Nursing Assignment: Evaluation of 2016 National Healthcare Quality & Disparities

Question

Task: To analyze an issue is to understand the problem and context of the problem. Nurses engage in policy analysis through the creation of policy briefs, which promote awareness of the problem, and provide context of the problem, resolution options and their pros and cons, and a recommended solution. Nurses use policy briefs to communicate issues and solutions to government policy analysts.

To prepare this nursing assignment, you are required to read the 2016 National Healthcare Quality and Disparities Report on the Agency for Healthcare Research and Quality website

Review the updated data and identify a possible meaningful policy change to improve care, lower costs, and reduce health disparities in your current role and place of practice, or the role you are pursuing. You will use this issue as you complete your policy brief. Search the Internet for the Association of Rehabilitation Nurses Health Policy Tool Kit and explore the toolkit.

Answer

1 Introduction
The 2016 National Healthcare Quality and Disparities Report undertaken in this nursing assignment have highlighted many disparities in healthcare rendered across USA. Such disparities have remained for rehabilitation nursing care as well. The current scope of discussion concerns evaluation of the 2016 National Healthcare Quality and Disparities Report and ways rehabilitation nurses can overcome certain disparities in the domain.

2 Underlying issue
The purpose of the Rehabilitation Nurses Health Policy Tool Kit is to inform nurses regarding the public and legislative policies such that patient and their family needs can be attended to. According to the 2016 National Healthcare Quality and Disparities Report, there was noticed a considerable improvement in overall healthcare however there have been some challenges as well.

Exploring the policy, a major issue identified is that though disparities considerably reduced from 2000 through 2014 – 2015 there was considerable variance across different areas (AHRQ, 2016). Disparities were noticed amongst poor and uninsured populations in priority regions. There were disparities for the Black and Hispanics which has decreased by 20% amongst this population group also in other racial and ethnic groups (ARN, 2021). Also, poor and low-income households are receiving the worst care when compared against high-income households with middle-income households receiving worst care than middle-income households.

3 Stakeholders
The stakeholders engaged in this policy includes the U.S. Department of Health & Human Services, The White House, the Government of the USA, the Agency for Healthcare Research and Quality amongst others (Jackson et al., 2014). While the above are the internal stakeholders who take active participation in designing and forming the policy, there are numerous external stakeholders involved which include healthcare professionals such as doctors, nurses and other practitioners, patients, their families, communities, society in general, other healthcare policy board members and many more amongst others.

4 Resolution
The roles of Rehabilitation nurses are extensive and involve a series of multi-disciplinary areas apart from providing rehabilitation to patients. Rehabilitation nurses need to be aware of the legislative processes and become involved in health policy advocacy for enhancing the overall healthcare system of the nation (Cook et al., 2012). Hence it is within their roles to ensure that patients from different population group are provided access to similar healthcare facilities. As rehabilitation nurse through advocacy, the issues identified in the disparities needs to be identified and tackled by specifically designing intervention plans for the same. The specific resolution includes catering to the identified (especially rehabilitation) needs of the racial minorities, the low-income group as well as a middle-income group.

5 At least 2 specific alternative resolutions
Alternative resolutions for the proposed issues include identifying specific needs of the low income and middle-income group such that specific intervention planning for meeting their rehabilitation needs can be attended to. A specific rehabilitation approach with adequate planning can enable suitable intervention, with a cost-specific approach that can enable tackling the issue. Adopting a specific approach with a key performance indicator (KPI) can enable tackling the issue to a great extent (Chin et al., 2012). KPI indicators adopted at individual healthcare centres specifically amongst rehabilitation nurses can enable effective intervention planning. With KPI measures being implemented every month and evaluation can enable effective intervention planning measures for tackling the issues.

6 Positive consequences of each resolution
Positive consequences associated with each resolution can be identified with effective tackling of the consequences. Understanding specific need-based interventions can enable designing specific intervention approach that matches the need of the community and social groups. This will enable an effective reduction in disparities amongst the low- and middle-income class groups. Further, they will avoid a generalised approach in tackling the need of this population. The benefit associated with KPI scores to be implemented amongst nurses and its evaluation amongst nurses will enable tackling issue identified amongst the low- and middle-income class. With KPI scores being implemented the low- and middle-income households having worse outcome can improvise significantly.

7 Negative consequences of each resolution
Though the intervention approach has been planned keeping in mind to bring about positive benefits amongst the targeted population group, there are some negative consequences identified as well. Negative consequences associated with identifying a need-based intervention approach might involve significant costs. To identify the broad-based intervention approach, there does not involve costs however for attending to the needs of the smaller population group, there are costs involved in identifying their needs (Dickman et al., 2017). For qualitative approach including coordination, effective treatment and healthy living along with care affordability for the targeted population group, effective research needs to be undertaken which might involve significant costs.

Again, adopting KPI scores amongst nurses and undertaking evaluation measures might involve considerable costs. This is the negative consequence associated with this measure. Also, it might be difficult to ascertain appropriate healthcare KPI to be adopted in the patient population.

8 Cost of each resolution
The cost associated with identifying a specific intervention approach includes $ 50,000 for undertaking research minimum. This involves planning a specific intervention approach for the targeted population group by undertaking research methodology. The cost will involve collecting data and then analysing them to arrive at specific outcomes related to the intervention. The cost associated with ascertaining KPI is significantly lower and might range between $500-$5000 maximum. This will involve online searching of KPI parameters adopted across US healthcare systems.

9 Financial implications of each resolution
With the resolutions aiming to reduce disparities in health amongst racial and ethnic minority’s also low- and middle-income groups, there will be considerable impacts. Financial implications in the short term might be raising insurance costs significantly and burdening the current healthcare system. However, long-term implications are considerable and might involve reducing disparities in health and the overall burden of healthcare costs.

10 Economic
The economic burden of such resolution might involve increased insurance costs and healthcare costs faced by the government.

11 Resources
Resources involved in implementing the resolutions might be considerable. It will involve financial resources, healthcare professionals especially rehabilitation nurses, healthcare centre and so on.

12 Quality of care
Overall implementation of the approach will bring about a considerable enhancement in the quality of care, especially amongst the low- and middle-income population group (Betancourt et al., 2016). The resolution approach is aimed at enhancing the overall quality of health care and ascertaining reduction in disparities in health faced by the low-income and middle-income population group.

13 Patient outcomes
The patient outcome, especially amongst racial and ethnic minorities, is expected to increase significantly. As the intervention approach is targeted at the low and middle-income population hence they are expected to have better health outcomes with reduced disparities in health.

14 Ethical considerations of each resolution
Ethical consideration of adopting a specific intervention approach might lead to ignoring the needs of the broad-based population. Hence every step to ensure that the needs of the overall population are being met needs to be considered while prioritising this approach.

Ethical consideration of adopting KPI scores might involve targeting specific outcomes only while ignoring the others. Hence every step needs to be assumed to ensure that when KPI is being adopted, it is uniformly being adopted for other disparities and healthcare outcomes as well. This will reduce ethical complications, leading to enhanced outcomes amongst the population.

15 Legal and regulatory considerations of each resolution
Legal and regulation consideration might be involved in each of the resolutions as it involves considerable new approaches. Appropriate permission needs to be obtained from healthcare centres and relevant legal authorities such as the Agency for Healthcare Research and Quality, the Association of Rehabilitation Nurses, also a necessary department of the US Health department and much more such that there is legal or regulatory compliance.

16 Include one legal case as supporting evidence for each resolution
Legal case as supporting evidence for the resolution of adopting a specific intervention approach isin accordance to the supporting file of the National Advocates for Pregnant Women as in Regina McKnight where in South Carolina Regina-McKnight 21-year-old African American women suffered stillbirth (NAPW 2005) (Paltrow, & Flavin, 2013).

For adopting KPI, the supporting case is of Rachael Lowe where a 21-year-old pregnant woman went to the hospital for seeking help for her addiction (Paltrow, & Flavin, 2013).

17 Include one existing regulation as supporting evidence for each resolution
Regulation as supporting evidence for each resolution areas proposed in the ARN's Health Policy toolkit.

18Conclusion
In conclusion, intervention planning needs to be undertaken such the disparities can be overcome in an effective manner. Also while applying such interventions careful planning with cost considerations need to be taken.

1 REFERENCES
AHRQ. (2016). 2016 National Healthcare Quality and Disparities Report. Agency for Healthcare Research and Quality-U.S. Department of Health & Human Services. Retrieved from [https://www.ahrq.gov/research/findings/nhqrdr/nhqdr16/summary.html]

ARN. (2021). ARN’s Health Policy Toolkit Educates and Informs. Association of Rehabilitation Nurses. Retrieved from [https://rehabnurse.org/about/advocacy/advocacy-toolkit]

Betancourt, J. R., Green, A. R., Carrillo, J. E., & Owusu Ananeh-Firempong, I. I. (2016). Defining cultural competence: a practical framework for addressing racial/ethnic disparities in health and health care. Public health reports.

Chin, M. H., Clarke, A. R., Nocon, R. S., Casey, A. A., Goddu, A. P., Keesecker, N. M., & Cook, S. C. (2012). A roadmap and best practices for organizations to reduce racial and ethnic disparities in health care. Journal of general internal medicine, 27(8), 992-1000.

Cook, B. L., McGuire, T. G., & Zaslavsky, A. M. (2012). Measuring racial/ethnic disparities in health care: methods and practical issues.Nursing assignment Health services research, 47(3pt2), 1232-1254.

Dickman, S. L., Himmelstein, D. U., & Woolhandler, S. (2017). Inequality and the health-care system in the USA. The Lancet, 389(10077), 1431-1441.

Jackson, C. S., & Gracia, J. N. (2014). Addressing health and health-care disparities: the role of a diverse workforce and the social determinants of health. Public Health Reports, 129(1_suppl2), 57-61.

Paltrow, L. M., & Flavin, J. (2013). Arrests of and forced interventions on pregnant women in the United States, 1973–2005: Implications for women's legal status and public health. Journal of Health Politics, Policy and Law, 38(2), 299-343.