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Policy Proposal

Alao Moussilimou

Capella University

NHS-FPX6004: Healthcare Law and Policy

Dr.Tangela Hales

1 July, 2023

Policy Proposal
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Every day, policies influence clinical decisions, hospital and clinic operating rules, and

healthcare spending by governments and insurance companies. As defined by the Institute of

Medicine, a clinical guideline is “a systematically developed statement intended to assist

physicians and patients in making decisions about appropriate medical care in a particular

clinical situation. “Guidelines provide precise instructions on order which diagnostic and

screening tests, Medical or surgical services provided, how long the patient should be

hospitalized or other details of clinical practice. (Woolf et al., 1999). This article presents metrics

from the Mercy Medical Center public health dashboard that was analyzed to suggest

organizational policy and practice guidelines. We believe it will lead to better quality and

performance related to poor benchmark performance.

The Need for Creating a Policy and Practice Guidelines

Mercy Medical Center's (MMC) dashboard highlights the need to develop policies and practice

guidelines to improve patient diabetes screening, staff training, support for adequate staffing of

medical professionals, and the need for multilingual inter-professional engagement of health

professionals and stakeholders to improve patient outcomes. As is evident from the dashboard

and factsheet, no specific benchmarks and criteria for MMC and underperformance ratings were

specified or recorded. One is the issue of proper adequate staffing, education and multilingual

communication to address racial diversity issues tracked in the dashboard. Moreover, this factor

affects the quality of care and organizational operations, as understaffing relative to the

population of the MMC community leads to hospital delays and overcrowding of health

facilities. Non-English speaking races may face difficulties due to language barriers. According

to Olani et al. (2023), ‘’ The impact of language barriers on patients includes avoidable medical
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errors, poor treatment adherence, poor health-oriented behaviour, additional treatment costs,

more extended hospital stays, weaker treatment relationships, and social desirability and

dissatisfaction with healthcare services. ’’ The repercussion for not making any change in that

regard would lead to a more complex diabetes condition and compound the factors affecting

diabetes self-management amongst the population and health care disparity for Non-English

speaking race. According to Kumar & Mohammadnezhad (2022), ‘’ health system challenges

such as lack of material resources and human resources compounded the factors affecting

diabetes self-management. Healthcare workers training as diabetes educators and developing

policies on diabetes self-management are highly recommended to facilitate diabetes self-

management.’’ Furthermore, regarding the language barrier, ‘’ Language barriers are essential in

accessing medical care and staying healthy. Social policies and health interventions that address

language-related health disparities can help reduce the public health impact of T2DM in

heterogeneous societies.’’ (Zheng et al., 2012).

Ethical and Evidence-Based Practice Guidelines to Improve Targeted Benchmark

Adequate staffing and education would also positively increase the number of patients for eye

and foot exams and the use of telemedicine and medical devices to help self-manage and monitor

diabetes. According to Piya et al. (2022)," Hospitals are seeing a growing number of patients

who have diabetes, most of whom are cared for by unprofessional staff. The increasing

prevalence of diabetes places a heavy burden on the healthcare system, with 1 in 4 to 5

hospitalized patients with diabetes. The increasing number of diabetic hospitalizations means

that most hospital care for people with diabetes is not provided by diabetes professionals, making

diabetes education for non-professional caregivers a priority. Studies show face-to-face hospital
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education increases healthcare workers' confidence in diabetes care. One of the ways to improve

diabetes care in hospitals has been using technology, including networked blood glucose meters

with a dashboard or the use of Flash Glucose continuous glucose monitoring systems."

Strategies for ensuring adequate staffing, overcoming language barriers and accessing

healthcare must be ethical and evidence-based care under state and national laws. According to

Han et al. (2021)," Empirical studies have shown that adequate nurse staffing is essential for

delivering quality care and safe nurse working conditions associated with better patient

outcomes. As of 2020, 14 states had implemented legislation to increase hospital nurse staffing.

The legislation includes three main approaches:

Mandating minimum nurse staffing ratios in hospitals

Mandating a staffing committee substantially comprised of registered nurses (RNs)

Mandating public reporting of nurse staffing levels

Through this strategy, there would be effective and adequate staff coverage for most of the

diabetic population that would visit the healthcare centre for screening.

The principle of Justice must be implemented to ensure that these strategies are ethical and

culturally inclusive in their application. According to Kathleen (2023)," Justice is that there

should be an element of fairness in all medical and nursing decisions and care. Nurses must care

for all patients with the same level of fairness despite the individual's financial abilities, race,

religion, gender, and sexual orientation." Therefore, ethical and cultural inclusiveness can be met

with adequate staff strength and education.

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These changes will directly affect the working environment and demands of healthcare

workers and other stakeholders. Also, more knowledge and education about diabetes are needed

to educate patients with correct information about their health. In contrast, patients must adjust to

newly acquired knowledge and learn techniques such as glucometer. However, healthcare

providers must provide financial arrangements and adequate budgets to cover the costs of hiring

more healthcare workers. Moreover, patients and community leaders must embrace and adapt to

change, actively participate in training, and switch from old health management methods to

prescribed treatments for health and self-care.

Potential Effects of Environmental Factors on Recommended Practice Guidelines

Eliminating Disparities in Diabetes Prevention, Access, and Care Act (H.R. 2651), this bill

will enhance research at the National Institutes of Health on the causes and effects of diabetes in

minority communities. Additionally, under the bill, the Centers for Disease Control and

Prevention will provide more effective diabetes treatment, prevention, and public education to

highly impacted populations. This includes access to effective community interventions such as

the National Diabetes Prevention Program. Finally, through the efforts of the Department of

Health Resources Services, the bill will empower public health workers in communities hard hit

by diabetes. (H.R.2651 — 114th Congress. 2015-2016)

Regulatory considerations that may affect the policies I recommend include activities that the

Department of Health Resources may be involved in providing specific education to the public

and encouraging the use of telemedicine. It may be restricted or regulated, which may require

approval. Also, because the CDC is responsible for public education, it may need more space for

people's education and training. Recommendations such as blood glucometer use and
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telemedicine may be impacted by the risk of privacy and sensitive patient data being

compromised. Furthermore, resources that could affect your recommended guidelines are

finances and support services. Given language barriers due to demographics and racial

differences, not everyone can afford to buy a blood glucose meter or embrace telemedicine, and

support services such as community workers require healthcare workers who understand the

language. Such a project would require sufficient funding for such human and technology

services and to communicate effectively with people of other races and non-English speakers in

their language while understanding their culture.

Stakeholder Involvement in the Development and Implementation of Proposed Policy

According to Lemke et al. (2015), ‘’ Stakeholder engagement is widely lauded as a tool for

improving clinical, scientific, and public health policy decision-making.’’ In respect to

implementing my proposal, the stakeholder is expected to collaborate; first of all, having a round

table meeting to plan would be needful, and for implementation, stakeholders like healthcare

providers are to ensure that there is adequate staffing that would make up for the population, and

this would require that they collaborate with the population census commission to get the actual

figure of the population and with CDC to know the number of those that frequent hospital, so

that adequate healthcare can be made available, and through collaboration with the government,

funding of significant projects like the purchase of medical devices and implementation of

telemedicine can be made available. The community leaders and patient care support the

healthcare team to ensure maximum support and orientation given to their people that would

further promote participation in eye and foot exams with the inclusive A1c test.
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The stakeholder group and their collaboration are important for successful implementation

because, According to Shrestha et al. (2022), ‘’ From a managerial perspective, stakeholder

engagement is important for acquiring knowledge, enhancing ownership, reducing conflict,

fostering partnerships, and fostering an ethical perspective that fosters inclusive decision-making

and promotes equity. ‘’

Conclusion

This proposal presents indicators from the Mercy Medical Center Public Health Dashboard

that have been analyzed to suggest guidance for organizational policy and practice. Specific

problem areas, such as an organization's current benchmarks and underperforming assessments,

call for proposed policy to address the identified issues, such as; understaffed and even language

barriers caused by the different cultures and races of the population. Addressing this issue

requires stakeholder intervention and cooperation in implementing the proposal through the

Need for Creating a Policy and Practice Guidelines.

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References

Han, X., Pittman, P., & Barnow, B. (2021). Alternative Approaches to Ensuring Adequate Nurse

Staffing: The Effect of State Legislation on Hospital Nurse Staffing. Medical care, 59(Suppl

5), S463–S470. https://doi.org/10.1097/MLR.0000000000001614

H.R.2651 — 114th Congress (2015-2016). Eliminating Disparities in Diabetes Prevention,

Access, and Care Act of 2015.https://www.congress.gov/bill/114th- congress/house-bill/2651

Kathleen Gaines. (2023). What is the Nursing Code of Ethics? Retrieved from:

https://nurse.org/education/nursing-code-of-ethics/

Lemke, A. A., & Harris-Wai, J. N. (2015). Stakeholder engagement in policy development:

challenges and opportunities for human genomics. Genetics in medicine : official journal of

the American College of Medical Genetics, 17(12), 949–957.

https://doi.org/10.1038/gim.2015.8

Olani, A.B., Olani, A.B., Muleta, T.B. et al. Impacts of language barriers on healthcare access

and quality among Afaan Oromoo-speaking patients in Addis Ababa, Ethiopia. BMC Health

Serv Res 23, 39 (2023). https://doi.org/10.1186/s12913-023-09036-

Piya, M. K., Fletcher, T., Myint, K. P., Zarora, R., Yu, D., & Simmons, D. (2022). The impact of

nursing staff education on diabetes inpatient glucose management: a pilot cluster randomised

controlled trial. BMC endocrine disorders, 22(1), 61. https://doi.org/10.1186/s12902-022-00975-

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Shrestha, A., Tamrakar, D., Shrestha, B., Karmacharya, B. M., Shrestha, A., Pyakurel, P., &

Spiegelman, D. (2022). Stakeholder engagement in a hypertension and diabetes prevention

research program: Description and lessons learned. PloS one, 17(10), e0276478.

https://doi.org/10.1371/journal.pone.0276478

Kumar L and Mohammadnezhad M (2022) Health Care Workers' Perceptions on Factors

Affecting Diabetes Self-Management Among Type 2 Diabetes Mellitus Patients in Fiji: A

Qualitative Study. Front. Public Health 10:779266. doi: 10.3389/fpubh.2022.779266.

Retrieved from: https://www.frontiersin.org/articles/10.3389/fpubh.2022.779266/full

Woolf, S. H., Grol, R., Hutchinson, A., Eccles, M., & Grimshaw, J. (1999). Clinical guidelines:

potential benefits, limitations, and harms of clinical guidelines. BMJ (Clinical research ed.),

318(7182), 527–530. https://doi.org/10.1136/bmj.318.7182.527

Zheng, Y., Lamoureux, E. L., Chiang, P. C., Anuar, A. R., Ding, J., Wang, J. J., Mitchell, P., Tai,

E. S., & Wong, T. Y. (2012). Language barrier and its relationship to diabetes and diabetic

retinopathy. BMC public health, 12, 781. https://doi.org/10.1186/1471-2458-12-781

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