Healthcare Standards

Healthcare standards in regulation are set to allow patients to obtain the best quality of treatment. To a large extent most standards are similar across several healthcare settings; however, upon in-depth scrutiny, specific differences arise indicating how different practice setting may be different from the others. This paper, therefore, analyses the similarities and difference between administrative structure and patient rights, in dialysis units and home care settings in healthcare.

Patient Rights


Firstly, in both Dialysis units and Homecare settings, patients have a right to be informed about their rights. This also comes up as a right to information, which implies that at all times patients must be aware of the scope of their rights (National Kidney Foundation, 2014; Marrelli, 2016). In the dialysis unit, the nephrologist must read all rights to their patients before the services, while in the homecare, the home care agency must provide written documentation of reasons, before initiating service. Failure to comply with this results in risking or putting the agency or healthcare organization in a precarious position in the event individuals decide to seek legal redress.

Within the dialysis unit, patients have a right to expect privacy while being under medical care but also have a right to choose who the information can be shared with (National Kidney Foundation, 2014). This is similar to the homecare settings, where privacy and confidentiality are paramount to service unless otherwise stated. The privacy and confidentiality rights, include having examinations and discussions on patient care being held in private and having the medical examination and information reports being kept confidential. Just like any other patient right, failure to comply with the set standards may trigger legal proceedings, which may be detrimental to the healthcare organization or home care agency (Marrelli, 2016).


The dialysis units are run by healthcare organizations and hospitals which offer the dialysis services to patient with kidney or renal problems. As such, despite there being a bill of rights the patient must conform to the functionality of the hospital. This implies that a patient’s autonomy is limited, with the rights accorded dealing with a patient’s treatment procedures. However, the home care setting grants the patient more power over an agency and the agency at all times must work to fit into the patient’s mode of life. For instance, while hospitals have a schedule that guides service delivery which the patient must conform with, the homecare service schedules are designer in a way aligns with the patients’ desires (Marrelli, 2016).

Administrative Structure


In healthcare provision, healthcare regulatory structure plays a significant role in ensuring the efficiency of the healthcare process. At the lower level closer to the patient, both settings provide personnel to provide specific functions. For instance, since the nursing care is the purview of a home care agency, hence the frontline is made up of nurses, nurse practitioners, home health aides, and physical therapists. This is also similar to the dialysis center which provides a nephrologist, nurse and other clinicians to help with the caring of patients at the lower level (Harris, 2015).

Patient care managers who directly oversee patient care also existent in both. Whereas they may have titles such as director of nursing in home health, or director of the dialysis in a dialysis unit, their functions tend to remain the same. For instance, they are responsible for how their staff operates and conducts themselves. In the event of a problem with patient care, this is this personnel are responsible for handling the issue.  However, the human resource manager is equally accountable for the provision of staffing resources in both health care settings (Harris, 2015).


Dialysis centers operate under hospital management structures. However, where a center is a separate entity, the structure tends to remain the same. This structure has significant differences compared to that of home care agencies. Firstly, hospitals, of which dialysis centers are part of are corporations which means that a board of directors oversees them. This board consists of individuals from which the hospital draws its funding such as religious groups or educational groups. On the other hand, however, the home care agency is under Chief Executive officers, who in most case doubles up as the owner. Such an individual is responsible for ensuring readiness for inspection, marketing, updating compliance requirements and legislation, as well as mitigating consumer complaints. The board of directors, on the other hand, have a duty to specific facilities within their hospitals, although their functions are limited to a smaller part of the hospital in comparison to the hospital size. However, while executive officers will have functions similar to those carried out by a CEO in the homecare facility, they are answerable to the board, which further highlights the difference (Harris, 2015).

Homecare agencies are mostly nursing based health facilities; hence it is only practical to state that the director of nursing is the first within the upper management levels. Such an individual is responsible for all clinical operations, conducted by their home health agency. They are more involved with policy and procedure and are far removed from the provision of services to the patient. On the other hand, a dialysis unit will have a departmental head in the hospital, with a manager who reports to the core management (Harris, 2015).



Harris, M. D. (2015). Handbook of Home Health Care Administration. Jones & Bartlett Learning: Massachesetts.

Marrelli, T. M. (2016). Home Care Nursing: Surviving in an Ever-Changing Care Environment. Indiana: Sigma Theta Tau International.

National Kidney Foundation. (2014). Dialysis Patients’ Bill of Rights and Responsibilities. New York: National Kidney Foundation.