Ethical and Policy Factors in Care Coordination

Assessment 2 Instructions: Ethical and Policy Factors in Care Coordination
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Assessment 2 Instructions: Ethical and Policy Factors in Care Coordination

Coordinators of healthcare activities need to be conversant with the code of ethics and policies that influence coordination and continuum care to achieve better outcomes. The paper focuses on nursing homes and explores the possible health policies that impact coordination and continuum care. It shows that failing to abide by necessary ethical frameworks and working following health policies could affect how practitioners work as a team to improve outcomes and follow up on a patient’s case starting from the time of entry and post-hospitalization. Better and effective coordination and continuum care only come when nursing homes follow ethical guidelines and work per health policies’ provisions.

How Government Policies on Health Affect Coordination of Care

Nursing homes need to be conversant with government policies and regulations that are likely to impact care coordination. For instance, the provisions of the Health Insurance Portability and Accountability Act (HIPPA) of 1996 have a considerable impact on how nursing homes coordinate care such that several caregivers effectively work on a patient’s case in a coordinated way to enhance the suitable delivery of health care services (Bova, Sullivan-Bolyai & Drexler 2012). Nursing homes learn from HIPPA the importance of safeguarding delicate patient health information from being utilized without the patient’s knowledge or approval. Nursing homes know that it is unlawful to use patient’s health data without their consent to facilitate healthcare activities, payment, treatment, and individual gain or public interest (Bova, Sullivan-Bolyai & Drexler 2012). Thus, nursing homes learn to protect patient data as various specialists work on a patient’s case. The Affordable Care Act (ACA) of 2010 is another government policy that impacts how nursing homes coordinate care. Nursing homes must notify the various specialists working on a patient’s case to acknowledge that the ACA forbids insurance firms from rejecting coverage because of pre-existing conditions and allows as many Americans as possible to access health (Manchikanti, Helm, Benyamin & Hirsch 2017). Adhering to ACA guidelines is essential to nursing homes and how they coordinate care because it encourages the equitable provision of attention rather than focusing on specific groups and individuals. Therefore, the management and individual practitioners in the various nursing homes need to become familiar with the policies to build effective coordinated care.

Policy Provisions that Raise Ethical Dilemmas for Care Coordination

Abortion laws as provided for in the landmark ruling of Roe v. Wade of 1973 and the legislation by various states continue to raise ethical dilemmas for care coordination. Nursing homes, especially in states that do not permit abortion, still wonder whether it is proper to establish coordinated activities for those who require abortion services (Bandewar 2005). The dilemma on abortion services also exists in nursing homes functioning in states that permit abortion, with some individual practitioners or facilities questioning whether it is indispensable to terminate an unborn child (Bandewar 2005). The dilemma surrounding abortion laws has resulted in mixed reactions in how facilities coordinate care for patients who require such services. Some go ahead to develop proper frameworks for assisting those in need of such attention, while others choose to scrap abortion from their services.

Another policy that raises ethical dilemmas and impacts the provision of coordinated care in nursing homes is assisted suicide or euthanasia, which vary from one state to the other. Some nursing homes still consider the ethics surrounding ending a person’s life, with some holding that the practice is unacceptable and unethical (Kalal 2019). Consequently, they do not develop coordinated structures to assist those who require such services. On the other hand, other facilities do not find any problem with performing euthanasia and have created systems to improve coordination while attending to such people or individuals.

Impact of the Code of Ethics for Nurses on the Coordination and Continuum of Care

The Code of Ethics for Nurses formulated by the American Nurses Association (ANA) outlines the nursing profession’s chief objectives, obligations, and values. It is a clear framework for the ethical duties and responsibilities of every person who joins the nursing profession (Zahedi et al. 2013). The primary ethical guidelines that guide nurses’ practices include; veracity, fidelity, nonmaleficence, autonomy, accountability, and justice (Zahedi et al. 2013). The code of ethics impacts coordination of care in the way caregivers learn the importance of avoiding disparity or discrimination while providing care to patients. The concept of justice requires practitioners to attend to everyone without prioritizing their race, religion, or background. The code of ethics promotes healthcare delivery across the continuum of care to attain the goals of Healthy People 2020, which chiefly aims at developing a healthier nation (CDC 2020). For instance, nurses provide services from the time a patient enters a nursing home and follow up until he or she is stable enough to proceed with daily activities with the motive of helping them achieve high-quality, longer lives free of risks and threats such as premature death, disability, injuries, and preventable diseases. 

Key Ethical and Policy Issues Affecting the Coordination and Continuum of Care

Conflict of interest is a possible ethical issue that could affect coordination and continuum of care. A situation where the aims or concerns of two different entities are not compatible could affect coordination and continuum of care because some caregivers may seek to acquire personal benefits from decisions or actions made in their capacity (World Health Organization 2018). For example, some nurses may choose to help a particular patient overcome their problem as a team, while one or more people assigned to the team may not support the suggestion. Such conflicting perceptions could tamper with service delivery after the patient leaves the facility (continuum of care), and the ultimate effect, in this case, is a poor or unsatisfying outcome.

Inadequate staffing is a policy issue that has direct adverse effects on the coordination and continuum of care. Insufficient or improper planning during policy formation and execution results in a low number of caregivers, which affect how various specialists work on a patient’s case and facilitate their recovery (World Health Organization 2018). The coordination level is likely to depreciate when a nursing home lacks enough employees, and the same is expected to happen with continuum care (World Health Organization 2018). The facility may not have enough caregivers to follow up on a patient’s case, which shows the importance of developing policies that advocate for enough staffing.


The study provides valuable information that may be important to nursing homes that offer a wide range of services to patients. Nursing homes learn vital lessons from health policies such as HIPPA and ACA that they can use to improve coordinated care. It also illustrates how nursing homes have to consider how controversial policies such as abortion and euthanasia impact coordinated care. The study describes the importance of following the code of ethics for nurses to achieve improved coordination and care continuum. The report identifies a conflict of interest as a possible ethical issue and inadequate staffing as potential ethical and policy issues, respectively, that could affect coordination and continuum care.


Bandewar, S. (2005). Exploring the ethics of induced abortion. Indian Journal of Medical Ethics

            2 (1), 18-21. doi: 10.20529/IJME.2005.009

Bova, C., Sullivan-Bolyai, S., & Drexler, D. (2012). Reframing the influence of the Health

            Insurance Portability and Accountability Act on research. Chest 141 (3), 782-786.

            doi: 10.1378/chest.11-2182

CDC. (2020). Healthy People 2020. Retrieved 16 January, 2020, from

Kalal, N. (2019). Review article on euthanasia. International Journal of Current Research 10

            (11), 75543-75546. doi: 10.24941/ijcr.32801.11.2018

Manchikanti, L., Helm, S., Benyamin, R., & Hirsch, J. (2017). A critical analysis of Obamacare:

            Affordable care or insurance for many and coverage for few? Pain Physician 20 (3), 111-

            138. ISSN 1533-3159

World Health Organization. (2018). Continuity and coordination of care. Geneva: World Health


Zahedi, F., et al. (2013). The code of ethics for nurses. Iranian Journal of Public Health 42 (1), 1-


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