Policies refer to the basic principles and fundamental positions that an organization sets to govern conduct. Within the context of the healthcare industry, the federal and state government has a set of laws that hospitals are expected to follow. In other words, there is an inevitable political context in that infirmaries must merge national regulations and internal policies. Moreover, some of the policies may not be applicable because they are too complicated, are out of date, confront the lousy culture that influences dysfunctional behavior, or need more resources for successful integration by clinics.
Policies in the context of the healthcare industry
Firstly, some federal and state policies are not relevant to be used in some healthcare organizations. For example, there were regulations from the Center for Medicaid and Medicare Services that led to 2583 hospitals getting penalties for readmission of patients with some acute diseases like typhoid (Ellison, 2019). However, there are healthcare organizations that do not accept payments made through Medicaid and Medicare. Particularly, some private healthcare organizations, unlike public ones, require their clients to either pay cash or personal insurance covers. In turn, the federal and state laws from the CMS are immaterial within the context of such clinics. Thus, the solution is to customize the national policy to fit within the scope of the healthcare organization.
Secondly, some of the state and federal policies are not updated and fail to address contemporary challenges that healthcare organizations face. For instance, the emergence and use of electronic health records have led to an influx of information, all of which are not updated in the definition of health records by the state (Finkelstein, 2017). The implication is evident in the many courts that have had to make adjustments in redefining the information that should constitute medical records. Yet, since the changes are witnessed at an organizational level, most hospitals have already updated their policies from evidence-based practices. In such cases, it does not make sense for the infirmaries to consider the state regulations when deciding on their specific policies. The solution is for the state to use evidence-based research and know first-hand experience of the evolved practices to continually update their laws.
Thirdly, some of the federal and state laws are complicated, making it difficult for healthcare organizations to interpret, contextualize and integrate them into their internal policies. In courts, evidentiary rules and civil procedures address the discoverable data (Finkelstein, 2017). The prosecutor and defense teams are expected to exchange some pertinent information that may be used as evidence in the future. Remarkably, the fact that even in a court of law, extra data indicates that some federal clauses may require an expert to interpret. Otherwise, the policymakers at the hospitals may not integrate laws that are complex into their internal policies. The solution is for employment lawyers who are competent in healthcare laws and regulations to join the team of hospital administrators.
Fourthly, some healthcare organizations have a negative culture that does not support integrating the regulatory requirements by the national and state laws. Particularly, institutions that have passive-aggressive, employee alienation, aggressiveness, and myopia dysfunctional characteristics foster malpractice in healthcare organizations (Sorensen et al., 2013). Such hospitals are defiant so that their policymakers show disinterest in investing in policy reformation that merges with the state or federal statutory requirements. Some hospitals may go against the national policies on providing services to Medicaid users. For example, some of the hospitals that were punished for the readmission of patients may have neglected fundamental basic guidelines to follow when discharging a patient (Ellison, 2019). Usually, when employees are not conscious of the state policies, they form a culture of negligence. Such an attitude may affect the implementation of patient-centered care and lead to errors in healthcare delivery.
Fifthly, there are situations where integrating the federal policy means having the necessary resources to implement in-hospital programs. For instance, the 1996 Health Insurance Accountability Act has a privacy rule for patients to request their medical records (Lye et al., 2018). The government allowed healthcare organizations to charge a reasonable amount to all patients who wanted to access the data. The challenge in the integration of that policy in hospitals is that the hospitals may not have the money to submit the medical records to clients. In turn, the fee charged by healthcare organizations remains high despite submissions required within 30 days (Lye et al., 2018). The implication is that integration of the policy may be difficult unless the hospitals customize their procedures. Therefore, the government should allocate extra money for some of its policies that require massive investments.
In summary, there are many challenges to the integration of federal and state policies in healthcare organizations that can be resolved. Some laws do not apply universally to all hospitals, hence the need for customization. The other difficulty may emerge due to state policies being old and failing to address contemporary issues. The solution is the continuous use of evidence-based practice to update the regulations. In other cases, the laws are complex and difficult to understand or merge with those of the hospitals. There are also instances where challenges occur due to the poor culture of healthcare organizations or resources. It is prudent for hospitals to try and minimize these issues so that there are comprehensive regulations to govern the provision of quality care.
Ellison, A. (2019). CMS penalizes 2,583 hospitals for high readmissions: 5 things to know. Becker’s Hospital Review – Healthcare News.
Lye, C. T., Forman, H. P., Gao, R., Daniel, J. G., Hsiao, A. L., Mann, M. K., DeBronkart, D., Campos, H. O., & Krumholz, H. M. (2018). Assessment of US hospital compliance with regulations for patients’ requests for medical records. JAMA Network Open, 1(6), 1-12.
Sorensen, R., Paull, G., Magann, L., & Davis, J. (2013). Managing between the agendas: Implementing health care reform policy in an acute care hospital. Journal of Health Organization and Management, 27(6), 698-713.
Finklestein, M. M. (2017). Redefining the “Legal medical record” and how to be prepared to respond to legal requests for a patient’s medical record. The Journal of Medical Practice Management, 33(1), 11-14.