Discussion questions
The core of shared governance is partnership and partnering support. Many healthcare organizations are implementing shared governance to expand empowerment and partnership within the organization. Discuss ways in which shared governance enhances employee satisfaction. Describe ways in which shared governance may influence patient outcomes.
Shared governance empowers employees by enabling them to exact more control over their work (Barden et al., 2011). This in turn enhances employee satisfaction and in health care settings translates into improved patient outcomes. Employee satisfaction is the outcome of the process via which an employee appraises his or her relationship with an organization. The factors that contribute to employee satisfaction are abstract. The findings of numerous job satisfaction studies, however, suggest that employee satisfaction is a product of both intrinsic and extrinsic factors. The various theories developed on the issue such as Herzeberg’s similarly attribute employee job satisfaction to factors intrinsic and extrinsic to the job and employees. Intrinsic factors include autonomy, task identity, skill variety, and task significance. Extrinsic factors, on the other hand, encompass work schedules, organizational policies, managerial relations, quality of supervision, organizational culture, and perceived organizational support (Marnewick, 2011, p. 1296). Shared governance enhances employee satisfaction ensuring that intrinsic and extrinsic motivators are present at optimal levels. This is because it decentralizes decision making enabling most decisions to be made by staffs at the point of service delivery. This enhances the autonomy of the employees by enabling them to exact more control over the content and implementation of their practices. It also improves relations and communications between senior and junior staffs, perceived organization support, working conditions, and fosters trust (Barden et al., 2011). All these factors foster employee satisfaction.
Increased employee satisfaction, on the other hand, reduces the rates of staff turnover. This in-turn translates to improved patient outcomes because high rate of staff turnover have been linked to poor patient outcomes. High rates of staff turnover adversely affect the quality of care provided by creating staff shortages and disrupting the continuity of care. High staff workloads that occur due to staff shortages have been linked with the occurrence of preventable adverse events. New staffs are also not able to provide an equivalent quality of care as those who quit (Mukamel et al., 2009).
Medicare and Medicaid were initiated in the mid 1960s in response to the growing number of uninsured elderly and disabled Americans. In recent years, the Medicare and Medicaid systems have become financially overburdened. Describe patient dynamics that have increased the number of Americans dependent upon Medicare and Medicaid for healthcare coverage.
Medicaid provides health insurance cover for the unemployed particularly children and pregnant women although a quarter of its beneficiaries are the disabled and elderly. Medicare, on the other hand, covers individuals older than 65 years (Swartz, 2009). An increase in the number of the elderly and individuals with chronic illnesses as well as an increase in the rate of unemployment are amongst factors that have contributed to an upward trajectory in the number of persons eligible for Medicare and Medicaid cover.
An increase in the number of elderly people is one of the variables that has increased the number of Americans dependent on Medicare and Medicaid for health coverage (Swartz, 2009). The two insurance schemes cover insurance for amongst others the elderly. Therefore, the characteristic increase in the number of the aged particularly those belonging to the baby-boomer generation has increased the number of people dependent on Medicare and Medicaid. The elderly also tend to suffer from chronic diseases that increase their reliance on these insurance schemes (Swartz, 2009).
An increase in the number of people with chronic diseases such as end-stage renal disease and mental illnesses has also prompted the spiraling in the number of Medicare and Medicaid dependants. In 2005, the number of Americans living with one and multiple chronic conditions was approximated to be 133 and 157 million respectively (Bodenheirner, Chen, & Bennett, 2009). Individuals with one or multiple chronic conditions are often unable to find or hold on to employment making them eligible for Medicaid. They also tend to belong to the low socio-economic class.
Economic downturns have also contributed to an increase in the number of people dependent on Medicaid (Swartz, 2009). These economic upheavals increase the rate of unemployment and concomitantly, the number of people and their dependants who lose or who do not qualify for employer-sponsored insurance.
In conclusion, increases in the number of the aged, the number of persons with chronic diseases and disabilities, and high rates of unemployment due to poor economic performance are three variables that have increased the number of Medicare and Medicaid dependants.
References
Barden, A.M., Griffin, M. T. Q., Donahue, M., & Fitzpatrick, J. J. (2011). Shared governance and empowerment in a registered nurses working in a hospital setting. Nurs Admin Q, 35(3), 212-218.
Bodenheirner, T., Chen, E., & Benett, H. D. (2009). Confronting the growing burden of chronic disease: Can the U.S. health care workforce do the job? Health Affairs, 28(1), 64-74.
Marnewick, C. (2011). Herzeberg! Can we trust you in Africa? African Journal of Business Management, 5(4), 1293-1303.
Mukamel, D. B., Spector, W. D., Limcangco, R., Wang, Y., Feng, Z., & Mor, V. (2009). The costs of nursing turnover in nursing homes. Med Care, 47(10), 1039-1045.
Swartz, K. (2009). Health care for the poor: For whom, what care, and whose responsibility? Focus, 26(2), 69-75.
