53/3 Dis R2


2 paragraphs and 2 sources giving additional thoughts about competing needs that may impact your colleagues’ selected issues, or additional ideas for applying policy to address the impacts described. 

A policy is typically developed to mold a profession and improve effectiveness and efficiency as with the relationship between healthcare delivery and healthcare policy.  A policy is considered an intervention to alleviate recognized issues and an attempt to prevent any further undesirable circumstances (Leeuw, Clavier, & Breton, 2014).  Changes in health policy such as the Affordable Care Act (ACA) and the Quadruple Aim, while they have created improved efficiency and effectiveness in health care delivery, they have also created strain in various aspects throughout the healthcare system – otherwise known as competing needs (Sage, 2014).
            Health care organizations have completely altered their business strategies in order to meet the demands of the ACA and the Quadruple Aim.  No longer are they following the “fee for service” model, but are now conforming to policy to receive reimbursement based on the quality of care provided (Park, Gold, Bazemore, & Liaw, 2018).  This massive change in health care delivery has resulted in an influx of patients and healthcare demands (Havens, Gittell, & Vasey, 2018).  While healthcare organizations are diligently working to conform to new health care policies and to meet the demands of the Quadruple Aim, there is a tremendous amount of stress being displaced onto the workforce.
            Healthcare providers are being overworked in attempts to meet new demands.  While healthcare organizations continue to take on the massive patient loads and continue to strive for efficient and quality care, the stress that is being placed on the providers, specifically bedside nurses, is resulting in workforce burnout.  What this ultimately leads to is a decrease in the quality of care provided (Jacobs, McGovern, Heinmiller, & Drenkard, 2018). 
            The ANA (2015) Code of Ethics, among many standards and guidelines, states that nurses not only should provide sound care to their patients but must also maintain self-care and a healthy work-life balance in order to be productive in their work.  “Fatigue and compassion fatigue affect a nurse’s professional performance and personal life” (ANA, 2015, p.19).  Without a sense of balance in the work environment, it is difficult, if not impossible to meet standards and achieve sufficient quality of care. 
            Policy can address competing needs by tackling issues from multiple angles.  This essentially explains why the Triple Aim transitioned into the Quadruple Aim.  Once healthcare leaders recognized the high demands that healthcare reform was placing on the workforce, the additional leg of the Aim evolved, to include improving the provider experience (Sikka, Morath, Leape, 2015).  Recognizing the need to not only improve conditions for patients but also for the workforce is imperative in meeting healthcare delivery goals.

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