PERSON A : Three of Quadruple’s components aim to lower cost, improve

PERSON A :     Three of Quadruple’s components aim to lower cost, improve health outcomes, and promote patient satisfaction. However, these Aims are not easy to achieve due to competing needs. The Affordable Care Act (ACA) has implications on how care is given by focusing on value over volume; the payment is made for a specific medical condition over a cycle of care and depends upon positive patient outcomes (Broome & Marshall, 2017, p. 64.
     As a result, healthcare Organizations have adopted a “business model that requires a reductionist, standardized approach to care delivery accompanied by often inflexible organizational policies, regulations, and operating procedures” (Kelly & Porr, 2018). The focus on cost-saving measures has resulted in poor patient outcomes and a lack of satisfaction for patients and healthcare professionals (Kelly & Porr 2018). 
     The need to reduce costs in my organization has resulted in the premature discharge of mentally ill patients who still need a higher level of care. I have seen patients discharged to shelters and motels only for them to be re-admitted in a week or two. The completing needs of saving costs have resulted in not providing adequate care fueling the vicious cycle of homelessness, incarceration, and re-hospitalization.
     Given the importance of housing as a social determinant of health, discharging patients to a shelter sets them up for poor health outcomes, including an increased mortality rate. A patient discharged to a shelter has no access to community-based support for follow-up appointments, lab monitoring, and a safe place to keep medications. They are also at a high risk of crime, violence, and involvement with the criminal justice system, which does not always know how to handle individuals in mental health crises, increasing their chances of being shot. Homelessness is the most visible manifestation of failures in mental health policy and other public policy areas (Gorfido, 2020).
     Health care policies that support Universal health care, Housing First, and community-based health care would be an excellent place to start in breaking this cycle. With Universal health care, the mentally ill population would have access to adequate treatment and potentially eliminate symptoms, enabling them to hold jobs and have the income to support their housing. For those with severe mental illness and who cannot function independently, adequate housing first programs and community-based clinics that offer therapeutic services are needed. They should have federal funding (Gorfido, 2020).
PERSON B: Following a decade of constant health system change, reorganization, reformation of the system and revisions to reimbursement and funding methods, many registered nurses have difficulty establishing ethical obligation. (Peterson, 2001). As professionals, registered nurses are pulled between a strong desire to adhere to the Code of Nursing Practice and the battle to exert influence in a continuously evolving health system where others’ i.e., stakeholder objectives may differ from their own (Peterson, 2001). These factors have prompted numerous nurses to express concerns that unnoticed and unsupervised policies in the health-care system by regulatory agencies have jeopardized their ability to advocate for their patients, their professional ethics, personal nursing practice, as well as their physical well-being (Kelly& Porr, 2018). For example, patients benefit from the transition or policies, but behind the scenes, health care employees are experiencing frightening levels of burnout. Conflicting service expectations, such as pressure to work in more flexible or cost-effective ways while maintaining professional standards, as well as changes in nurses’ duties, nurse-to-patient ratios, can undermine nurses’ integrity and ultimately patient care (Kelly &Porr, 2018). Also, because of high stress in the workplace, nurses lose the enthusiasm and drive they once had for their profession. A lack of happiness in the workplace has been shown to be associated with a variety of negative outcomes in the workplace, including increased tardiness, burnout, high turnover, and substance addiction (Schoenwald et al.,2010). 
                                     
                                                                Impact on National Issues 
Resources are “anything believed by the individual to assist in achieving goals” (Nielsen et al., 2017). As a result, resources enable employees to successfully fulfill their jobs and achieve their goals, so improving their overall well-being and ability to perform well (Nielsen et al., 2017). Workplace resources can inspire motivation and enhance well-being through intrinsic motivation, by fulfilling key human needs such as autonomy, competence, and connectedness, and by ensuring that resources are readily available (Nielsen et al., 2017). For instance, supportive leaders and coworkers who assist an individual in accomplishing work duties may boost an individual’s capacity to accomplish work objectives, resulting in increased job satisfaction and performance. Thus, organizations emphasize teamwork. Health workers’ well-being is positively correlated with productivity, according to the “happy worker–productive workers,” postulate; however, organizations must learn how to keep happy and productive personnel (Nielsen et al., 2017). In conclusion nurses are frequently asked to offer better care with limited resources, which has resulted in emotions of dissatisfaction and stress in workplaces. For this prevalent stressor to be alleviated, healthcare workers, particularly nurses, must recognize the need to speak out and become active in policymaking, not only locally but also at the state and national levels.