Financial Implications of Patient and Family-Centered Care Initiative
In today’s bad economic times, calls to reduce healthcare costs have been very loud. Indeed, the cost of healthcare has been rising constantly and all stakeholders are becoming concerned about people’s capability to meet these healthcare costs (especially among the lower-middle-income and low-income groups) (Landgrave, 2004).
As such, there has been an increased focus on adopting more pocket-friendly healthcare models. Among such initiatives are the patient and family-centered care initiatives. This initiative has also received tremendous support because of its ability to improve healthcare quality (Magee Women’s Hospital, 2011). However, among the greatest concerns for its adoption is its cost of introduction and implementation.
Based on the financial implications of adopting the patient and family-centered healthcare model for Magee Women’s hospital in the USA, this paper points out that the incremental costs for adopting patient and family-centered care are rather dismal (compared to the benefits associated with it) (Magee Women’s Hospital, 2011, p. 4).
Nonetheless, among the main processes that require immediate financial considerations when implementing the healthcare model is training healthcare personnel to learn new elements of healthcare as explained in the patient and family-centered model. More importantly, all other auxiliary programs that are expected to support such a process also require adequate funding. Depending on the requirements of an organization, among the most notable projects that require significant financial allotment is the construction or development of an innovations center (Magee Women’s Hospital, 2011).
This center is expected to provide different auxiliary programs that are aimed at improving training and education programs to support the proper implementation of patient and family-centered care initiatives. Another important function that will be supported through the construction of an innovations center is the provision of a resource center to caregivers, both within and outside the institution.
Apart from the construction or development of the innovations center, a significant amount of financial resources is expected to be allocated to the development of a care team (Magee Women’s Hospital, 2011). The care team is expected to be comprised of different professions in the healthcare sector. When Magee women’s hospital introduced their patient and family-centered healthcare model, they had to recruit physicians, nurses and therapists (Magee Women’s Hospital, 2011, p. 4).
The introduction and maintenance of such a team require adequate money which may be spent through recruitment processes, the provision of allowances, payment of overtime expenses (and other expenses that may be incurred to maintain such a team). Recruitment and maintenance of such a team is often subject to the commitment of the team members in realizing the true goals of the team.
Perhaps the most notable financial cost for the introduction of a patient and family-centered care model is the training of staff. Referring to Magee’s women’s hospital implementation of the patient and family-centered care model, it was explained that “The entire team of physicians, nurses, therapists, and ancillary staff were trained on the Disney Corporation’s model of treating customers well from their first experience to their last, with the goal of constantly exceeding expectations” (Magee Women’s Hospital, 2011, p. 5). Indeed, training the nursing staff amounted to extra costs.
Landgrave (2004) explains that, in today’s digital age, the cost of training the nursing staff may include the cost of buying new books, computer-based resources and other materials (or equipment) that may be useful in the entire exercise.
However, since most of the nursing staff that will be re-trained are recruited from within the institution, Landgrave (2004) explains that, perhaps the most effective way of ensuring desirable training outcomes are attained is adopting instructor-led training. Such a training methodology may involve the recruitment of instructors. Precisely, such an initiative requires adequate funding. However, it is important to explain that instructor-led training is the most expensive training method (but it is optional for organizations) (Landgrave, 2004).
Even though the above recommendations (for introducing the patient and family-centered care model are elaborate), they mainly constitute tangible costs associated with the same. There are other (intangible) costs that are still associated with the introduction of this healthcare model. For example, subjecting existing nurses through the new training program may lead to wasted man-hours which would have otherwise been used in the daily running of the institution. For explanatory purposes, Landgrave (2004) explains that,
“If you send 10 developers to an off-site, all-day class, you’ll not only pay $1,500 per developer for tuition and travel expenses, but your organization will also lose 400 hours of work time and 400 hours of personnel cost at your current internal rate. At a modest $35-per-hour rate, that equates to a minimum of $29,000—$14,000 for employee time, plus $15,000 for training fees (excluding travel) for a week of training” (p. 10).
The complication in subjecting existing employees to new training programs arises when the desired results for the training program are not effectively realized. For example, it is difficult to justify training programs if the nurses have a negative attitude towards the whole program (or they do not understand the importance of introducing the patient and family-centered care model) because they will spend a lot of organizational doing “nothing”.
Ethical and Legal Implications of Patient and Family-Centered Care Initiative
The growing number of medical errors in the recent past has brought to fore many concerns regarding the ethical conduct of healthcare professionals (Pozgar, 2012). Healthcare professionals have an important ethical duty when they interact with patients and other individuals in the healthcare practice.
However, the introduction of new healthcare models has further complicated the ethical and legal implications in healthcare. The introduction of the patient and family-centered model is one such complication. Notably, the patient and family-centered healthcare model has introduced a new relationship in healthcare – family and nurse relationships.
Traditionally, the main relationship in healthcare service provision has been constrained between healthcare service providers and patients. However, the introduction of the ‘family’ in this relationship brings with it a new legal obligation that healthcare service providers need to consider. In detail, nurses have a duty to include family members in their decision-making process, failure to which the institution may be sued (Pozgar, 2012).
Another ethical implication that arises from the introduction of patient and family-centered care is the fact that nurses are trained to take care of the patient in a holistic way; however, the introduction of the ‘family’ in the healthcare model seems to substitute their roles. Indeed, nurses are trained to provide emotional and physical support to patients in a holistic manner such that the quality of their services should not be perceived to be lacking (or insufficient).
However, the introduction of family support through the patient and family-centered model questions the reliability of the healthcare services provided by the nurses. This healthcare model can therefore be said to substitute the nurses’ roles, thereby making them irresponsible to the patients’ welfare. The sub-delegation of roles to family members may prove to be a legal and ethical issue that needs to be properly addressed (or explained).
In addition, the introduction of patient and family-centered care emphasizes on two main elements in the provision of healthcare – patients and family members (Reuter-Rice, 2011, p. 59). Therefore, the emphasis on these two groups overshadows the role of the healthcare providers. In other words, it is easy to point out that the roles of the healthcare service providers are being effectively demeaned in this context.
However, healthcare service providers are more informed about pertinent health issues. The focus on patients and family members however erodes this fact. This situation creates a significant ethical problem because under the patient and family-centered model, the healthcare professionals are supposed to focus on patients and family members (more) but, among the three most important contributors to the provision of healthcare services (patients, family members and healthcare service providers), patients and family members are least experienced with healthcare matters.
Therefore, the ultimate question in this context therefore lies in determining whose views should prevail in a critical health dilemma. Should the patient’s views be more important than the healthcare service providers? Or should the contributions of the family members be considered with the same weight as patients and healthcare providers? The patient and family-centered model however stresses on patients’ and family members contribution more that the healthcare service providers (Reuter-Rice, 2011, p. 59). This situation changes the traditional healthcare model and poses a serious ethical dilemma as well.
References
Landgrave, T. (2004). The true cost of training staff. Web.
Magee Women’s Hospital. (2011). Patient- and Family-Centered Care Initiative is Associated With High Patient Satisfaction and Positive Outcomes For Total Joint Replacement Patients. Web.
Pozgar, G. (2012). Legal and Ethical Issues for Health Professionals. London: Jones & Bartlett Publishers.
Reuter-Rice, K. (2011). Pediatric Acute Care. London: Jones & Bartlett Publishers.