Introduction
In the USA, there are plenty of healthcare regulatory agencies to go around – they monitor and regulate every sphere of public and private healthcare, on various levels ranging from state to federal. These organizations work with nurses, hospital personnel, and legislative bodies, in order to make sure that all healthcare institutions are conducting their business according to the law, and do not endanger or infringe standard procedures, practices, or violate patient rights. It is important for a DNP graduate to know what these organizations are, which ones operate in his or her area of practice, what they do, and how they would affect medical practice. The purpose of this paper is to identify 5 major healthcare regulatory agencies in the US, describe the agency, level of regulatory authority, scope of regulatory authority, and role within the US healthcare system.
Centers for Medicare and Medicaid
Centers for Medicare and Medicaid (CMS), previously known as Healthcare Financing Administration, is an agency that regulates and works with various state-funded healthcare programs, such as the Medicare, Medicaid, SCHIP, health insurances, and other related areas (“Regulations and guidance,” n.d.). The agency operates on a federal level and has 10 regional offices, including its headquarters in Woodlawn, Maryland. Each of these offices oversees several states. CMS provides guidance, legislation, administrative simplification procedures, regulations, and policies to all states, with the regional offices dealing with more specific realities of the healthcare institutions located under their jurisdiction (“Regulations and guidance,” n.d.).
CMS has a direct influence on DNPs, whether they’re still in training or graduates, as CMS defines the standards of practice and care, as well as admissions for certain spheres of healthcare. For example, until AACN advocated for CMS to change the language for nurse reimbursement, APRN services required a nurse to have a master’s degree, rather than a graduate degree alone. In relation to the area of practice, a DNP nurse would need to relate to the rules and regulations established by one of the regional offices responsible for his or her region. In addition, a DNP nurse will need to deal with different CMS regulations, depending on her area of expertise – pediatric care, treating adult patients, elderly patients, and palliative care.
Agency for Healthcare Research and Quality
Agency for Healthcare Research and Quality (AHRQ) is a federal agency that, as the name suggests, considers itself with research and improvement of the quality of healthcare, cost reduction, addressing patient safety, reducing medical errors, etcetera (“Agency for healthcare research and quality: A profile,” n.d.). It is an agency that operates on a federal level and falls under the jurisdiction of the US Department of Health and Human Services (HHS). Its headquarters are in Rockville – a suburb of Washington DC.
There are several ways in which AHRQ could be relevant to a DNP graduate’s medical practice. For one, AHRQ supports and regulates all medical research done either by organizations or individuals, and offers support in terms of materials, information, equipment, funds, and grants. All nurses are expected to do research in order to improve medical standards and practices in the country. Should a DNP graduate involve himself or herself in research, they should seek out AHRQ for help, advice, and funding.
Joint Commission on Accreditation of Healthcare Organizations
Joint Commission on Accreditation of Healthcare Organizations, or JCAHO, is a federal agency responsible for the evaluation and accreditation of all healthcare organizations in the US (“About the joint commission,” n.d.). This system is implemented to ensure that all healthcare organizations operating in the country conform to the standards of quality healthcare. Without it, such regulation would be impossible, and the patients would be forced to trust a myriad of unaccredited organizations of all shapes and sizes with their health, and suffer from their varying degrees of deficiencies. The agency’s headquarters are located in Oakbrook Terrace, Illinois (“About the joint commission,” n.d.).
A DPN graduate would not encounter JCAHO directly. This agency’s duties involve examinations of entire healthcare organizations rather than individual nurses and doctors. However, hospitals are made of individuals, and the performance of each and every employee may affect the overall score in a positive or a negative way. In addition, should a DPN desire to open her private practice or a healthcare organization, it too would be subjected to JCAHO’s judgment.
Centers for Disease Control and Prevention
Centers for Disease Control and Prevention (CDC) is a healthcare agency based in Atlanta, which oversees all measures taken for the prevention of health threats from infectious diseases. As widespread infections are a national problem, this agency also operates on a federal level. Its activity is not limited to a single state or a region of the country. The CDC is in charge of monitoring and assembling a great deal of information, such as birth defects and disabilities, data on environmental health and promotion, information on injury and violence rates in different areas of the country, vaccination, work safety, smoking, and tobacco use, etc. (“Smoking and tobacco use,” n.d.). The agency falls under the jurisdiction of HHS.
A DPN nurse does not interact with this agency directly. The data filled out about patient statistics may or may not be used to constitute a report for the CDC. However, the agency takes a direct involvement in the prevention of outbreaks through either working in the field or doing preventive measures. The information bulletins spread by the hospital to warn patients of certain health risks are developed and distributed under the jurisdiction of CDC.
Food and Drug Administration
The Food and Drug Administration (FDA) is a federal healthcare agency that is responsible for promoting public health through monitoring the foods, drinks, beverages, and other consumable items on the US markets. Under its jurisdiction falls the regulations of tobacco products, alcohol, dietary supplements, over-the-counter drugs, pharmaceuticals, and a myriad of other products (“U.S food & drug administration,” n.d.). Since it is a federal agency, its authority spreads over all states and federal subjects. Naturally, all medical facilities have to follow the regulations in regards to the allowed and available pharmaceuticals, medicines, drugs, and dietary choices.
A DNP graduate would need to deal with the FDA regulations all the time, as its guidelines on what medicines and drugs are allowed and which are not are expected to be followed. In addition, FDA regulates the food served at the hospitals and other medical facilities, in order to ensure that hospitalized patients are all healthy and fed. Nurses and therapists that deal with cases of obesity, as the FDA provides guidelines for treating those. Blood supplies used for transfusion and other medical practices are also regulated by the FDA.
Conclusion
HHS has many federal agencies under its jurisdiction that cover every aspect of public healthcare, imposing necessary regulations in order to promote quality care and protect the interests of the patients, as well as ensuring that healthcare is provided in the most effective and cost-efficient way possible. This paper covered five federal agencies, but there are much more, including state and local healthcare agencies that provide rules and regulations tailored to the local specifics and state laws.
References
About the joint commission. (n.d.)
Agency for healthcare research and quality: A profile. (n.d.)
Regulations and guidance. (n.d.)
Smoking and tobacco use. (n.d.)
U.S food & drug administration. (n.d.)