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Background of the Community Health Needs Assessment
The healthcare system has been a topic of heated debates among a great number of specialists, governmental officials, and the random citizens. Increased costs for healthcare services, deterioration of their quality, and the increase of the U.S. population are only some of the issues targeted in such discussions. It was clear that the healthcare system required reform as soon as possible. After a long time of development and endorsing the reform President Barack Obama introduced the Patient Protection and Affordable Care Act (PPACA) in 2010 that after numerous debates and protests was upheld by the Supreme Court in 2012 (Hoff, 2013). The Act introduced a wide range of changes, but it supported the policy issued in 2008 by Medicaid and Medicare for not paying for the outcomes of never events. As the patient cannot be billed as well, the healthcare facilities have to evaluate the risks, predict possible financial damages, and prevent the harm to the patients.
Healthcare facilities are obliged to take care about the community and be aware of their needs. Protection of people from avoidable harm is an essential responsibility of the healthcare system, but the achievement of this goal is more complex. The prevention of never events has specific procedures and processes in order to minimize the risks to the patients’ health. However, despite the existence of such procedures, some of them still occur in the healthcare facilities due to human factor, negligence, or technical malfunctions. In the conditions where the hospitals are held financially responsible for never events, it is the responsibility of the facility to make sure they do not occur. According to the definition of this term “never events are serious, largely preventable patient safety incidents that should not occur if the available preventative measures have been implemented by healthcare providers” (Barnett, 2012).
While discussing the issue of quality of the current health services and the need to change the responsibility for never events, it is important to remember that the concept of qualification came from the private sector where the manufactured products or services are usually evaluated in terms of satisfaction or dissatisfaction by the customers. Following the demand to increase responsibility for never events, the hospitals have to construct a high-quality Community Health Needs Assessment (CHNA) following the correct procedure. The hospitals have to evaluate its inner structure, jurisdictional issues connected to the never events, engage the community into the process through survey or interview, and collect the data for the further analysis. The main focus here is the incidence of never events, previous reimbursement of them by Medicaid and Medicare programs, changes in the legislation regarding this issue, and the main reasons why the never events occurred.
Rationale
Health services do not have the relationship with its addressees as with the consumers of the services, as the agencies are aimed to help and support the vulnerable individuals. However, the disadvantages of the system outbalance its positive sides. The biggest issue is rising of health care costs, prices for drugs and growing government budget for medical expenditures. “Health care spending now consumes more than 17% of U.S. GDP and is expected to account for more than 19% of GDP by 2019; as health care costs have risen, so has the number of uninsured Americans” (Orentlicher, 2011). The reformation of the health care system is inevitable, as the issue has already reached its boiling point. There are both pros and cons of the health care reform as well.
The implementation strategy for the CHNA has to follow a multifaceted strategy that will include all specificities of the hospital, the incidence of never events, strategic investment patterns, institutional assessment, and the previously collected data regarding the community and its needs. Later, the results will have to be reported to the public in order to increase the reputation of the hospital, improve its effectiveness in delivery of health services, and foster the transparency and ethical conduct in the institution. The CHNA has to be conducted through the several panel sessions where the Board will approve all further steps of the evaluation. According to Barnett (2012), there is an “importance of engaging other key providers such as community health centers in the CHNA and implementation strategy development process” (p. 4). The main issue here is the significance of engagement of several institutions providing health services to the public in order to decrease the never events and design an approach where the hospitals will operate with the utmost precaution.
Further monitoring practices are essential for the successful maintenance of the never events and the hospital’s responsibility for it. Each type of never event, either it is wrong site surgery or technical malfunction, has to be addressed with the respective countermeasure. For instance, the technical equipment has to be double-checked for malfunctions before each procedure. It is usually estimated that the provision of health services is the responsibility of the U.S. government and inability to meet the requirements is always treated as a failure of this structure, but in the present conditions the private organizations, in this case hospitals, have to increase their fiscal responsibility regarding its actions.
The obligation of healthcare entities to bear responsibility for the mistakes made by the healthcare personnel or technical malfunction after the patient’s admission increases the judicial and financial duties of the hospitals. The Community Health Needs Assessment (CHNA) has to be conducted by every healthcare facility by taking into consideration the incidence of never events in the hospital, the most common reasons patients ask for medical assistance, the areas where never events occur more frequently, the measures implemented for the prevention of never events, the effectiveness of the countermeasures, and the reputation of the medical facility.
References
Barnett, K. (2012). Best Practices for Community Health Needs Assessment and Implementation Strategy Development: A Review of Scientific Methods, Current Practices, and Future Potential. Report of Proceedings from a Public Forum and Interviews of Experts, 1-16.
Hoff, J. (2013). ObamaCare. Independent Review, 18(1), 5-20.
Orentlicher, D. (2011). Controlling Health Care Costs through Public, Transparent Processes: The Conflict between the Morally Right and the Socially Feasible. Journal of Corporation Law, 36(4), 500-514.
