Policy Analysis
The Affordable Care Act (ACA or Act) is one of the public policies that impact the health care system, nursing, and the quality of relationships that may be developed between patients and medical workers. The ACA aims to solve existing system problems in America through reforming the private market, expanding health care to the poor population, and changing the way of how medical decisions should be made (Fischer, 2016).
Drivers to be addressed in this policy include a perfect combination of service costs, quality levels, and access to care for patients with different incomes. At this moment, the American public understanding of the Act remains unclear because people lack necessary information and examples (Pasek, Sood, & Krosnick, 2015). The investigation of Bakalar (2017) shows that the number of uninsured people has considerably decreased during the last five years: 28 million in 2016 compared to 48 million in 2010. Therefore, it is possible to say that the ACA appears to be achieving some of its intended results and has positive effects on health care, nursing, and the quality of services.
Particularly, my nursing practice in the emergency department undergoes certain successful changes with this Act. Nurses turn out to be one of the key leaders in reforming the way of how health care should be delivered. Nursing care becomes coordinated and value-based, removing organizational problems that lead to nurse shortage (Fischer, 2016). Besides, the prevention of diseases and promotion of wellness become possible as new evidence-based strategies are offered to and by nurses.
In total, the ACA has already changed many lives and working conditions for nurses. Still, the application of Kingdon’s Model can be a solid contribution to this policy development as new problems and solutions may be discussed and solved. Nursing interventions can be a serious step in improving the ACA in the US population and healthcare system.
Workflow Improvement
A workflow in any hospital is a combination of properly coordinated steps and decisions, communication and problem-solving, information exchange, and professionalism. Each department has its peculiar features, and the medical staff should be ready to think fast. For example, the workflow in the emergency department (ED) includes the necessity to evaluate much new information and cooperate with different people (Lee et al., 2015). Therefore, such concepts as the possibility to read others’ experiences via social media sources, get educational presentations from invited experts, and observe various workflow tools using the current technologies and online services can be used to redesign the ED workflow.
It is hard to predict the number of resources and people in the emergency department. The improvement of information management systems and contact mechanisms occurs regularly. For example, Chartier, Simoes, Kuipers, and McGovern (2016) suggest paying special attention to such factors as the utilization of beds in the ED and the necessity to remove bed turnaround delays. This change is possible with the help of making optimized decisions, evaluating the already achieved results, and using in-house technologies, operational timing systems, and monitored rooms (Chartier et al. 2016). Each step is an important part of the plan-do-study-act cycle the result of which is to reduce time-to-bed.
The effects of technology on the work of hospitals and emergency departments, in particular, may vary. On the one hand, technologies can help gather enough information about patients from different facilities in a short period (Everson, Kocher, & Adler-Milstein, 2016). On the other hand, some medical employees can be confused with several options and required new knowledge. Additional training and education can be required to monitor the effects of technology, as well as to monitor the abilities of people who participate in such evaluations. Patient satisfaction decreased staff turnover, and the discovery of new workflow improvement options are the results that should be achieved.
References
Bakalar, N. (2017). Nearly 20 million have gained health insurance since 2010. The New York Times. Web.
Fischer, K. (2016). How the educational funding provisions of the patient protection and Affordable Care Act will affect the nursing shortage in the United States. Northwestern Journal of Law & Social Policy, 11(1), 54-77.
Pasek, J., Sood, G., & Krosnick, J. A. (2015). Misinformed about the affordable care act? Leveraging certainty to assess the prevalence of misperceptions. Journal of Communication, 65(4), 660-673.
Chartier, L. B., Simoes, L., Kuipers, M., & McGovern, B. (2016). Improving emergency department flow through optimized bed utilization. BMJ Quality Improvement Reports, 5(1), 1-6. Web.
Everson, J., Kocher, K. E., & Adler-Milstein, J. (2016). Health information exchange associated with improved emergency department care through faster accessing of patient information from outside organizations. Journal of the American Medical Informatics Association, 24(1), 103-110.
Lee, E. K., Atallah, H. Y., Wright, M. D., Post, E. T., Thomas IV, C., Wu, D. T., & Haley Jr, L. L. (2015). Transforming hospital emergency department workflow and patient care. Interfaces, 45(1), 58-82.