Coordinated Governance in Healthcare
Efficient and effective operations in hospitals demand specialty coordination between the governance, medical staff, administration, and board of trustees. Care coordination by improving health workforce governance is critical for accountability, consensus building, and inclusivity in leadership and decision-making. Although patients, staff, and other healthcare providers strongly influence the hospital’s decision-making when executing governance functions, various factors cause tension among them, hindering efficient, coordinated governance (Manis et al., 2022). The ACA, targeted at enhancing the healthcare delivery system, recommends collaborative leadership in hospitals for transparency and improved innovation.
Factors that Hinder Collaborative Governance
The primary function of coordinated governance in healthcare includes oversight of general provider staff, quality assurance, hazard control, and development programs aimed at quality improvement. Factors central to effective coordinated governance include poor communication, cultural barriers, relationships among professionals, many tasks, lack of appropriate institutional coordination mechanisms, and insufficient resources (Brazil, 2018). Poor communication skills by care providers lead to a lack of clarity and affect interactions in collaborative leadership. Communication also affects positive reinforcement, feedback, errors, and time management.
Cultural Barriers to Co-ordinated Governance
Healthcare leaders have diverse cultural backgrounds that could result in misunderstanding meanings, social behaviors, beliefs, stereotypes, and prejudices. Cultural and social barriers affect open interaction and information-seeking and lead to negative emotions and attitudes toward others (Young & Kroth, 2017). The lack of organizational structure and culture that encourages diversity, inclusivity, and harmonious coexistence contributes to the tension between allied health professionals. Conflicting cultural values also implicate respect and trust among governance members. Moreover, a lack of relationship-forging skills affect how health professionals exchange and integrate ideas to enhance innovativeness and quality of care.
Effects of Schedules and Institutional Mechanisms on Collaboration
Increased workload and tight deadlines in healthcare affect the time dedicated to allied collaboration in leadership. Healthcare providers suffer high stress and fatigue, affecting their performance, accountability, autonomy, and cooperation. Poor staffing, ineffective management, and unregulated schedules contribute to a chronic workload influencing coordinated care. Mutual adjustments of work processes, inclusivity in scheduling, direct supervision, and standardization regulate the workload in healthcare to create time for allied leadership (Brazil, 2018). Institutional mechanisms implemented should align with collaborative leadership in healthcare settings. For example, informatics facilitates rapid communication and ideas exchange in allied governance.
Tension in Governance and Understanding of Professional Roles
Task prioritizing, unequal power, and poor understanding of professional roles implicate coordinated care. Collaborative health care helps address the potential gaps in patients’ support systems geared towards tremendous success in patient health outcomes. Task prioritizing compel physicians to overlook their responsibilities in care coordination and focus on their primary roles (Manis et al., 2022). Unequal power contributes to tension in consolidated care as the junior staff is nervous to correct their authority and seek answers. Moreover, when hospital staff has limited knowledge of their secondary roles, such as good communication and relations, managers, staff, and executive board are encouraged to work in silos.
Public Readiness to Deal with Quality Survey
Patients are not ready to have and interpret information from survey reports on healthcare quality owing to their extreme complexity. Medical survey reports on the quality of care conducted by organizations such as the LeapFrog Group derives from operational aspects and various quality estimates and value judgments attached to them. For a long, quality of care has been defined as the degree of conformity with present standards encompassing all elements, procedures, and outcomes of patient-physician engagements (Dunsch et al., 2018). The public often has implicit parameters against which they judge the quality of care rather than explicit and are only in their minds and not considered by the survey organizations.
Publics’ Ability to Make Choices about Medical Care
The misguided value judgments patients hold about the quality of care render them inadequate in making choices regarding medical care. Since patients are likely to misinterpret the reports by considering the implicit variables rather than explicit variables, their choices are likely to be misplaced. Although LeapFrog organization’s website is updated monthly, displaying each hospital’s results, the patient’s interpretation of quality and satisfaction is likely to conflict with the evaluation metrics utilized by the survey. Nevertheless, structural quality reviews of the quality of care provided in health facilities are elemental to monitoring the quality of care by informing hospital management and policymakers of the quality issues affecting care.
Development of Entrepreneurial Physician Health Facilities
Over the previous years, physicians’ entrepreneurship has become a trend in American healthcare, with many providers investing in healthcare centers, laboratories, and specialties that have bed various benefits and shortcomings. Healthcare policy initiatives have evolved from an unregulated industry to a heavily monitored one. Physicians who are willing to venture into health ought to acknowledge the Anti-Kickbacks Statute and Stark Law, Qui Tam Provisions, and Health Insurance Portability and Accountability HIPAA Act (Greenblatt, 2021). Although the increased competitiveness, innovativeness, and outstanding treatment associated with physician-owned facilities enhance healthcare, it creates the risks of ethical and legal contraventions that affect patients.
Advantages of Physicians’ Entrepreneurship
Entrepreneurial physician initiatives are establishing competitive, free-standing diagnostic and treatment centers and specialty hospitals, posing unprecedented financial challenges to the hospitals. Physician-owned healthcare facilities have enhanced the quality and access of care in America. According to Young & Kroth (2017), the upward trajectory of the number of health facilities in the US contributed by investing physicians has reduced the burden on public and community hospitals and set standards for quality care from industry experience. High accountability and transparency in for-profit health facilities owned by physicians compared to public health facilities increase competitiveness hence quality and affordability of care (Greenblatt, 2021). In another dimension, physician entrepreneurship has revolutionized innovation in medicine, enhancing patients’ outcomes. Finally, the physician-patient relationship is fostered by providers’ entrepreneurship initiatives helping patients access personalized care solutions.
Disadvantages of Physicians’ Entrepreneurship
However, on the downside, there may be a conflict of interest when physicians invest in healthcare that may influence patients’ decisions hence outcomes. For example, physicians working in a public facility and owning a medical laboratory may be inclined to recommend patients to their facilities for tests at a higher cost. Personalized care is an ethical dilemma in that providers should allow patients to have control over decisions about their health. Moreover, physicians’ entrepreneurship is implicated by bias in value commitments, power dependence, intra-organizational dynamics, and interest dissatisfaction, affecting the quality of care patients receive. The American Medical Association provides an ethical guideline to prevent conflict of interest that may compromise patients’ health.
References
Brazil, K. (2018). A call for integrated and coordinated palliative care. Journal of palliative medicine, 21(S1), S-27. Web.
Dunsch, F., Evans, D. K., Macis, M., & Wang, Q. (2018). Bias in patient satisfaction surveys: a threat to measuring healthcare quality. BMJ global health, 3(2), e000694. Web.
Greenblatt, W. H. (2021). Physician Entrepreneurship: Evidence from Massachusetts (Doctoral dissertation, Massachusetts Institute of Technology). Web.
Manis, D. R., Bielska, I. A., Cimek, K., & Costa, A. P. (2022). Community-informed, integrated, and coordinated care through a community-level model: A narrative synthesis on community hubs. Healthcare Management Forum (Vol. 35, No. 2, pp. 105-111). Sage CA: Los Angeles, CA: SAGE Publications. Web.
Young, K. M., & Kroth, P. J. (2017). Sultz & Young’s Health Care USA. Jones & Bartlett Learning. Web.