Standards of Care vs. Policy: What Takes Precedence?

Navigating the Complex World of Standards and Policies

Hello Advocates,

This issue of the Rescue RN Newsletter tackles a complex subject: the delicate interplay between standards of care and policy. Do we compromise best practices if they are not reinforced by policy?

The Dilemma: Best Practice Meets Real-World Constraints

Standards of care represent the pinnacle of medical practice, driven by the latest evidence and expert consensus. Yet, these standards often clash with institutional policies or, worse, are undermined by legal and financial constraints.

When laws encourage rather than mandate CPR and AED training due to budgetary limits, are we responsible for following best practices?

Reminder -Outcomes are humans...

Standards vs. Policies: The Interconnectivity

Standards of care serve as the compass for quality and consistency. They are the aspirational goals set by professional organizations that define excellence. Policies, in contrast, are the rules that institutions and governments enact – they are the enforcers, the tangible instruments that mandate action.

From Guidelines to Governance: The Journey of Standards

For a standard of care to evolve into policy, there must be irrefutable evidence of its benefit, coupled with the advocacy to formalize these practices into law or institutional regulations. This transition is critical for moving from what is recommended to what is required, ensuring uniform compliance, and safeguarding patient safety.

The Joint Commission has updated its resuscitation care standards in response to the variable survival rates from in-hospital cardiac arrests.

By addressing critical factors such as the quality of hospital personnel training, adherence to evidence-based protocols, data collection, and internal quality control mechanisms, these standards aim to reduce unnecessary variations in practice.

Their overarching goal is encouraging hospitals to adopt a proactive and responsive approach to resuscitation and post-resuscitation care, ultimately maximizing patient survival with the best possible neurological outcomes. These standards signify a commitment to excellence in patient care and underscore the importance of consistent, evidence-based practices across healthcare facilities.

Flexibility vs. Enforceability: Striking the Right Balance

The fluid nature of healthcare necessitates that standards of care maintain a level of flexibility. This latitude allows healthcare providers to exercise judgment and tailor care to the individual, respecting the multifaceted nature of medicine.

The Challenge of Enforcement

Without the concrete backing of policy, adherence to standards can be inconsistent, often influenced by the availability of resources or institutional priorities.

This variability can result in unequal care delivery, which becomes a clarion call for universal compliance with critical standards.

Reminder -Outcomes are humans...

The Path Forward: Universal Adherence, Individual Care

Our mission is to ensure that vital standards become more than just guidelines; they should be expectations ingrained into the fabric of our healthcare delivery. We advocate for translating essential standards into enforceable policies while preserving the personalized approach necessary for patient-centered care.

Our Collective Role: Upholding Standards, Shaping Policies

Each one of us has a role in this endeavor. By supporting education, training, and the institutionalization of standards of care, we contribute to a healthcare environment where patient safety and quality care are not optional – they are fundamental.

Until our next discussion, let us all commit to a higher standard, regardless of the policy landscape, because when it comes to saving lives, every moment and every action counts.

In unity and with purpose,

The Rescue RN Team

Healthcare is an ecosystem where policy should reflect our highest standards, and every decision should honor our commitment to patient care.