The role of government is, partly, to enact laws that focus on promoting the public good. A good example is the Affordable Care Act which saw a considerable number of individuals acquire health insurance coverage. In the same manner, Florida’s Hospital Patient Protection Act seeks to address the various health issues within the state. Some of the healthcare challenges considered are such as the nurse-to-patient ration, the qualification requirements of nurses among other hospital staff, reducing patient care costs, among others. However, there is a need to discuss the various implications of the law and how they influence both access and delivery of healthcare services in Florida. Of the issues mentioned, the cost of health care across the country remains a domineering challenge. As patients present with diverse health care needs, hospitals are forced to address nursing shortage by hiring more workers while also investing in training already existing and oncoming health professionals. Thus, a discussion of the strengths and weakness of the policy as pertains to cost would allow for identification of opportunities for improvement.
Background of Issue
Access to competent nurses has its own financial implications which have a considerable effect on the health care outcomes of patients across the country. In Florida, the bill in question makes it clear that its focus is to promote a competent body of medical professionals. In part it reads, “A health care facility may not assign a direct care registered nurse to a clinical unit unless… such nurse has demonstrated competence in providing care in the clinical unit” (Florida Hospital Patient Protection Act, 2019). In this particular section, the act explains the importance of having qualified and skilled nurses who are entrusted with administering treatment and catering for diverse patients’ needs. Understandably, a primary concern for the policy in question is the direct access to high quality health care services. Therefore, there is no compromise when it comes to the competence of those entrusted with patients. Scholars Manoochehri, Imani and Atshzadeh-Shoorideh and Alavi-Majid (2015) discussed the impact of employing novice nurses. The various themes they identified were such as task rearing, knowledge and profession rearing roles. With such themes, it becomes evident that nurses, as is required by the act in question, should demonstrate their capacity to handle patients’ needs. The idea is not only to have a reliable nurse-to-patient ratio, but also to ensure that employed nurses are qualified. Therefore, the policy has emphasized the effect that having competent nurses will have in promoting healthy outcomes for patients.
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Undoubtedly, the cost of health care in the United States as well as in other developed countries has been a major challenge. Vulnerable populations, for instance, have diverse health care needs which put pressure on the government in terms of resources. Emanuel, Glickman and Johnson (2017) explained that roughly 57% of the U.S. population worry about both availability and affordability of health care services. Additionally, more than 60% complain that prescription drug prices are high and should be a top priority for health care. The issues being raised can be summarized as the outcome of never-ending increases in cost across the continuum of health. However, in Florida, the policy in question seeks to address the challenge of cost in health care. It demands that patients must be cared for only in clinical or hospital units whereby “… the level of intensity, type of care, and direct care registered nurse staffing levels meet the individual requirements and needs of each patient” and that further, “A health care facility may not use an acuity adjustable unit to care for a patient” (Florida Hospital Patient Protection Act, 2019). The section at hand seeks to optimize the use of already existing health care resources while avoiding such costs as the demand for more nurses to cater for patients’ needs.
One of the debates which has been given considerable attention is the nurse-to-patient ratio discussion. In order to better manage the health care environment in hospitals alongside other health care facilities, there is a need to consider the impact of advocating for the employment of more nurses. Everhart et al. (2013) conducted a study in Florida addressing the effect of nurse staffing on hospitals’ financial performance. The findings showed that there was a positive effect on financial performance but only for competitive hospital markets and not for the less competitive ones. Such a finding demonstrates that there is a divided effect as pertains to the demand for more nurses in hospitals with an aim of improving patients’ outcomes. The policy under discussion is precise in its focus on the issue of patient acuity. As mentioned earlier, the concern is not whether there are enough nurses to address patients’ needs but whether already existing nurses are sufficient enough in their capacity to administer care services. Hence, that is a major point of concern especially in regions where there is a higher intensity in terms of demand for health care services.
Recommendations
Patient safety is one of the core factors under which the policy in question is based. However, when it comes to cost, there are certain aspects which should be considered. As mentioned earlier, more nurses are likely to improve a hospital’s performance if it is in a competitive market. The implication is that the delivery of health care services has become intensified demand swift action from concerned parties. While there are those who argue for an increase in the ratio of nurses to cater for diverse patients’ needs, there are those in contention of the same. Livanos (2018) explained that health care changes rapidly implying that an inflexible policy might not be able to “… account for the changes in technology, design, and innovation” (p. 68). Therefore, the recommendation is that Florida should not adopt a “one-size-fits-all” attitude which is likely to undermine the effect of the dynamic environment of hospitals. For instance, it is possible to have a high intensity for less demanding care needs which implies that more nurses should be employed. However, it is important to consider the effects on cost as pertains to hiring and overall hospital financial performance.
A major provision which could bring about positive outcomes in Florida involves strict policies on the provision of training and development opportunities for medical staff. In the current age of continued technological advancement, hospitals are being forced to invest in such a resource to promote positive patient outcomes. Emanuel, Glickman and Johnson (2017) explained that already existing workforce should be exposed to extensive training on how to use technology such as electronic health records to promote patients’ health outcomes. The likely impact would be reduced processing time of a patient’s data hence pushing for efficient admission and discharge. That being the case, hospitals in Florida will not only be ahead when it comes to technology integration but will also experience a positive outcome in terms of addressing the public’s health care needs. However, it is important to consider that some health care professionals might be opposed to integration of technology possibly due to job security issues. However, a balance should be established between the use of both technology and the human labor force.
References
Emanuel, E. J., Glickman, A., & Johnson, D. (2017). Measuring the Burden of Health Care Costs on US Families. Jama,318 (19), 1863. doi:10.1001/jama.2017.15686
Everhart, D., Neff, D., Al-Amin, M., Nogle, J., & Weech-Maldonado, R. (2013). The effects of nurse staffing on hospital financial performance: competitive versus less competitive markets. Health care management review , 38 (2), 146-55.
Livanos, N. (2018). A Broadening Coalition: Patient Safety Enters the Nurse-to-Patient Ratio Debate. Journal of Nursing Regulation,9 (1), 68-70. doi:10.1016/s2155-8256(18)30056-5
Manoochehri, H., Imani, E., Atashzadeh-Shoorideh, F., & Alavi-Majd, A. (2015). Competence of novice nurses: role of clinical work during studying. Journal of medicine and life , 8 (Spec Iss 4), 32-38.
