Raisha G.
asked • 11/07/18Healthcare system
Describe the impact you think agencies (external factors) such as the FDA,CDC, HRSA,and CMS have on access, cost, and quality in healthcare delivery. Describe how cultural competency and health literacy (internal factors) affects the diagnosis and treatment of patients. Explain whether you believe internal or external factors have more impact on healthcare and why.
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1 Expert Answer
Gracie S. answered • 23d
Tutor
New to Wyzant
Experienced RN educator passionate about empowering learners!
External agencies such as the FDA, CDC, HRSA, and CMS play a critical role in shaping access, cost, and quality within healthcare delivery. The HRSA enhances access by funding community health centers and workforce programs for underserved areas, while the CMS influences both access and cost through reimbursement models and coverage policies. The FDA affects cost and quality by regulating the approval and safety of drugs and medical devices, and the CDC promotes quality care through public health standards and disease prevention efforts. Internal factors, including cultural competency and health literacy, directly impact the accuracy of diagnosis, treatment adherence, and overall patient outcomes. Providers who demonstrate cultural awareness and communicate in ways patients understand foster trust and improve compliance, whereas low health literacy can lead to mismanagement and poorer health outcomes. Although external agencies establish the structure and regulation of healthcare, internal factors often exert greater influence on individual patient experiences and outcomes, as effective care ultimately depends on communication, understanding, and trust between patients and providers.
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Ari B.
As an ER nurse, I believe I can provide a unique perspective on this question when it comes to one particular external factor, namely the Emergency Medical Treatment and Active Labor Act (EMTALA), impacting the health care system for the worse. EMTALA was passed into law in 1986, in order to make sure that emergency services could not be denied to anyone seeking treatment regardless of ability to pay. This means anyone seeking emergency services must be assessed by providers and stabilized before being discharged even if they cannot cover the cost of treatment or are uninsured. While the intentions are good- this has lead to a tremendous burden on the healthcare system. For instance, hospitals can cap patients on the floors upstairs based on the nurses available, meaning if there are only 2 nurses on staff, they can cap the number of patients the nurse can take care of to lets say 6 per nurse, so only 12 patients can be admitted to that floor. In the emergency department, there can be no caps because of this law, which has and does lead to dangerous nursing ratios. Depending on the Emergency department, it is not uncommon for a nurse to have greater than 16 patients during a shift. This increases the risk of mortality and mistakes tremendously. I will never forget walking on to shift one night and hearing someone yell, “get this man a stretcher!” For a man who collapsed in triage, only to hear someone shout back “We’ve run out of stretchers!” Because the emergency department was so packed with patients. I believe the man wound up being transported to our resuscitation bay in a wheelchair. It also increases wait times drastically. Patients often get “bottle necked” waiting in the emergency department for beds upstairs. I’ve seen admitted patients wait up to 5 days in the emergency department for a bed upstairs to become available. The quality of care cannot be the same in an emergency department where the number of patients and acuity of those patients are highly variable to a floor where there is a set number and acuity of patients. There are many more ways this law impacts care that i haven’t mentioned. Feel free to contact me for more information regarding this topic.12/18/23