmissions and emergency visits. Additionally, electronic health records simplify administrative tasks. It also improves data accuracy, privacy, and confidentiality. This reduces overhead costs. VBC addresses the high cost of healthcare by improving long-term health outcomes and reducing costs. It makes healthcare cheaper and more sustainable for patients and providers.

Our value-based care (VBC) policy has both ethical benefits and drawbacks. Ethically, VBC is patient-centered as it focuses on outcomes and quality. This is in line with the principle of beneficence. This means that patient welfare is paramount.  Standardized treatment guidelines and prevention practices promote Justice. Furthermore, it makes healthcare more equal and accessible. Nevertheless, VBC raises ethical concerns around conflicts of interest; for example, healthcare providers may avoid high-risk patients to preserve good outcomes. Therefore, they will discriminate against patients with complex health needs. Additionally, focusing on cost efficiency may unwittingly curtail patient autonomy if cost is prioritized over individual patient choices and needs. The strengths of VBC are its approach, teamwork, and comprehensive care plans that respect patient dignity and general well-being. The challenge is ensuring financial incentives do not trump the moral obligation. That is, every patient should be treated regardless of risk profile. Good supervision and patient advocacy processes are key safeguards as they help mitigate ethical risks and ensure the policy’s primary objective of better patient care without compromising ethics.

I would propose a hybrid model to balance the competing demands of staff, patients, and resources. This model combines patient-centered medical homes (PCMH) and value-based care. Moreover, it will fix VBC’s ethical flaws. It puts primary care physicians in charge of every aspect of their patient’s care to ensure continuity and wholeness. Social determinants of health, for example, can be addressed by having social workers and care coordinators on PCMH teams (Anderson, 2021). This will reduce the workload for clinicians and improve patient outcomes. Fair care for high-risk patients requires clear rules to protect against selection bias. Patient-centered ethics can be encouraged through regular ethical audits and training. These will make sure that financial incentives do not trump patient needs. Promoting a collaborative working environment and stronger support networks will be more ethical, better for staff, and better resource allocation.

References

Anderson, D. (2021). Social justice in health: the patient-centered medical home and health disparities (Doctoral dissertation, Rutgers University-Graduate School-Newark). https://doi.org/doi:10.7282/t3-twb8-mw51

Chen, P. T., Lin, C. L., & Wu, W. N. (2020). Big data management in healthcare: Adoption challenges and implications. International Journal of Information Management, 53, 102078. https://doi.org/10.1016/j.ijinfomgt.2020.102078

Teisberg, E., Wallace, S., & O’Hara, S. (2020). Defining and implementing value-based health care: a strategic framework. Academic Medicine, 95(5), 682-685. https://doi.org/10.1097/acm.0000000000003122

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Competing needs arise within any organization as employees seek to meet their targets and leaders seek to meet company goals. As a leader, successful management of these goals requires establishing priorities and allocating resources accordingly.

Within a healthcare setting, the needs of the workforce, resources, and patients are often in conflict. Mandatory overtime, implementation of staffing ratios, use of unlicensed assisting personnel, and employer reductions of education benefits are examples of practices that might lead to conflicting needs in practice.

Developing Organizational Policies and Practices

Leaders can contribute to both the problem and the solution through policies, action, and inaction. In this Assignment, you will further develop the white paper you began work on in Module 1 by addressing competing needs within your organization.

To Prepare:

• Review the national healthcare issue/stressor you examined in your Assignment for Module 1, and review the analysis of the healthcare issue/stressor you selected.
• Identify and review two evidence-based scholarly resources that focus on proposed policies/practices to apply to your selected healthcare issue/stressor.
• Reflect on the feedback you received from your colleagues on your Discussion post regarding competing needs.

The Assignment (1-2 pages):

Developing Organizational Policies and Practices

Add a section to the 2-3 page paper you submitted in Module 1. The new section should address the following in 1-2 pages:

• Identify and describe at least two competing needs impacting your selected healthcare issue/stressor.
• Describe a relevant policy or practice in your organization that may influence your selected healthcare issue/stressor.
• Critique the policy for ethical considerations, and explain the policy’s strengths and challenges in promoting ethics.
• Recommend one or more policy or practice changes designed to balance the competing needs of resources, workers, and patients, while addressing any ethical shortcomings of the existing policies. Be specific and provide examples.
• Cite evidence that informs the healthcare issue/stressor and/or the policies, and provide two scholarly resources in support of your policy or practice recommendations.
• Due to the nature of this assignment, your instructor may require more than 7days to provide you with quality feedback.