Regulation and Accreditation – Health Care Policy (Nursing)

00:00 Welcome back, everyone.

00:02 We know that hospitals and health care organizations strive to offer affordable quality care to all.

00:08 However, this can be difficult with the challenges we currently face in healthcare, such as limited resources and times of nursing shortages.

00:16 Two strategies to help ensure hospitals and health organizations meet their goal is through regulation and accreditation.

00:25 Healthcare regulations and standards are necessary to ensure compliance and to provide safe health care to every individual who accesses the system.

00:34 Regulatory and accreditation agencies can be classified one of two ways.

00:38 First, mandatory.

00:40 The mandatory classification includes federal state and local regulatory agencies that establish rules and regulations for the health care industry.

00:49 The second classification is voluntary.

00:52 This include other agencies such as those for accreditation.

00:56 They provide rankings or certification of quality.

00:59 They serve as additional oversight.

01:01 And they ensure that healthcare organizations promote and provide quality care.

01:06 Now the Department of Health and Human Services enhance and protect the health and well-being of all Americans.

01:13 It provides for effective health and human services.

01:16 It fosters advances in medicine, public health, and social services.

01:22 This includes the Centers for Medicare and Medicaid, and what they do is oversee most of the regulations related directly to the health care system.

01:31 Also, the Agency for Healthcare Research and Quality who conducts research aimed at improving the quality of health care, reducing cost, and addressing patient safety and medical errors.

01:42 Regulatory departments include the Centers for Disease Control who examine public health and warns a possible health threats from infectious diseases.

01:52 Also, the Food and Drug Administration.

01:54 The FDA is responsible for controlling the safety and effectiveness of the country's drug supply for both humans and animals.

02:03 And the Agency for Toxic Substances and Disease Registry.

02:06 They monitor and regulate the effects of hazardous materials on public health.

02:12 And finally, the Environmental Protection Agency who protects human health and the environment through the writing and enforcing of regulations based on laws passed by Congress.

02:22 When we think of CMS, we think of Medicare which is for the elderly and disabled.

02:28 Also Medicaid which is for lower-income individuals and families.

02:34 You've got the State Children's Health Insurance Program for health insurance coverage for children under 19.

02:40 The Health Insurance Portability and Accountability Act, what we call HIPAA, provides security provisions and data privacy in order to keep patient's medical information safe.

02:51 So let's look at the Health Insurance Portability and Accountability Act a little deeper.

02:56 The information protected by this Act include a patient's name, address, birth date, and social security number.

03:03 Also, the individual's physical or mental health condition.

03:06 Also, any care provided to an individual.

03:10 And also information concerning the payment for care of the individual which could identify the patient or for which there is a reasonable basis for patient identification.

03:20 Accreditation agencies.

03:22 The first one is the Joint Commission on Accreditation of Health Care Organizations.

03:27 This organization works to ensure that healthcare organizations provide quality care.

03:33 And also the National Committee for Quality Assurance, they ensure the quality of managed care plans.

03:39 Now remember, the primary reason for health care regulation and accreditation, well, sometimes confusing, is to ensure that the care being provided by health care practitioners and healthcare facilities is safe and effective for everyone who accesses the health care system.

03:55 So in thinking of everything we've covered today, I'd like you to consider this question, what are four types of information protected by the Health Insurance Portability and Accountability Act? That would be the patient's name, address, birth date, and social security number, with the individual's physical or mental health condition, any care provided to an individual, and information concerning the payment for care of the individual to identify the patient or for which there's a reasonable basis for patient identification.

04:33 I hope you've enjoyed today's video on regulation and accreditation.

04:36 Thanks so much for watching.