NURS 8100 Issues in Health Care Reform (Interview)

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Potential Challenges with the Health Reform

We discussed the potential challenges of enacting mandatory nurse staffing ratios and approaches to address them with Rep. Greenwood. I explained that the main shortcoming of the health reform is that health organizations will be mandated to increase the number of nurses without getting increased reimbursement for patient care. Besides, the costs of hiring additional nurses needed for the increased mandated ratios will not be compensated by additional payments to health organizations (de Cordova et al., 2019). This will lead to unfunded mandates. Fortunately, the challenge can be addressed by providing a market-based incentive to healthcare organizations to improve nurse staffing levels (de Cordova et al., 2019). This will separate nursing care from the current room and board charges and adjust healthcare payments for optimum nursing care.

Preventative screening for chronic diseases gives individuals clarity and a sense of security, protecting them, and allowing them to live a longer, healthier life. To achieve this, the word needs to be spread about these wonderful immunizations and screenings. One way to do this is by creating a patient profile. This patient profile would be essentially a portal with all of their medical info, immunizations, medical history, and family history. This patient portal will remind them of the dates to be tested. For example, every year a woman should have a pap smear. It will alert them when it is needed, while also showing various health centers near them. Another example would be when their immunizations expire, such as the Tdap and tetanus shots. Based on family history, it would alert you at certain ages to be tested or screened for cancer. For example, if you have a history of breast cancer, should be tested at 30 and every year after. There is a lot of information out there and it tends to get lost in translation. This app or patient profile helps track and keep your medical history up to date.

According to the AACN (2006), “Political activism and commitment to policy development are central elements of professional nursing practice” (p. 13). Throughout this course, you will hone the skills and competencies required for this type of involvement in policy.

Interviews are one type of research that can serve as a helpful source of knowledge. Research is an important element in the process of developing skills and competences. As a result, this Assignment (which you will begin this week and complete by the end of Week 9) allows you to choose a health reform problem of interest and debate it with a state or national lawmaker (or their aide).

Thank you for your informative discussion this week addressing unintended consequences of health care reform with a focus on accountable care organizations. This response will expand on your posting based on additional research.

Cost as you mentioned is a determinant for a health care reform historically and also in the current times. ACOs offered a hopeful solution to better health care. According to Kaufman, Spivack, Stearns, Song & O’Brien (2019), ACOs have contributed to less patients going to the emergency rooms, and more preventative care especially for those who suffer from chronic diseases with occasional exacerbations.

Another research done by Ouayogodé, Mainor, Meara, Bynum, Colla, (2019), validated the role of ACO in health care management and coordination. ACOs have proved to transform primary care and decreased fragmented health care that has been existence for a long time. This has especially affected those who have complex health care needs requiring different clinicians to provide care. Although ACOs may not be perfect, clinicians are offered incentives to help improve care coordination which in turn leads to decreased overall spending.

References

Kaufman, B. G., Spivack, B. S., Stearns, S. C., Song, P. H., & O’Brien, E. C. (2019). Impact of Accountable Care Organizations on Utilization, Care, and Outcomes: A Systematic Review. Medical Care Research and Review, 76(3), 255–290. https://doi.org/10.1177/1077558717745916

Ouayogodé, M.H., Mainor, A.J., Meara, E., Bynum, J.P.W., Colla, C.H. (2019) Association Between Care Management and Outcomes Among Patients With Complex Needs in Medicare Accountable Care Organizations: JAMA Network Open, 2(7). https://doi:10.1001/jamanetworkopen.2019.6939

To get ready:

Choose a state or national politician or assistant to question about current health care reform issues (state representative or lawmaker, senator, congressman, governor, etc.).
Request a meeting with the individual’s office as soon as feasible. Remember that getting on their calendar may be challenging, so plan ahead of time. The interview might take place either in person or over the phone.
Before the interview, consider the following question: What health-care policy problem is most important to me?
What issue do I wish to bring to this person’s attention?
With this in mind, prepare a list of interview questions focusing on your selected health policy problem. You might also want to include the following questions about health care reform:
In terms of health-care reform, what are your constituents most concerned about?
What are the costs and benefits of the recently passed health-care reform legislation?
Week 9’s seventh day

To finish:

Write a three- to four-page report summarizing and analyzing the interview and the health-care reform themes you discussed.

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Your written assignments must follow APA guidelines. Be sure to support your work with specific citations from appropriate Learning Resources and additional scholarly sources as appropriate. Refer to the Publication Manual of the American Psychological Association to ensure that your in-text citations and reference list are correct. Due by Day 7 of Week 9.

Week in Review

This week, you reviewed health-care reform-related concerns and analyzed significant health-care reform legislation for good outcomes and potential unintended repercussions.

You will study the process of developing health care policy beginning with agenda setting and the policy proposal next week.

NURS 8100 Issues in Health Care Reform (Interview)

To the following week:

Week 3

Assignment 1: Health Care Reform Issues Interview

LOs for the program: 4, 5

4: Professions/Partners

5: Good Communicators

DNP Requirements: 5, 6

5: Healthcare Policy for Healthcare Advocacy

6: Improving Patient and Population Health Outcomes Through Interprofessional Collaboration

(To view the table, scroll below.)

ASSIGNMENT PROMPT

Target

5 points

Acceptable

3 points

Unacceptable

1 point

Score/Level

Health Care Reform Interview

Part 1:

Define and discuss your list of questions used for the interview around your selected health care reform issue.

Program LO: 4, 5

DNP Essential: 5, 6

Exemplary quality.

Uses advanced critical thinking skills; does not summarize or paraphrase the content of the literature review; instead, demonstrates content mastery using examples and/or personalized reflections about the content of the literature review; demonstrates an applied level of understanding through personalized reflections about

Meets all requirements for LOs 4 and 5.

Exceeds expectations regarding Essentials 5 and 6.

Well-executed, high-quality work.

Content is of professional portfolio quality; addresses at least 80% of the major subsections in the assignment using adequate critical thinking skills; includes some summarizing or paraphrasing of the literature review; demonstrates content mastery through examples and/or personalized reflections on the content of the literature review; demonstrates an applied level of understanding through personalized reflections on the content area. It meets all requirements for graduate-level work.

NURS 8100 Issues in Health Care Reform (Interview)

Meets expectations for LOs 4, 5.

Meets expectations for Essentials 5, 6.

Superficially developed, unacceptable quality.

Content needs substantial revision for it to be of a professional portfolio quality; addresses less than 50% of the major subsections in the assignment using weak critical thinking skills; consists primarily of a summary of main ideas from the literature review; does not demonstrate an applied level of understanding. Does not meet expectations for graduate level work.

Insufficient to meet expectations for graduate work.

for LOs 4, 5.

Insufficient Essentials 5, 6.

Part 2:Write a 3- to 4-page paper providing a summary and analysis of the interview and the health care reform issues you discussed (may include social, political, economic, ethical concerns)

Program LOs: 4, 5.

DNP Essential: 5, 6.

Exemplary quality.

Content is of a professional portfolio quality; addresses questions/issues discussed in the interview; the summary and analysis applies advanced critical thinking skills; does not summarize or paraphrase the content of the literature review; instead, demonstrates content mastery using examples of and/or personalized reflections about the content of the literature review; demonstrates an applied level of understanding through personalized reflections about the content area. Excels in meeting expectations for graduate level work. Fully meets expectations for LOs 4 and 5.

Fully meets expectations for Essentials 5 and 6.

Well-developed good quality work.

Content is of a professional portfolio quality; addresses about 80% of the major subsections in the assignment using adequate critical thinking skills; includes some summarizing or paraphrasing of literature review; demonstration of content mastery using examples of and/or personalized reflections about the content of the literature review; demonstration of an applied level of understanding through personalized reflections about the content area. It meets expectations for graduate level work.

NURS 8100 Issues in Health Care Reform (Interview)

Meets expectations for LOs 4, 5.

Meets expectations for Essentials 5, 6.

Superficially developed, unacceptable quality.

Insufficient to meet expectations for LOs 4, 5.

Insufficient to meet expectations for Essentials 5, 6.

Part 3: References and APA requirements

The majority of references are from scholarly journals, supports the topic well, and are current. Paper stays within page requirements. APA format used correctly throughout.

Excels in meeting expectations for graduate level work.

Most references are from scholarly journals and support the topic. Most references are fairly current. The paper stays within requirements. APA format used with minimal errors.

Meets expectations for graduate level work.

References are not sufficient or are mostly from the lay literature or out of date. The paper is either too long or too short. Weak writing quality and/or little evidence of correctness of APA format.

Does not meet expectations for graduate work.

Assignment:

To prepare:Identify a state or national politician (state representative or legislator, senator, congressman, governor, etc.), or aide, whom you would like to interview regarding current issues in health care reform.
As soon as possible, contact the individual’s office to request a meeting. Keep in mind that it may be difficult to get on their calendar, so plan accordingly. You may conduct the interview in person or by phone.
In advance of the interview, ask yourself:
What health care policy issue is important to me personally?
What issue do I want to bring to this person’s attention?
Develop your list of questions for the interview around your selected health policy issue. In addition, you may wish to include questions related to health care reform:
What are your constituents most concerned about regarding health care reform?
What are the trade-offs associated with recent health care reform policy?

Learning Objectives

Students will:

Evaluate the involvement of professional nursing organizations in health policy
Explain how professional organizations could support a policy proposal/recommendation

NURS 8100 Issues in Health Care Reform (Interview)

By Day 7 of Week 9

To complete:

Write a 3- to 4-page paper providing a summary and analysis of the interview and the health care reform issues you discussed. Part 1 (5 points), Part 2 (5 points), Part 3 (5 points). Total points= 15 maximum

Health reform involves revamping a country’s or state’s health care system. It entails addressing the ever-rising costs of health care for individuals, families, and the government. Health reforms center on improving the benefits citizens receive from the country’s healthcare system and increasing access to health insurance. Healthcare reforms aim to lower the number of uninsured individuals, making healthcare more affordable and enhancing the quality of care. During this course, I met with a state legislator and discussed a healthcare reform issue that has caught my interest. The purpose of this paper is to give a summary and analysis of the interview and discuss the health care reform issues I presented.

Selected State Legislator

I planned to present my healthcare reform of interest to a legislator from my state Illinois. With the help of my colleagues, I was able to plan a meeting with Representative LaToya Greenwood through her personal assistant. Greenwood is a Democratic member of the Illinois House of Representatives. She has represented the 114th district since January 2017 and is the chairperson of the Health Care Availability and Access Committee (Illinois General Assembly, n.d.). She is also a member of several other committees such as Prescription Drug Affordability; Agriculture & Conservation; Approp-Elementary & Secondary Education (Vice-Chairperson); Data Analytics & IT; Appropriations-Human Services; Cybersecurity, Public Utilities; Museums, Arts, & Cultural Enhancement.

Rep. LaToya Greenwood was the legislator of choice due to her admirable track record. She has chiefly sponsored numerous bills as a Representative. She recently passed House Bill 4645 to strengthen minority representation in health care and stop the uneven quality of care across underserved communities (Illinois General Assembly, n.d.). The bill was founded on her belief that every citizen in Illinois deserves the highest quality of health care at an affordable cost. Furthermore, Rep. Greenwood is dedicated to fighting for affordable prescription drugs and increasing the workforce in public health.

Summary of the Interview

The PA scheduled a one-hour meeting on 15^th April 2022 at the Representative’s office from 10 am to 12 pm. The Rep welcomed me to her office, and after establishing rapport, I explained my purpose for the meeting and the desired outcomes from the meeting. The health care reform of interest was the introduction of a bill on mandatory Nurse-to-Patient ratios in all healthcare settings across Illinois. I explained to the Rep that hospitals in Illinois do not observe the WHO-recommended nurse-to-patient staffing ratios, which are purposed to promote safe patient care and prevent nurse burnout. I gave an example of the California nurse-to-patient staffing ratios act. The bill was passed to address the increasing concern that patients’ safety is often compromised by inadequate staffing attributed to the increasing severity of health conditions and complexity of care (Livanos, 2018).

I explained the benefits of enacting a bill on mandate nursing ratios, including the challenges the state currently faces due to the lack of that reform. There is a connection between nurse workload and patient morbidity and mortality rates. Hospitals with unsafe nurse-to-patient ratios overwork their nurses, resulting in burnout. Features of hospitals with high nursing workloads include increased incidences of medical errors and missed nursing care. Various studies found a high prevalence of hospital-acquired infections, like urinary tract infections and pneumonia, and failure to perform CPR in facilities with a high nurses’ workload.

I informed Rep. Greenwood that the biggest benefits from a health reform on safe nurse-to-patient ratios would be improved patient outcomes, reduced morbidity and mortality rates, reduced nursing turnover, and increased patient and staff satisfaction (Griffiths et al., 2018). Safe staffing ratios are equivalent to greater job satisfaction and reduced nurse turnover, saving organizations from the costs spent in frequently hiring new nurses. nurse-to-patient ratios influence most patient outcomes, most noticeably in mortality rates. Nurse staffing ratios are linked to a higher likelihood of patient survival. Lee et al. (2018) found that patients were 95% more likely to stay alive when health facilities observed a hospital-mandated nurse-to-patient ratio. Besides, managing critically ill patients in settings with high nursing workloads and unsafe staffing ratios was associated with a significant decrease in the odds of survival.

Potential Challenges with the Health Reform

Feedback from the Legislator

Rep. Greenwood was pleased with the presentation since she is devoted to increasing the workforce in Illinois public health. She agreed that the proposed reform would significantly improve nurses’ working environment and quality of patient care resulting in improved health outcomes. She requested that I leave her with the printed proposal so that she can through it and make amendments where necessary. She also stated that she would organize another meeting to discuss the amendments and the way forward.

Conclusion

Enacting mandatory staffing ratios is the healthcare reform of interest. I presented the reform to Rep. LaToya Greenwood of the Illinois House of Representatives representing the 114th district. I presented the reform to Rep. Greenwood and discussed the benefits of enacting the bill on patients’ health outcomes and nurses’ job satisfaction. We also discussed potential challenges and solutions.

References

de Cordova, P. B., Rogowski, J., Riman, K. A., & McHugh, M. D. (2019). Effects of Public Reporting Legislation of Nurse Staffing: A Trend Analysis. Policy, politics & nursing practice, 20(2), 92–104. https://doi.org/10.1177/1527154419832112

Griffiths, P., Maruotti, A., Recio Saucedo, A., & Redfern, O. C. (2018). Nurse staffing, nursing assistants and hospital mortality: retrospective longitudinal cohort study. BMJ Qual Saf.. https://doi.org/10.1136/bmjqs-2018-008043

Illinois General Assembly. (n.d.). Representative Biography. https://www.ilga.gov/house/Rep.asp?MemberID=2902

Lee, A., Cheung, Y. S. L., Joynt, G. M., Leung, C. C. H., Wong, W. T., & Gomersall, C. D. (2018). Are high nurse workload/staffing ratios associated with decreased survival in critically ill patients? A cohort study. Annals of intensive care, 7(1), 1-9. https://doi.org/10.1186/s13613-018-0269-2

Livanos, N. (2018). A broadening coalition: Patient safety enters the Nurse-to-Patient ratio debate. Journal of Nursing Regulation, 9(1), 68-70. https://doi.org/10.1016/S2155-8256(18)30056-5