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The practice of giving patients the best treatment possible is referred to as care coordination. In order to enhance the delivery of healthcare, integrating diverse components of the process in a logical way is required. Undoubtedly, a care coordination plan’s performance depends on a number of factors, including health policy, the use of local resources, the ANA nurse’s code of ethics, and many more. The key premise of care coordination is patient-centered care, which ensures the benefit of the patient. Patient-centered care is all it takes to ensure that the patient is at the center of the care process. Patient-centered interventions aim to ensure that the patient plays an active role in the care process (Misselbrook, 2017). Patient engagement is critical to improving care delivery and providing the best outcomes.
One of the main issues the Christian African American Community faces is the ethical issue of perinatal care. During the postnatal period, when women undergo significant physiological changes that put them in danger of mortality, healthcare workers have been known to spend less time with African American patients, dismiss their symptoms and concerns, and sever ties with them (Scott et al., 2019). This made it necessary to create a care coordination plan that concentrated on three distinct problems. This care coordination plan is based on the specified timeline of 8 weeks, which seems appropriate to address the key issues. Additionally, it was essential since patients’ lives and relationships are significantly impacted, which also had a big negative impact on their health.
The first aspect of the problem is fetal anomalies are dangerous consequences that are frequently linked to the ethical issue of perinatal care. The brain, nervous system, or sensory perception are just a few examples of body parts or systems that are impacted by these functional disorders (Kiernan & Jones, 2019). Patients must be informed about the condition, its prevalence, and what care coordinators are doing to prevent major complications. Thus, patient education would help a patient cope with the issue, while other medical interventions, such as fetal surgery for severe congenital malformations or receiving adequate care before and during pregnancy, can also be beneficial (Kiernan & Jones, 2019). Birth Defects Registry, National Birth Defects Prevention Center and the Mayo Clinic are possible community resources for treating fetal anomalies.
The second severe issue connected to the ethical issue of perinatal care is fetal-maternal conflict. When a pregnant woman declines medical therapy or intervention deemed essential to maximize the safety of the patient’s life and that of her unborn child, a conflict between the mother and fetus results (Scott et al., 2019). In these situations, it is morally advised for the care coordinator to consider the patient’s objections to his medical advice before deciding what to do next. Respect should be shown for the woman’s independence and her deliberate rejection. Patient education, expert counsel, or enhanced health screening are all examples of potential solutions (Scott et al., 2019). Maternal Health Center, CHC-Community Health Center, and the Mayo Clinic are community resources that can be employed to assist the patient.
The third aspect is depression, which is a prevalent disorder that impacts patients facing this ethical issue. A patient’s psychological health is impacted when facing this issue and significantly impacts her future life. Although they are separate mental health issues, anxiety and depression frequently co-occur. Depression, a mood disorder, might negatively impact a person’s life. It is marked by despair, rage, or a sense of loss (Frias et al., 2020). Although depression and anxiety are difficult to diagnose, these issues must be treated since they might have a serious impact on the patient.
It is vital to make sure that the patient resumes the regular routine and takes medication, if necessary, while the practitioner has to teach patients about depression and anxiety in order to treat these psychiatric problems. It is also crucial that the patient has a good social environment with amiable individuals who can improve the patient’s life. The Minnesota Mental Health Center, the Mayo Clinic, and Heart Partners Regional Hospital may be community resources that the patient needs in this case.
A crucial component of medical care is ethics. Throughout the treatment process, healthcare providers must make moral decisions. The provision of ethical medical care involves the use of ethical principles and values throughout the delivery of medical treatment while also taking into account the patient’s requirements. The primary policy manual that aids nurses in operating within an ethical framework is the ANA Code of Ethics for Nurses (Haahr et al., 2020). Additionally, the fundamental ethical values of autonomy, fairness, nonviolence, and compassion are crucial for effective care coordination (Misselbrook, 2017). These premises are crucial for ethical considerations in care coordination.
Healthcare professionals have to ask themselves numerous questions related to uncertainty about their decisions. For example, “Did the coordination of treatment offer the patient the best potential care related to ethical considerations?” Another possible question to consider is “Was patient safety ensured during the care coordination process?” Regarding the practical outcomes of the decisions, the key variable is the benefit to the patient (Haahr et al., 2020). Any decision on intervention should be made with the patient’s best interests in mind as far as the practical results are concerned. For example, the practical effect of fetus surgery can be overshadowed when the patient is not educated on the issue, and it is ethically incorrect to provide the intervention without her concern. Getting a patient’s approval is essential to making any choice and is the center of all practical considerations.
The fundamental definitions, choices, strategies, and plans that are used to provide the highest quality of medical care while also taking patient safety and maintaining health standards are known as health policies. To give citizens the highest quality of healthcare possible, the government must create a health policy (Cabanal, 2018). In this specific instance, some healthcare strategies that are crucial for the coordination of treatment are applicable.
Addressing the care coordination for the Christian African American Community, several policy provisions can be highlighted. The chosen community has benefited from administrative simplifications and Medicaid coverage, highlighted in The Affordable Care Act, which increased access to healthcare. To satisfy the needs of patients, there was a need to coordinate medical care due to an increase in the number of patients (Haahr et al., 2020). Another beneficial aspect of health policy provision became the ethics section of the Health Insurance Portability and Accountability Act (HIPAA). The Christian African American Community benefited from it due to the allowance for insurance coverage for a variety of medical requirements. In addition to it, emphasis on ethics when delivering care was the key premise that reflected the healthcare issues faced by the community.
One of the expected goals for care coordination is patient satisfaction. The aforementioned training sessions allowed the patient and other stakeholders to express how satisfied they were with the care coordination procedure (Cabanal, 2018). The prior improvements will be integrated into the final care coordination plan as described in the preceding section to further increase patient satisfaction.
Numerous aspects of the Healthy People 2030 initiative suggested that the care coordination procedure was in line with the objectives of Healthy People 2030. To assist the country in achieving particular health goals and targets by the year 2030, Healthy People 2030 was established (Healthy People 2030, 2020). The framework for Healthy People 2030 states that perinatal care is a significant area of healthcare that needs to be addressed (Jackson et al., 2021). In fact, the initiative identified care coordination as a technique to treat ethical issues connected with perinatal care (Jackson et al., 2021). This indicates that the coordination plan meets the initiative’s standards in full.
The care coordination plan must be based on certain principles that develop through training sessions. Whether in individual or family session, regular meeting is an essential principle because it makes sure that everyone engaged is aware of their responsibilities under the care coordination plan (Quinn et al., 2017). It is feasible to deduce from the sessions what the patient anticipated from the care coordination plan, making changes based on evidence-based practice. Another crucial principle is reviewing the plan with the patient, which allows the care coordinator to make interventions and educate the patient a priority.
The plan must always be improved and revised. The need for changes can be evident to both parties in different situations. Sometimes the patient signals that more sessions are needed since the present number is insufficient. Within the context of the selected community, greater participation of the family in the sessions, which had an impact on them as well, may also be linked to the need for modifications and alterations. Owing to the diversity of the Christian African American Community, more interdisciplinary approaches may be needed in some sessions; the care coordinator may also observe in order to better explain particular interventions to the patient. Revisions to the final treatment plan would aid with a better understanding and coordination of care.
References
Cabanal, J. (2018). Patient-centered policies must be centered on healthcare workers too. OECD Observer, 1-3.
Frias, C. E., Garcia‐Pascual, M., Montoro, M., Ribas, N., Risco, E., & Zabalegui, A. (2020). Effectiveness of a psychoeducational intervention for caregivers of people with dementia with regard to burden, anxiety, and depression: a systematic review. Journal of Advanced Nursing, 76(3), 787-802.
Haahr, A., Norlyk, A., Martinsen, B., & Dreyer, P. (2020). Nurses’ experiences of ethical dilemmas: A review. Nursing Ethics, 27(1), 258-272.
Healthy People 2030. (2020) Social Determinants of Health. Web.
Jackson, D. N., Trivedi, N., & Baur, C. (2021). Re-prioritizing digital health and health literacy in healthy people 2030 to affect health equity. Health Communication, 36(10), 1155-1162.
Kiernan, E., & Jones, K. L. (2019). Medications that cause fetal anomalies and possible prevention strategies. Clinics in Perinatology, 46(2), 203-213.
Misselbrook, D. (2017). Culture and ethics in healthcare. Handbook of Primary Care Ethics, 27(1) 45-52.
Quinn, M., Robinson, C., Forman, J., Krein, S. L., & Rosland, A. M. (2017). Survey instruments to assess patient experiences with access and coordination across health care settings: Available and needed measures. Med Care, 55(7), 84–91.
Scott, K. A., Britton, L., & McLemore, M. R. (2019). The ethics of prenatal care for black women: Dismantling the structural racism in “mother blame” narratives. The Journal of Perinatal & Neonatal Nursing, 33(2), 108-115.
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