In 2010, the United States Congress established the healthcare reform, which implied introducing obligatory medical insurance for the entire U.S. citizenry, providing special conditions for the indigent people. The Affordable Care Act has contributed to spreading of the medical insurance coverage among the population, which, consequently, has a considerable impact on nursing practice (Heim et al., 2015; Eguia et al., 2018). As more clients have had recourse to hospitals and clinics, the healthcare organizations encounter the necessity to adjust to the law. Another problem addresses developing organizational policies and practices in the field of healthcare. As a significant number of details should be taken into consideration, occasionally, competing needs arise while deciding the internal policy. In the healthcare field, such a problem regards the operation cost. The owner’s intention to cover all the expenditures, gain appropriate profit, and supply high-quality services may result in a nursing shortage (Mіllіkеn, 2018). This way, the purpose of the paper is to outline the essential measures for reorganizing the medical services and analyze the organization cost and problem raising around this topic and propose efficient practical steps.
The Impact of the Affordable Care Act on the Organization
The organization, which I have been employed for the past five years, Trinity Health Services, has undergone the influence of the Affordable Care Act. It is notable that the emergency department is attended by clients more rarely than it has been before, while acuity tends to increase. Another significant consequence of the Affordable Care Act is improving the ambulatory offerings in the organization, so the process of shifting to urgent care facilities and major care services has become more comfortable. In addition, obtaining the medical insurance policies comprehensively has contributed to addressing health care offerings to receive a fundamental treatment more often, as compared with the situation before passing the Affordable Care Act. This way, the cases of invoking the emergency department for the reason mentioned above have become less common. In summary, the general outcome of the reform has had a positive influence on Trinity Health Services.
All healthcare organizations have had to adjust to new conditions in various fields of medicine, take into consideration new hardships and elaborate on implementation strategies. In the article Public health laboratories and the Affordable Care Act: What the new healthcare system means for public health preparedness, Malcarney, Seiler and Horton introduce an example of such an adjustment. Devoted to Ebola breakout, the paper contains a meaningful piece of information about the Affordable Care Act (Malcarney et al., 2015). As the article regards the infectious disease spreading, the suggestions, which are advanced by the authors, may stay relevant to the current situation.
The researchers address two significant issues regarding the topic, which are sufficient funding and managing a vast group of people. These ideas were prompted by the expansion of healthcare insurance caused by the Affordable Care Act and the necessity to test a great number of people. The authors suggest two options for overcoming hardships with finances. The first item implies “ensuring that all PHLs are capable of billing insurers for covered services”, while the second one includes ensuring “that all PHLs are capable of billing at competitive rates” (Malcarney et al., 2015, p. 544). The second step, which is proposed by the researchers, is network inclusion of PHLs to test different forms (Malcarney et al., 2015). The authors are convinced that, otherwise, PHLs would not receive enough funding and capacity, so this strategy is worth taking into consideration.
In addition, there are other reflections on the adjustment to the new law. An informative article regarding the Affordable Care Act is Tuberculosis elimination efforts in the United States in the era of insurance expansion and the Affordable Care Act. The object of exploration of this article is tuberculosis and the influence of the insurance expansion on the treatment process (Balaban et al., 2015). As tuberculosis appears to be a socially dangerous disease, bringing more people into the healthcare system is a matter of extreme importance. In this context, the comprehensive insurance coverage among the U. S. population appears to be sufficient in the fight with this disease, as the number of medical analyses will increase.
However, the adjustment to the Affordable Care Act may be effortful. This article addresses the funding problem too and claims that the additional legislation should be advanced to provide appropriate treatment (Balaban et al., 2015). As the number of patients tends to increase, it is essential to supply the clinics with additional material and human resources. The greater number of people obtain insurance, the more laboratory services, research, clinical consultations, and other parts of the treatment process should be conducted. In this context, employing more professionals and installing additional equipment present a matter of great significance.
These strategies address not only the treatment changes, but also the healthcare organizations in general. All the clinics and hospitals, including Trinity Health Services, must adjust to the increased human density and high demand. According to Coombs (2020), “the rate of Americans without insurance held steady at a historic low of 8.8 percent in the first year of President Donald Trump’s administration” (para. 1). Therefore, many of the healthcare organizations have encountered insufficient funding for purchasing new equipment and conducted a significant number of medical analysis and laboratory services. This way, it is crucial to mark this pressing concern. Moreover, the management of the treatment process requires the network inclusion of PHLs. In addition, clinics and hospitals need to employ additional personnel to provide medical services for as many people as possible. For these reasons, nurses are required to work in the conditions of rapid changing of demand and overcome the lack of equipment and spare places.
Developing Organizational Policies and Practices
The organization cost appears to be the aspect that may cause competing needs. The willingness of the owner to achieve high productivity goals and avoid additional expenditures has a negative impact on nursing practice, and such concerns occasionally lead to nurse shortage. According to Haddad et al. (2020), “nurses are a critical part of healthcare and make up the largest section of the health profession” (para. 1). Therefore, it is evident that these competing needs affect the customers too. The necessity to maintain the operation costs in accordance with the standards of productivity levels, which are vital for a company’s development, may prevent nurses from supplying the medical services properly.
It has become a common sight when the number of employed professionals in the enterprise is not rational or less than required. Consequently, other employees have to overwork in order to match the organization’s requirements and standards and provide each client with appropriate attention. For instance, nurses frequently have only half an hour for the appointment, and in case of additional treatment or consultation is necessary, they cannot deprive the client of it. It not only leads to delays in a queue but also affect the nurses. They do not have the appropriate time to take a break or have a meal, which impacts on their condition. In addition, nurses do not have enough time for their plans and lives, as there is the lack of appropriate staff in an organization.
Nurses appear to be extremely vulnerable to emotional burnouts, resulting in leaving the profession at all. Haddad et al. (2020) state that “the national average for turnover rates is 8.8% to 37.0%, depending on geographic location and nursing specialty” (para. 7). In addition, the fact that the majority of nurses are female should be taken into consideration, too. Caring for family and upbringing children present an integral part of their lives. As for men in this profession, they also have to fulfill their social roles as fathers and spouses. This way, working long hours and additional shifts may significantly disturb the employees.
In summary, competing needs in the healthcare field may be presented by the nursing shortages, which is caused by the organization cost and the intention to avoid overspending. Nurses encounter heavy workload that has a negative impact on their job and life satisfaction and may become the reason for constant stress and burnouts (Kulju et al., 2016). That is why this pressing concern should be addressed by healthcare organizations urgently.
Relevant Policy in Trinity Health Services
Trinity Health Services appears to be my present place of employment for five years. The aforementioned issue has affected the organization too, so it has to stick to a certain policy. Trinity Health Services has established a comprehensive program for the realization of personal potential in profession and career. Nurses are motivated to put the full extent of their experience and education into practice and expand them (Nursing Professional Development, n.d.). For this reason, the organization participates in nursing research, which impacts on the quality of medical services. Such an approach provides a strong motivation for nurses and appears to be helpful for reducing turnover.
Another beneficial way of supporting nurses is an investment in their leadership by Trinity Health Services. The organization attempts to find professionals determined to achieve leadership roles and facilitate them. For instance, a new program has been established for Chief Nursing Officers in order to improve their leadership skills by supplying necessary knowledge and practice (Nursing Professional Development, n.d.). With the combination of the previous program, this measure helps maintain the turnover rate among nurses at the minimum level.
Analysis of the Policy in Trinity Health Services
The current policy toward nurses and their interests in Trinity Health Services is beneficial in relation to avoiding turnover. It supplies the staff with an excellent opportunity to realize the personal potential in a career, which positively impacts job satisfaction among employees. This way, the relevant approach contributes to the solution to one of the ethical considerations, which arises from the competing needs. However, the policy still requires some improvements, as it does not submit any options for nurses’ burnouts and a high level of stress at the workplace. Overworking and additional shifts present a pressing concern, which nurses still frequently encounter. The proposals for managing these issues are presented in the next section.
Elaborating new policy in the organization or correcting the current one in accordance with competing needs may become a beneficial solution. One approach regards the necessity to systemize the schedule of nurses in an organization. For instance, limiting the work hours for a certain number would prevent the staff from overworking. This way, the necessity to recruit more personnel would become even more evident and threatening for an organization’s running, as the quality of delivering medical services would decline significantly. Such a measure would stimulate the manager to find the replacement in order to match the productivity level.
Apart from the option mentioned above, there are more comprehensive ones. One of them is proposed by Vari M. Drennan and Fiona Ross in the article “Global nurse shortages-the facts, the impact and action for change”. The authors notice “the positive impact of for transition programmes and support for newly qualified nurses” (Drennan & Ross, 2019, p. 7). This proposal would definitely be beneficial for attracting new employees and creating favorable working conditions. In addition, the researchers draw attention to the manager leadership style, which may appear to be helpful in solving these competing needs. They claim that it is essential to elaborate measures of motivating the staff to do their best at the workplace (Drennan & Ross, 2019). This way, the problems of turnover may be reduced to the possible minimum.
Another possible proposal on reducing the nurses’ job dissatisfaction and overfatigue regards organizing special leisure time opportunities. For instance, a medical organization may propose an incentive of establishing particular cooperation programs with health centers, resorts, or hotels. This way, the employees would be supplied with chargeless options for spending vacations qualitatively. This program would contribute to all the competing needs, as it appears to be the solution for nurses’ overfatigue. Furthermore, the quality of medical services and patient treatment predominantly depends on the medical staff’s condition, as this job requires accuracy and carefulness. As well as enthusiastic and exuberant professionals definitely benefit the entire organization, providing leisure time opportunities would allow the workers to spend their time with families and fulfill their social roles as parents and spouses.
The Affordable Care Act is intended to provide as great number of the U.S. population as possible with medical services of high-quality. Despite the beneficial for American society goals, the program needs to be improved. All healthcare organizations should receive additional funding to be capable of servicing such a considerable number of clients. Furthermore, the comprehensive insurance coverage implies installing extra equipment, expansion of hospitals and building new clinics. Therefore, the necessity of taking further steps for improving health care should not be underestimated, and this problem should be drawn attention urgently. As for the organization cost, it may cause competing needs in healthcare and become one of the reasons for the nursing shortage, which leads to burnouts and turnover. This problem also regards some ethical considerations, as overworking makes private lives and convenient pace impossible for the nurses. The solution to this issue lies through attracting and recruiting new staff members and suppling professionals with motivation. Another possible improvement addresses the organizing of employees’ leisure time and providing them and their families with attractive options. This way, the competing needs in the healthcare field could be overcome.
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