Policy, Politics and Global Trends in Health Sector Why the Public Policy Issue Was Chosen?

According to the report released by National Priorities and Goals -- aligning efforts meant to transform America's Health care (NQF, 2009; Partnership, 2008). NPP (National Priorities Partnership) came up with 6 priorities. If the priorities are addressed, it could improve the quality of health care delivered to the U.S. citizens. NPP consists of 48 major U.S. health care organizations, which work with NQF (National Quality Forum). It identifies and advances priorities geared at improving health care in the future (NQF, 2009). NPP has identified palliative care as one of the six priorities that can help improve patient-based utilization outcome. This article provides the background to help identify steps to assist match the medical treatment of the patient and family objectives. It concerns itself with access to quality hospice services and palliative care (Meier, 2011). This policy looks at the part of palliative care that can be incorporated into the United States of America's health care system.

1. It enhances the value of health care

The value in health care refers to the ratio of quality to cost. The value can be improved by reducing the cost and also improving the quality. People who have multiple functional impairment and chronic conditions constitute10% of the patients in the U.S. It accounts for more than half of the cost of health care (Office of the Assistant Secretaryfor Planning and Evaluation, U.S. Department of Health and Human Services, and The Lewin Group, 2010). Palliative care that targets the patients in hospitals are evolving (Goldsmith, Dietrich, Du & Morrison, 2008). As a result, they have increased both their value by reducing the cost of care for those who are sick and those suffering from complex problems. Hospices that are certified as Medicare serve over 1.5 million dying Americans every year. From this discussion, it is evident that hospice programs and Palliative care are crucial to improving the health care value through the ability to improve the quality of care and reduce the cost the health care system faces.

2. Improving the Quality of Care

Palliative care and hospice programs are meant to improve the psychological and physical symptoms of patients and, family caregivers. It is also meant to improve the bereavement outcome and ensure physical satisfaction.

These goals can be achieved through the care provided by the nurses, social workers, spiritual counselors' psychologists, aids, pharmacists and physicians. In such cases, palliative care and hospice teams are charged with the responsibility of establishing goals and plans for safe transitions out of health units and support families in crisis.

Proper communication on the patient's prognosis and the goals by all the teams ensure better decision making and guarantees consistent follow up. Discussions at a family level lower the cost and reduce the burden on the family (Wright, et al., 2010). It also reduces dissatisfaction and improves bereavement outcome. According to the recent studies, it has been demonstrated that both palliative and hospice care are associated with a significant prolongation of the patient's life (Bakitas, et al., 2009) (Connor, Pyenson, Fitch, Spence, & Iwasaki, 2007).

Relevance of the Public Policy Issue to the Nursing or Health Profession

An audit at the national hospital deaths revealed that 25% of patients could not have lost their lives at home, if community resources were in place. However, without hospice beds or support, many families have little choices, even when the patient's condition deteriorates (Hospice Friendly Hospital programs 2010). Ultimately, these impacts heavily on emergency departments, bed utilization, trolley waits usage as well as discharge rates.

For instance, Milford Care Center has been able to reduce death rates by 6%. In the same breadth, nationally, palliative care has been able to reduce the proportions of death in hospitals from 43% to 21%. According to studies conducted in the U.S., Canada and Spain, it demonstrated that Palliative care had a positive impact on the cost of acute care (Irish Hospice Foundation, 2014). In effect, it has been able to increase the deaths occurring at home from 26% to 42%. This shows that there is a positive impact of development of palliative care programs. This means that the policy will benefit health care and nurses by reducing the costs associated with staying in hospitals.

The Financial Impact of the Policy to the Community or Organization

According to recent statistics (Morrison et al., 2008), palliative care has helped save $2,659. In the U.S., 2% of the 30 million people who are hospitalized die (AHRQ, 2002). This number includes the 4% of patients...

According to the 2009 data, all U.S. hospitals with more than 50 beds have established palliative care centers (Goldsmith, Dietrich, Du, & Morrison, 2008). The centers affect more than 1.5% of all the discharges and are estimated to save over $1.2 billion annually.
The Impact of My Values on Public Policy Issue

Care is considered the greatest value both in personal life and in field. Hospital palliative services have become more significant since they provide the much needed care, even when medicine cannot provide the desired cure. Patients deserve quality health care during the time of illness. It is meant to meet the needs of the dying patients, thus hospitals are under an obligation to offer such programs in pursuance to the principles of non-maleficence and beneficence. Clinicians must always relieve pain and improve the quality of life of their patients to the best of their abilities (Paulus, 2008).

The Ethics and the Principles of the Perspective

The theory ethics of care places more significance in the elements of relationship and human life dependencies. It seeks to maintain a relationship by promoting caregivers and care receivers' well-being. It entails meeting your needs and those of other people. It is anchored on the motivation to care for the vulnerable or those who are dependent. Thus, care ethics affirms the importance of caring, moral deliberation as well as reasoning (Sander-Staudt, 2015).

Importance of Decision Making in Public Policy Issue

Hospices are better placed to provide improved symptom management compared to the cure-based care. Patients, who have access to hospice care lead an improved life, don't suffer from depressions and associated symptom issues. They are less exposed to risks that lead to hospitalization and incur reduced costs from utilization of health care facilities and resources.

The benefits are also extended to friends, caregivers and family who are always satisfied with the quality of care given.

According to research published in the journal of American Medical Association (Obermeyer et al., 2014), hospice care is important to cancer patients since they are less likely to be hospitalized or admitted in ICU or undergo invasive procedures. This study was conducted on 40,000 cancer patients who died in 2011. The study concluded that health care costs are reduced by $9,000 per hospice patient. In addition, almost seventy-five percent of non- hospice patients died in nursing homes or hospitals compared to the fourteen percent of the hospice patients. According to the study, there is need for physicians and patients to discuss the importance of the palliative care (Brikman, 2014). All said, it is clear that hospice and palliative care has not made inroads in the healthcare settings. Consequently, there is need for the policymakers to realize the importance of the policy to avail the care to those who need it.

Challenges of Addressing the Chosen Public Policy Issue

One of the main challenges of receiving hospice and palliative care include: access, inadequate workforce, lack of research evidence that can be used as a guide and a measure of care as well as lack of knowledge on the benefits of hospice and palliative care.

Access to Hospice and Palliative Care

Palliative care has only been available to patients in hospice programs (National Consensus Project for Quality Palliative Care, 2004). Fortunately, there are many hospitals that provide palliative care programs, which take care of the seriously ill patients and those waiting to die. More than 62% of U.S. hospitals with 50 beds and 84% of hospitals with over 300 beds have been reported to have the palliative care programs. However, in the U.S., access to hospice programs and palliative care is highly variable. In the south, the profit hospitals with less than 100 beds are not likely to have palliative care programs ((American Hospital Association, 2009; CAPC, 2010). This is not the case for the not-for profit hospitals outside the south. In settings in which palliative care is available, there is still a great deal of variability, and patients have access to half the time of nurses as well as full time interdisciplinary palliative care experts. Even though, it is important to note that the presence of palliative centers that are adequately staffed may not guarantee full access to palliative care services.

Workforce

Lack of medical and nursing workforce experienced in palliative care is one of the barriers to accessing palliative care services. In the past few days, the number of palliative medicine specialists has experienced significant shortfalls (Salseberg, 2002). This calls for a policy whose objective is to increase…