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Formulation of the Problem
The sphere of medical services is developing every year, which contributes to the emergence of new methods of caring for people. However, one of these was the initiative to create home health facilities. The essence of this proposal is to provide assistance to patients at home, which will significantly reduce the number of unnecessary patient transportation and provide comfortable treatment. At the same time, this initiative has opposing sides and causes ethical concerns. Among them may be insufficient supervision of patients, the need for doctors to travel a lot to individuals, or the possibility of violating moral norms. Thus, this work aims to study the business issue of home health facilities, which has ethical implications. First of all, it is necessary to gain an understanding of what the business proposal under study is. Home health care is an approach to treatment that involves the provision of medical services not within the hospital but at the patient’s home. It was proposed as an alternative to traditional methods of treatment, as it has several significant advantages for both patients and healthcare organizations. Therefore, it helps to reduce the cost of providing care to individuals with similar effectiveness of care as in a hospital. Moreover, patients feel much more comfortable, which also contributes to a more successful course of healing, and medical facilities are freed from possible overloads of wards. However, despite all these positive aspects, this initiative raises several concerns that require more detailed consideration. Despite the presence of some areas of undesirable influence, home health facilities are very popular in the healthcare sector. Research shows that it “is one of the fastest-growing healthcare industries in the United States, with approximately 1.4 million people employed in home health care services” (Choithramani, 2022, para. 3). Depending on the complexity of the disease or the severity of the patient’s injury, a plan is selected and services that will be provided to the individual at home. Hence, the patient can be visited by a direct attending physician, who will check the patient’s condition and prescribe treatment depending on the condition. Moreover, nurses can come to people who will ensure that the correct course of care is followed. Most often, these medical professionals are engaged in health maintenance activities, for example, wound dressing, ostomy care, or pain control.
Critical Thinking
Regarding the business issue in question, a critical thinking overlay is needed. This is due to the fact that it has both positive and negative sides, thereby requiring the need for their assessment. The problem with home health facilities is the issue of their effectiveness compared to traditional hospitals. Therefore, “caring problems, inadequate nurses’ ability, poor management, lack of adequate infrastructure, cultural difficulties, coordination and inter-professional cooperation” are noted among the challenges (Fatemi et al., 2019, p. 3). Moreover, issues often arise related to inadequate wages and lack of job satisfaction among medical personnel.
Decision-Making Techniques
Thus, when implementing the initiative to create a home health facility, a clear and structured formation of the decision-making process is required. Thus, it is necessary to consider several steps at once that must be taken before proceeding to direct action.
Step 1: Goal Identification
In order to avoid ethical problems as much as possible, it is necessary to clearly define the purpose of implementing the treatment approach. This is especially true of such new initiatives as home health services since the public is not yet thoroughly familiar with them. When setting a goal for an organization, the next step will be to adhere to it, around which further activities will be formed. It is worth noting that a critical component is gaining an understanding of how the proposed initiative can contribute to solving current problems in healthcare.
Step 2: Gather Information
After managers determine the goal that will serve as a guide for further development, they should start collecting information. Thus, conducting data research can provide valuable knowledge about earlier attempts at implementation of the initiative and what challenges have arisen. Moreover, providers are given a deeper understanding of which areas require more assistance and how home health facilities can be effective in them. In addition, collecting information will help identify newer solutions that will not only provide an advantage among competitors but also provide the most productive and successful outcomes. The collection of information also contributes to the factors that affect decision implementation. Among them may be the need for services, the level of the disease.
Step 3: Consequences
The most critical step in deciding on the implementation of the initiative is to consider the possible consequences of the activity. This is especially true for the provision of medical services, since people’s health depends on how the assistance will be provided. Thus, it is important to initially identify possible negative outcomes and ways to deal with them. This is also due to the fact that undesirable consequences can also affect the staff and the facilities itself. Moreover, the criticality of this step is that it allows you to weigh in advance all the pros and cons of various solutions.
Step 4: Evaluation of the Decision
After determining the goal, possible consequences and collecting information, managers need to make a final decision regarding their initiative. The next step will be to conduct an assessment after the implementation of the proposal. This is important for timely identification of possible problems and shortcomings.
Resources and Actions for Implementation
For any initiative that affects government organizations and services, several steps must be followed. Thus, in order to function within the state, the facility must acquire an Employer ID Number. It represents Federal Employer Identification Number (FEIN), which has nine digits for identification and taxation purposes. Next, it is necessary to obtain registration with the secretary of state, which will also allow you to carry out the intended activities within the region. Creating a formal business plan is essential to create the basis for an initiative to provide services at home. Hence, it needs a description of the start-up capital, possible costs, the number of employees, and other aspects related to the financial side of the implementation. In more detail, the business plan should include an executive summary with a description of the facility and what kind of activity it plans to perform. Moreover, it will provide information about the goals and tasks that will be performed. Further, it is necessary to draw up a marketing plan that will describe the advertising company and measures that will help spread awareness about the initiative. After this step, it is vital to create an operational and financial plan and also submit it for consideration. They are of particular value, as they inform about the facility itself and all aspects that relate to staff, supplies, and resources. Financial plan forms an understanding of how a company will manage its cash flow forecast, a balance sheet, and a break-even point analysis. After ensuring the previous steps and making sure that they meet all the necessary requirements, it is necessary to determine such aspects as funding and state licensing requirements, and insurance. Obtaining these items will enable further consideration of the necessary resources for the formation of the home health facility. Therefore, one of the most important is the preparation of a plan for hiring employees to perform official duties. Managers need to take this process incredibly seriously, since the reputation of the entire medical institution and, first of all, the quality of patient’s health will depend on their activities.
Ethical implications
The work of a clinical provider, even within a home health facility, is directly associated with ethical risks as long as it is based on interactions between two or more individuals. In this case, one of the main ethical implications of the home health facility is the potential conflict of interest that arises between the provider and the patient. Since the health care provider comes to the patient’s home for the purpose of providing home care, it is not unlikely that aspects of their communication will include additional health-related topics. During their discussion, there is a risk that the non-medical interests of the two parties will not align; this may include religious, cultural, societal, or political views. Thus, the home health facility experience can be disruptive if clinical providers are not influential leaders with advanced communication, leading to conflict and confrontation. Another ethical consequence of this decision is the need to respect the patient’s right to choose unconditionally. Home care is often motivated by the patient’s desire to grow old at home, in an environment that is comfortable and familiar to them, or a reluctance to be in hospices for terminally ill patients (MSP, n.d.). In either case, the client’s desire is paramount and should not be challenged by the provider. The health care provider must accept the patient’s choice and respect their decisions rather than discourage or insist on other forms of treatment. It is worth clarifying that this strategy is more sensitive when the patient’s care at home cannot be adequately provided and being at home proves disruptive to health. Even in this case, however, the ultimate decision rests with the patient if they are competent. Another ethical consequence of the home health facility is the development of an undesirable friendship between the clinical professional and the patient. It should be pointed out that the relationship between the two parties should be positive and constructive, leading to the well-being of the patient. However, this does not mean that the clinical provider should become a full-fledged friend to the patient, spending time with the patient in addition to performing professional tasks. Ignoring this important aspect can lead to subordination in the nurse-patient relationship, leading to disruptive effects on clinical support. If the patient is not living at home alone, an additional ethical consequence of the home health facility is the safety hazards to the household members. For example, if an elderly mother lives with her young children (grandchildren), this situation is potentially dangerous for the children if the patient is prescribed medication. The medications the patient receives should be in a place away from the children to eliminate the possibility of accidental ingestion. This is just one example of additional safety precautions in the case of family patients. For this reason, the clinical provider should educate the patient to inform them of the possible risks and to talk about measures to improve the safety of the household.
References
Choithramani, A. (2022). 14 steps to start a successful home healthcare agency. Care Academy. Web.
Fatemi, N. L., Moonaghi, H. K., & Heydari, A. (2019). Perceived challenges faced by nurses in home health care setting: A qualitative study. International Journal of Community Based Nursing and Midwifery, 7(2), 118. Web.
MSP. (n.d.). The four principles of health care ethics for home care providers. Manchester Specialty Programs Insurance. Web.
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