Politics of Patient-Centered Care - Essay Example

THE POLITICS OF PATIENT-CENTERED CARE Introduction To steer and orient heath systems to patient-centred and evidence-informed approaches, it is important for governance to rely on new tools for promoting performance measurement and accountability in the context of broadened alliances and partnerships. Establishing strong governance at the planning, policy, provision, and purchasing levels facilitates rapid changes concerning the culture of service delivery[Gun13]. As such, in the 21st century, the cornerstone of governance within the health system involves making health policies more intersect oral, evidence-informed, transforming leadership accordingly, and participatory. With this in mind, the political arena has a major role to play in the establishment of such policies both at the national and state level. Health care professionals are the implementers of the established health policies and hence are now faced with a key responsibility in directing positive affluence towards the political process of health care systems’ governance. Ranging from the development of national health plans to financing of health care initiatives, the political environment has a direct influence over the healthcare system[Gun13]. This paper is a proposal examining the current state of political influence over patient-centred care and recommending the role that health care professionals can play in influencing the political climate in promoting patient-centred care initiatives. Patient Centred Care in Australia Patient-centred care has gained much relevance in the health care system over the recent past considering the importance of involving the patients in making health care decisions that involve their health. Research and the international shift towards patient-centred care have been the major drivers of increased pressure on national governments to establish policies that would facilitate the integration of patient centred care into the health care system[Ram13]. Australia has seen increased political initiatives aimed at promoting patient-centred care, an aspect that has been associated with improved patient outcomes across the health care system. The health care system in Australia is majorly funded via a tax-based, small, compulsory health insurance levy and general taxation[Ram13]. Medicare, the national health insurance scheme that is funded through taxation, provides free public hospital treatment for patients and access to a medical doctor of their preference through the out-of-hospital care program. On the other hand, the Government Pharmaceutical Benefits Scheme offers patients subsidies in access to medicines (Surbone et al., 2013, p. 379). A majority of the doctors in the Australian health care system, including both specialists and general practitioners (GPs), are from the private sector[Ann13]. These individuals are self-employed and hence funded by the Medicare system. On the other hand, nurses are employed by the government and the private health care organisations. Undoubtedly, health care professionals play a major role in facilitating patient centred care and implementing the policies established by the government to promote patient-centred care (Edvardsson & Innes 2010, p. 836). As much as consumers and health care professionals are important in ensuring patient-centered care is promoted across the health care system, the political environment plays the regulatory role and hence it is of major importance to the promotion of patient-centred care. For patient-centred care to be effectively implemented, all the stakeholders should be involved in the establishment of polices and their implementation. As such, health care professionals have a role to play in influencing the establishment of patient-centred policies in the political environment (Forman 2011, p. 220). Initially, nurses were shut out of the process of policy development and hence had to bow to the policies that were in some areas not favourable to them, considering the fact that they are the ones experiencing the daily challenges of implementation of patient-centred care (Forman 2011, p. 234). Nevertheless, health care policy in Australia has undergone increased reform to incorporate nurses through their representative organisations and to include them in the active implementation of patient-centred initiatives. One of the areas that have seen increased reform involves the Practice Nurse Incentive's program. The government introduced this program in 2011, to offer funding that would allow for increased employment of nurses and hence addressing the issue of staffing within the health care organisations. Sufficient staffing is key to the implementation of patient-centred care as it allows nurses enough time with the patients, which is key in understanding the patient and establishing a relationship that will allow the patient to open up to the nurses and to participate in the health care process. Increased incentives towards general practice among nurses also allow for increased flexibility among nurses, allowing them to focus in areas that require greater attention[And11]. Another major reform that has been well implemented in the health care setting towards promoting patient centred care involves expansion of the Medicare rebates to include nurse services that are provided outside public hospitals. The federal parliament also approved nurse rebates covered by the Pharmaceutical Benefits Scheme[Pat13]. Nevertheless, in as much as such initiatives have been put in place, there are other areas addressed inadequately through the established initiatives. In such a case, it is the role of nurses to ensure that they are actively involved in the policy planning and development process to allow for the areas that are of greater importance to them to be adequately catered for in the developed policies[Eps11]. Nurse Leadership in The Health Care System Nurse leadership is highly important in defining health policy and provides an avenue through which nurses can be able to influence the health care process and to establish a system that would allow them, to effectively offer their services towards promoting patient centred care. Individuals are most likely to adopt environments and policies that they play a role in establishing as they consider the various challenges and obstacles that they may face during the planning and development of the policies. In Australia, at the level of health systems, Nurse leaders are found in various areas including steering groups and agencies, government departments, health advocacy groups, and health care regulatory bodies (Wong et al. 2013, p. 711). With their deep understanding and experience in the health care sector, nurse leaders have a major role to play in facilitating positive reform within the health care system. The have increased knowledge of the societal, economic, and political forces that define health care, and the health care needs of the consumers with regards to accessibility of quality care. Through their positions, nurse leaders identify and challenge the cultural, social, and financial barriers faced by individuals in accessing health care (Willcocks 2012, p. 9). Based on their professional backgrounds, nurse leaders have a better understanding of the relationships and roles of the different groups providing health care in Australia. Nurse leaders are hence well placed within the health care system to support the embracement of patient-centred care, informed by the perspectives and values of their profession. As such, nurse leaders can draw on health systems, operational, and clinical perspectives to participate in national debates concerning patient-centred care. Nurse leaders also have a clear understanding of the complex interactions of regulation, policies, and economic incentives, with a clear understanding of the needed changes to promote necessary reforms (White 2011, p. 835). As such, the nurse leaders establish partnerships at the national, state or local level, including partnerships with other health care professionals, community advocates, policy makers, and political representatives. Such partnerships are highly important in influencing the political environments impact on health care policy. Nurse leaders, as representatives of nurses share their understanding of the nursing profession and the general practice of patient-centred care with policy makers and political representatives, allowing for the inclusion of such policies in the development of patient centred initiatives (Wang et al. 2011, p. 446). As representatives of the health care professionals, nurse leaders are expected to present the grievances and challenges that are faced by the health care professionals, including nurses in implementing patient centred care. Health care policy makers organise forums through which leaders including nurse leaders are engaged in discussions pertaining the development of policies that would facilitate quality health care including patient-centred policies. The Current Role of Health Care Professionals in Health Politics There are various initiatives that have been put in place by the national, state, and local governments in Australia with the view of promoting patient-centred care. Among the various initiatives that have been put in place, listening to the patient feedback has received increased support across various jurisdiction (Maville & Huerta 2013, p. 11). This forms the first role of health care professionals in influencing health politics. Moist jurisdictions across Australia carry out surveys to determine the experiences of the patients across different settings. Health care professionals are highly involved in such surveys even as they administer the various survey tools within the health care organisations including questionnaires and interviews with the patients. In New South Wales, health care professionals are involved in conducting Patient and Care Experience surveys on an annual basis (Maville & Huerta 2013, p. 24). Besides, there is an increased call for condition-specific surveys to determine the aspects to consider in establishing condition-based health care policies. Such a survey includes the cancer experience survey that is carried out among cancer patients by the Cancer Institute NSW. The Victorian Patient Satisfaction Monitor survey is another state survey that is carried out by the state government with the help of health care professionals to determine the level of satisfaction of health care professionals and the various factors that drive such satisfaction. Other State-level surveys conducted within the health care environment to determine trends and the level of patient centred care include Queensland Health Patient Satisfaction review, the Australian Capital Territory Healthcare Survey, and the Western Australia and South Australia Patient Evaluation of Health Services review. Tasmania has established a Patient Satisfaction System in view of measuring patient-centred care (Maville & Huerta 2013, p. 27). The results obtained from such surveys are important in identifying the trends in patient care and patient centred care, to benchmark findings against service providers of the similar status, monitoring performance, and informing patient quality and safety and health service planning initiatives (Crisp et al., 2013, p. 48). In this case, consumers and patients are involved in the process of interpreting the survey findings and offer direction concerning areas of priority. Health care professionals communicate the findings of such surveys to the related State authorities. Such information is highly important in informing policy development initiatives and influencing legislative functions of the State. Another role played by health care professionals, including nurses, in influencing the political environment and its impact on the health system involves conducting their national duty and exercising their right to voting-in the right leaders (Guzys & Petrie 2014, p. 64). The kind of leaders that are voted into the local, state, or national government implement their plans for the public. As such, by ensuring that good leaders with a proper understanding of the need for patient-centred care and the various issues that surround patient centred care such as the obstacles that may be faced by health care professionals while implementing this kind of care are voted into power, health care professionals positively influence the development of proper policies and political initiatives towards patient-centred care. In addition, Health care professionals also elect or appoint their leaders in the various representative organisations, who represent their views and interests on patient-centred care. The use of social media and other media platforms to call out to political figures on issues of importance in the health system also allows health care professionals to effectively influence the politics of health even as such political leaders explore the raised issues and push for change (Smith et al. 2012, p. 348). Political figures have established platforms on social media networks that allow them to communicate and listen to members of the public. Health care professionals exploit such platforms and raise issues of importance in promoting patient-centred care. Proposals for Change As much as health care professionals have various avenues through which they influence the political arena and the establishment of effective health policies and initiatives. It is clear that there has been less empowerment of health care professionals in Australia, to allow them to effectively have a say in health care politics. In most cases, politicians, who have less knowledge of matters of health care make the important decisions that affect the practice of health care professionals, including nurses. The benefits of patient-centred care have already been evident in health care settings, with different measures of positive patient outcomes being registered. As such, allowing health care professionals, who implement the established policies and initiatives on the ground, to have a say in health care politics would allow for the establishment of more effective patient-centred initiatives. Primary health care and policy are shaped by the contributions of members of the public, who are the consumers of the health care services, in identifying areas of priority in the prevention of disease, facilitating healthy living, disability and injury (Edvardsson & Innes 2010, p. 840). As such, the development of policies must meet the treatment, health care rehabilitation, and self-management needs of the people. Nurses are the first advocates of the patients as the relationship that they establish with the patients allow them to develop a better understanding of their needs for care[Eil09]. In some cases, they may fail to meet the patient needs as a result of the impairments that exist within the applicable policies. Case in point, without proper funding from the government to allow for the access of some of the health care provisions by members of the public, nurses may not do much to assist such patients to meet their case specific needs. With this in mind, it is important for the process of policy development to actively involve health care professionals and consumers of health care in the establishment of policies that affect them and their needs. Governments at all levels should establish open forums through which they can engage health care professionals in discussing the various areas of patient-centred care that are still facing challenges or require improvements and the measures that can be put in place to effect such changes (Smith et al., 2012, p. 128). This will allow for a clear understanding of the changes required in the established policies among the political class and, hence, the effective establishment of appropriate policies that would promote patient-centred care. The establishment and implementation of any health services and health policy are based on the belief that “nothing about us can be done without us”. As such, the sustainability and legitimacy of any of the major policy decisions on primary health care highly depend on how well such decisions reflect the views and values of the community. Community participation and engagement requires the opportunity for nurses, other health care providers, and members of the community to assess evidence, identify priorities, and establish and implement approaches towards improving health care as per the identified priorities (Forman 2011, p. 179). Considering the importance of community engagement, it is thus important for the governments at all levels to establish a Commission that involves all the stakeholders in making important policy development decisions. By having representatives on such a commission, the health care professionals will be able to effectively influence the development of effective policies, including policies surrounding issues of funding of patient-centred care initiatives, among others. The role of health care professionals in research is also important in influencing the political environment. Some of the decisions made regarding policy development, not only in the health sector but across other sectors, highly rely on scientific or social studies where applicable. As such studies depict a clear picture of the situation on the ground and hence provides guidelines on which of the initiatives may be effective in changing the situation (Maville & Huerta 2013, p. 34). As such, by engaging in research on patient centred care and publishing such information, nurses and other health care professionals would feed information that can be relied upon in the health care system, in making important decisions that would determine the effectiveness of patient-centred initiatives in promoting the health of the society. Another approach through which health care professionals can effectively influence the political health care environment involves vying for political positions within the society. If nurses vie for political positions and are elected into office, they will have an advantage of using their political influence and their background understanding of the health care sector to advocate for proper policy development that are directed towards improving patient centred care (Forman 2011, p. 156). Less health care professionals venture into politics, thus leaving individuals with less understanding of the health care sector to take up political positions and to make important decisions that affect the health care environment. Having politicians that are also aware of the health care environment and the various challenges that are faced in implementing patient centred care would allow for proper establishment of effective initiatives that would promote positive improvements in terms of promotion of patient centred care. Conclusion It is evident that health care professionals have an important role to play in influencing health politics and promoting patient-centred care. The political environment is highly important in influencing the health care programs and approaches through policy development. By influencing the political environment and the development of policies that define professional health care practice, health care professionals play a major role in effective patient centred care. It is without doubt that health care professionals already play an important role in influencing the political environment at different capacities including as Nurse Leads, voters, and conducting government surveys. Nevertheless, this paper has identified gaps in terms of the role of health care professionals in influencing the political environment and has hence proposed various approaches that could be upheld towards facilitating proper political influences of the health sector, including vying for political office, establishment of integrative Commissions that would include health care professionals, and engagement in research. References Gun13: , (Almgren, 2013, p. 172), Gun13: , (Almgren, 2013, p. 189), Ram13: , (Ramlaul & Vosper, 2013, p. 25), Ram13: , (Ramlaul & Vosper, 2013, p. 26), Ann13: , (Boxall & Gillespie, 2013, p. 23), And11: , (Miles & Mezzich, 2011), Pat13: , (Staunton & Chiarella, 2013, p. 6), Eps11: , (Epstein & Street, 2011, p. 101), Eil09: , (Willis, et al., 2009, p. 41), Read More