Healthcare Regulation
by Amber Leandro
1. Regulation
1.1. Keep patients and employees safe by controlling how practitioners practice.
1.2. Keep organizations in balance with the laws of the State/Nation
1.3. Board of Nursing: ensures nurses are legally able and competent to practice nursing and also regulates complaints and illegal practice.
1.4. Medicare/Medicaid: regulates healthcare by making hospitals met standards to reimburse for care.
2. External Entities
2.1. Nursing State/National laws ( Board of Nursing, Board of Medicine, Board of Pharmacy, etc)
2.2. Insurance Companies: What they will pay for depends on the quality of health care that is given to the patient. ( Did the patient acquire an infection that could have been prevented, etc).
2.3. Accrediting Bodies: Do the health care organization have accreditation? How does this reflect the quality of patient care?
3. Accreditation
3.1. Pathway focuses on shared governance and supportive practices.
3.2. Baldridge focuses on the business end of quality.
3.3. The Joint Commission focuses on patient safety and quality care.
3.4. Magnet focuses on excellence in nursing, quality of outcomes, and innovation care.
4. Internal Entities
4.1. Shared governance: Do nurses have the resources to provide quality care? Is there voice heard? Employee satisfaction?
4.2. Monetary resources: is the organization making a profit to support resources needed to provide quality patient care.
4.3. Patient population: Do the patient choose the health care organization because of high HCAP scores? Is there a speciality the patient needs that the organization provides?
4.4. Does the organization have the proper resources to provide for the patient's needs? (Equipment, staff, space, providers)
4.5. Nursing Education: is there encouragement to pursue education growth?
