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What do you do if your patient's needs clash with the hospital's financial constraints?

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Navigating the complex terrain of healthcare can be daunting, especially when your patient's needs seem at odds with the hospital's budget. You're in the thick of it, advocating for the best possible care, but the reality of financial constraints looms large. It's a delicate balance, ensuring your patient receives the necessary treatment without compromising the hospital's resources. In this article, we'll explore practical strategies to address this conflict, empowering you to champion your patient's health while acknowledging the economic factors at play.

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Elise Anna Harris

3 x Breast Cancer Survivor, Pink Fund Ambassador, Voices Of Black Women Ambassador, Lemonista Educator

1 Understand Limits

Healthcare is not limitless, and understanding the financial limits of the institution is crucial. It's important to be aware of the hospital's budgetary constraints and the reasons behind them. This knowledge allows you to navigate the system more effectively and identify alternative solutions that may be more cost-effective without sacrificing the quality of care. Transparency about these limitations with your patient can also help manage their expectations and foster trust in the care they're receiving.

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2 Evaluate Needs

When faced with financial limitations, it's essential to critically evaluate your patient's needs. Determine which treatments are absolutely necessary and which could potentially be deferred or substituted with more cost-effective options. This doesn't mean compromising on care; rather, it's about prioritizing interventions based on urgency and impact. Engage in open dialogue with your patient about their condition and treatment options, ensuring they are informed and involved in decision-making.

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Chioma Okere

Dedicated Health Coach for Busy Professionals || Health Content Writer for Healthcare Brands || Passionate Nurse & Health Influencer || Turning Health Information into Practical Actions That Empower Healthy Living.
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Evaluating patients needs are one of the vital ways of navigating financial constraints in healthcare. Be open to the patient about their health condition and treatment options so they will understand and make informed decisions. Then prioritise based on urgency and impact. The best intervention that meets patients need can still be given, while looking for other treatment options that can suit the financial means

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3 Seek Alternatives

In situations where resources are tight, creativity is key. Seek out alternative therapies or treatment options that may be more affordable yet still effective. This could involve generic medications, outpatient procedures instead of inpatient stays, or even exploring programs that offer financial assistance for certain treatments. Your role as a patient advocate is to explore every avenue to secure the best possible outcome for your patient within the financial framework of the hospital.

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Chioma Okere

Dedicated Health Coach for Busy Professionals || Health Content Writer for Healthcare Brands || Passionate Nurse & Health Influencer || Turning Health Information into Practical Actions That Empower Healthy Living.
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Secure other alternative options that are quite affordable but effective. This is an important step to take when ensuring that the patient gets the care they need despite any financial constraints. Outsource it and make it available for patients.

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Winston C.

Business Co-owner
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As an RN, especially as a Case Manager, advocating for your patient means seeking out other resources when necessary. This sort of situation is a good point to involve a Case Manager (if you are not one) and a Social Worker to seek outside and alternative resources. Also, if your facility has one, involving the ombudsman's office or "Patient Experience" office, and Risk Management if there might be health consequences due to the hospital's constraints. The Chaplain's office may help bring more resources to bear on the issue. Be sure to collaborate with your colleagues and unit manager and get their perspective; they may know a way to handle it based on previous cases.

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4 Collaborate Closely

Collaboration with healthcare providers is imperative. Work closely with doctors, nurses, and other medical professionals to develop a care plan that aligns with both the patient's needs and the hospital's budget. This team-based approach ensures that everyone is on the same page and that the patient's care is coordinated and comprehensive. It also allows for pooling of knowledge and resources, which can lead to more innovative and cost-effective solutions.

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Elise Anna Harris

3 x Breast Cancer Survivor, Pink Fund Ambassador, Voices Of Black Women Ambassador, Lemonista Educator
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In my experience there should be a compromise on both sides. Both patient and clinician should meet somewhere in the middle. Sit down and write out ways to work out resolution

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Elise Anna Harris

3 x Breast Cancer Survivor, Pink Fund Ambassador, Voices Of Black Women Ambassador, Lemonista Educator
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In my experience there should be a compromise on both sides. Both patient and clinician should meet somewhere in the middle. Sit down and write out ways to work out resolution

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Maria Niedzielska

GradDip in Health and Medical Sciences (UNDA); CEMS MIM (UCD); M.A. in Management & Marketing (SGH)
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Navigating clashes between patient needs and hospital financial constraints can be daunting. While aligning both interests may seem idealistic (it's unlikely there's going to be a team of nurses and doctors to create a plan with the patient), it's not impossible. Begin by exploring avenues to secure funding, such as engaging with insurance providers or directly contacting drug manufacturers for support. Enlisting the expertise of a skilled patient advocate, negotiator, or lawyer can facilitate these discussions. Once financial support is secured, present the case to the hospital administration to advocate for the patient's needs. It's a challenging process, but perseverance and strategic advocacy can lead to positive outcomes for patients.

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5 Educate Patients

Educating your patient is a powerful tool in managing the clash between their needs and financial constraints. Help them understand the costs associated with their care and why certain decisions are made from a financial perspective. Empower them with knowledge about their condition and the healthcare system, so they can be active participants in their own care and potentially identify areas where savings can be made without compromising their health outcomes.

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6 Advocate Firmly

Despite the challenges, remember that your primary responsibility is to your patient. Advocate firmly for their needs, using logical reasoning and persuasive communication to make a case for necessary treatments. While it's important to recognize financial realities, it's equally important to ensure that your patient does not suffer due to budgetary restrictions. Be prepared to negotiate and seek out support from hospital administration if needed to ensure your patient receives the care they deserve.

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7 Here’s what else to consider

This is a space to share examples, stories, or insights that don’t fit into any of the previous sections. What else would you like to add?

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What do you do if your patient's needs clash with the hospital's financial constraints?

1

2

3

4

5

6

7

1 Understand Limits

2 Evaluate Needs

3 Seek Alternatives

4 Collaborate Closely

5 Educate Patients

6 Advocate Firmly

7 Here’s what else to consider

Patient Advocacy

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What do you do if your patient's needs clash with the hospital's financial constraints?

1

2

3

4

5

6

7

1 Understand Limits

2 Evaluate Needs

3 Seek Alternatives

4 Collaborate Closely

5 Educate Patients

6 Advocate Firmly

7 Here’s what else to consider

Patient Advocacy

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