Essay on Ethical and Policy Factors in Care Coordination

Published: 2021/12/28
Number of words: 1533

Care Coordination

Various definitions of care coordination have been advertised under a wide range of headings. Care coordination can be regarded as the intentional synchronization of exercises and data to further develop wellbeing results by ensuring that the requirements and preferences of care beneficiaries and their families for medical care and local area administrations are met over in the long run (Bower, 2016). It is beneficial to patients to have viable consideration coordination because it assists them in achieving the best possible outcomes. The number of individuals with constant ailments and other medical care concerns is expanding as individuals carry on with longer lives, there is an expanded interest for proficient consideration coordination as they move between different medical services settings and specialists. Numerous ongoing illnesses and comorbidities are pervasive among the nursing home populace; subsequently, care coordination is basic for accomplishing the ideal outcomes in these settings.

Government Policies That Affect Care Coordination

Care coordination in nursing homes is impacted by various diverse government laws and guidelines. The Nursing Home Reform Act (NHRA), the Health Insurance Portability and Accountability Act, the Affordable Care Act (ACA), and the Hospital Readmissions Reduction Program (HRRP) are instances of such laws. The Affordable Care Act, also known as Obamacare, transformed into a healthcare policy in 2010 when the former president, Barrack Obama, consented to it (Courtemanche, et al., 2018). After consent, many provisos included in this statute came into operation on different dates as the bill was being rolled out and implemented. With the goal to expand admittance to health care coverage, lower medical services costs, and advance preventive consideration and general prosperity through the Affordable Care Act, the arrangements of the law were carried out (Courtemanche, et al., 2018). The Hospital Readmissions Reduction Program (HRRP) was one of the arrangements of the Affordable Care Act (ACA).

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ACA incorporated an arrangement known as the Hospital Readmissions Reduction Program (HRRP) that permitted emergency clinics with an unreasonable number of readmissions to be punished. A few illnesses, including chronic obstructive pulmonary disease (COPD), pneumonia, elective essential arthroplasty, among others, were explicitly covered by the HRRP (Catalyst, 2018). To accomplish this, the goal was to associate instalment to the nature of treatment that one got and cultivate proficient correspondence and care coordination to incorporate the patient and their family, guardian, or nursing home to restrict the occurrence of readmissions Further, establishing adequate communication with the patient, their family, and the nursing home assists with decreasing missteps and holes in care along the continuum of care. For certain individuals, this adds to worked on generally speaking outcomes.

The Nursing Home Reform Act was sanctioned because a few states and governments concentrated on that uncovered the disregard, misuse, and disparity that nursing home patients were exposed to. To help shield nursing home patients from physical, mental, or social disregard or misuse, the NHRA was set up. This government guideline, known as the Health Insurance Portability and Accountability Act (HIPAA), is intended to keep patient delicate wellbeing data from being delivered unprofessionally without obtaining patient assent (CDC, 2018). The expression “sensitive wellbeing data” alludes to data that is viewed as delicate by the public authority. These are patient health information that could be presented in various forms, such as diagnosis, treatment, and personal information. The establishment of HIPAA focused on privacy rules, which delivers a bunch of rules that oversee patient health information might be unveiled to people or associations that fall inside the privacy rule’s purview.

Patient health information has become more troublesome with the inescapable utilization of electronic clinical records (EMR) as these are technological devices that are prone to cyber attack, and unauthorized personnel can get access to these data with ease since they are contained in the software. To help secure patient health information, facilities set up an assortment of insurances. Offices have specific gadgets that are to be utilized to get to any PHI, and these gadgets are furnished with interesting programming to help protect them from programmers. In cases where professionals disregard following HIPAA rules implies that they are acting unprofessionally and may face the consequences with ranging severity depending on the level of patient health information disclosure. These professionals can face possible heavy penalties such as license termination, heavy fines, and even face criminal charges.

Principles of Health Care Ethics

Health care is guided by various health policies, principles, acts, and guidelines for good decision-making, professionalism, and efficiency in delivering quality care to patient needs. The provision of quality health care is motivated by the desire to enhance better outcomes and patient satisfaction. There are four ethical principles in nursing which entail beneficence, autonomy, justice, and non-maleficence (McDermott-Levy, Leffers & Mayaka, 2018). These principles are utilized when health care professionals are faced with an ethical dilemma and need to make amicable decisions for better outcomes and showcase professionalism. Patient autonomy alludes to allowing patients to make choices regarding their desired care interventions. Consequently, beneficence regards the conduct that is characterized as acting in the best interest of the patient’s wellbeing. A doctor’s nonmaleficence conduct, as outlined in the principle, demonstrates that the professional tasks with intervening for the patient’s health are not supposed to participate in activities that hurt a patient intentionally and with information. At last, justice is treating every persistent with similar regard, reasonableness, and objectivity, paying little heed to their experience.

Ethical Dilemmas and Care Coordination Related to Government Policies

In their work lives, medical service providers frequently experience moral difficulties. Various moral hardships might create in the nursing home climate, including understaffing, the utilization of limitations and mental prescriptions, and the limitation of patients’ capacity to practice their freedoms to self-assurance. With regards to moral hardships, it is feasible to follow them back to an absence of adequate representatives. According to Harrington (2020), pressure ulcers, limitation utilization, ailments, and misfortune in actual capacity have all been connected to understaffing. With regards to mind coordination, the HRRP is one government strategy that makes moral inquiries. This program puts a strain on the nursing home workforce since establishments are reluctant to send as of late released patients back to the emergency clinic inspired by a paranoid fear of being readmitted to the facility. Notwithstanding HIPAA, another administration practice that might give a moral issue is the Patriot Act of 2001. Due to a misconception of the HIPAA guidelines, significant data may be deferred in its transmission between medical services experts. This may bring about a deferral in getting vital clinical treatment. Accordingly, the patient might endure negative fallouts.

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The Code of Ethics for Nurses and Impact on Care Coordination and Continuum of Care

At the point when the American Nurses Association (ANA) distributed the Code of Ethics for Nurses in 1950, it was viewed as noteworthy. An aggregate of nine provisos with understanding comments was included for the enactment. In particular, the first four sets of the provision in the code of ethics highlight the medical attendants’ commitments to the patient. The subsequent two address medical caretakers’ obligations to support individual and expert improvement to convey protection and great consideration while safeguarding and creating morals in the working environment. Others accentuate medical attendants’ obligations to draw in with other medical care experts and the overall population to diminish holes and advance civil rights in medical care conveyance and conveyance techniques.

Health People 2030 builds up quantifiable general wellbeing goals over the course of the following ten years and gives the essential instruments and assets to accomplish those destinations. Intending to destroy wellbeing disparities while at the same time advancing wellbeing and prosperity for everybody, Healthy People 2030 is a worldwide development. In particular, Healthy People 2030 targets social determinants of wellbeing, which might be characterized as attributes in an individual’s current circumstance that affect their wellbeing and personal satisfaction (, 2020). To ensure that patients get great medical services, an attendant’s moral job is to help them in keeping away from wellbeing aberrations/social determinants of wellbeing.


American Nurses Association. (2015) Code of Ethics for Nurses with Interpretive Statements. Silver Spring, MD: American Nurses Association,, publishers.

Bower, K. A. (2016). Nursing Leadership and Care Coordination. Nursing Administration Quarterly, 40(2), 98–102.

Catalyst, N. E. J. M. (2018). Hospital readmissions reduction program (HRRP). NEJM Catalyst.

CDC. (2018). Health Insurance Portability and Accountability Act of 1996 (HIPAA).

Courtemanche, C., Marton, J., Ukert, B., Yelowitz, A., & Zapata, D. (2018). Effects of the Affordable Care Act on Health Care Access and Self-Assessed Health After 3 Years. Inquiry : a journal of medical care organization, provision and financing, 55, 46958018796361. (2020). Determinants of Health. Retrieved from

McDermott-Levy, R., Leffers, J., & Mayaka, J. (2018). Ethical principles and guidelines of global health nursing practice. Nursing outlook66(5), 473-481.

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