Health Care Delivery Models and Nursing Practice Essay

Examine changes introduced to reform or restructure the U.S. health care delivery system. In a
1,000 word paper, discuss action taken for reform and restructuring and the role of the nurse
within this changing environment.
Include the following:
Outline a current or emerging health care law or federal regulation introduced to reform or
restructure some aspect of the health care delivery system. Describe the effect of this on nursing
practice and the nurse’s role and responsibility. Health Care Delivery Models and Nursing Practice Essay

ORDER  HERE A PLAGIARISM-FREE PAPER HERE

Discuss how quality measures and pay for performance affect patient outcomes. Explain how
these affect nursing practice and describe the expectations and responsibilities of the nursing
role in these situations.
Discuss professional nursing leadership and management roles that have arisen and how they
are important in responding to emerging trends and in the promotion of patient safety and quality
care in diverse health care settings.
Research emerging trends. Predict two ways in which the practice of nursing and nursing roles
will grow or transform within the next five years to respond to upcoming trends or predicted
issues in health care. Health Care Delivery Models and Nursing Practice Essay

The nursing profession has experienced numerous changes. In 1980s, there was a shift to all registered nursing staffing that led to nursing care being solely delivered by highly skilled nurses. Additionally, at the moment, health care institutions are restructuring their workforce in a bid to cut costs. Hospitals are reducing the number of registered nurses, but increasing the number of unlicensed assistive personnel (UAP). Health care institutions are establishing nursing care delivery models, which include nursing teams consisting of a registered nurse leader and assistive personnel such as the UAP. Currently, there is a focus on a nurse as a supervisor of a team of care givers with a spectrum of cognitive skills and knowledge. Due to the fact that a registered nurse if held responsible for the outcome of nursing care delivered by a team, registered nurses should be skilled in capacities, such as delegation, and so forth. Health Care Delivery Models and Nursing Practice Essay

It is imperative for present-day nurses to have delegation skills as much as the critical thinking and traditional assessment nursing skills. The solution to performing in the function of a care leader is an understanding of the principles and role of delegation. Nurses are advocates of patients, and the objective of delegation is to guarantee that patient safety and quality care reach the bedside.

However, delegation is a challenging skill to obtain. It is simply a leadership and management skill. Nursing students in their early education experience should be introduced to the concept of a nurse as a care giver or a leader of a care delivery team. Nursing students need to be provided with ample opportunities to practice such skills in the clinical setting. They should know which kind of nursing skills should be delegated, and those that cannot. More significantly, they should be aware of basic delegation skills which be expected in their first nursing experience or job where they will have to supervise and lead care delivery. Health Care Delivery Models and Nursing Practice Essay

A popular model for delivering enhanced nursing primary care, which has gathered momentum and is now being tested globally, is the medical home. This model is likely to get more prominence in the coming years when accountable care organizations (ACOs) start operation, because many believe that primary care practices that belong to an ACO will want to adopt some elements of the medical home model to manage the care of their ACO patient panel efficiently enough so as to generate shared savings ( ). Health Care Delivery Models and Nursing Practice Essay

In general, there is a scarcity of research to allow a satisfactory evaluation of what the model of medical homes can accomplish. At least, there is some supportive evidence for some elements of medical homes. According to ( ), improvements are required in quality of preventive care, patient access, care processes, and general cost savings resulting from inpatient utilization and reductions in emergency department. Health Care Delivery Models and Nursing Practice Essay

Research, which documents remarkable success stories show the efficiency of the medical home care model in controlled settings, although the efficiency of this model when adopted generally remains an open question. Like other good ideas, it might prove challenging to spread an initiative, which works tremendously well in some environments to the broader health care arrangement. Furthermore, health care organizations, which already meet most of the requirements linked with being a medical home, can actually improve more through incremental improvements, while nursing practices in need of change might be stuck if they cannot muster the human and financial capital needed to fix their practices. Health Care Delivery Models and Nursing Practice Essay

In short, the medical home model has the potential to transform the manner in which health care is delivered. The risk posed by the present enthusiasm for the theory is that is can lead to the adoption of unproven models on a broad scale nationwide before assessments of existing pilots can reveal what works best in what environments, and what points of reimbursements are required to get providers to engage in all the new activities covered in the medical home model. This could potentially lead to a failure to save costs or improve quality and could result in a good idea being termed ineffective before it has been given a chance to do well ( ).

When patients receive care from various sources, connecting that care into an effective trajectory becomes challenging. Policy reports globally urge a combined effort to enhance continuity of care and avoid fragmentation. However, efforts to explain the problem or offer solutions are weighed down because continuity has been described and measure in countless ways. Continuity of care is conceived in a different way in nursing. The experience of care by a one patient with a provider is the first core factor of continuity; the second factor is that care continues over time, at times this is referred to as chronological or longitudinal continuity ( ). Both factors should be present in order for continuity to exist, however their presence does not amount to continuity. Health Care Delivery Models and Nursing Practice Essay

The aging population in the entire world is growing rapidly as the largest portion of healthcare spending come from the cost of inpatient hospital. It is expected that more jobs will be available in the community and few will be available in acute hospitals. According to The United States Bureau of Labor Statistics, the number of human and social service assistance will grow by nearly 23% between 2008 and 2018. In 2008, over 65% of employees in the medical field were in social and health care assistance industries (Zerwekh, 2011, p. 530).
The ACO’s impact in the field of nursing will be positive as it will provide many opportunities for nurses who will seemingly become not only providers of care but also managers of care. Nurses with good qualifications in client management in the field of care will greatly be demanded since hospital systems will need people to manage clients and families and that these hospital systems will also acquire physician practices. It will be coherent for nurses to understand all the care provided at each level in the field such as, negotiating with medical pharmaceutical and medical providers, maximization of insurance payments and finally engagement and support of family members. Therefore, the role of nurses will increase in importance. Nurses will have to get advanced education in care leadership and management in order to position themselves better for success. Health Care Delivery Models and Nursing Practice Essay

ORDER  NOW

The main purpose of the expected changes is to transform the fee-for-service which is seen as the major driver of health cost in the nation. This purpose will be accomplished through proposed initiatives such as medical homes and nurse-managed health clinics which are aimed at taking medical services to the grassroots while cutting medical cost. The proposed system that will replace fee-for-service is taking shape and it will mainly involve increased clinical and financial accountability. This initiative will not only lower cost but will also redefine healthcare as a diverse activity that will encompass far more than sick care. The objective of the proposed amendment is to improve factors that make people exacerbate their illnesses including those that make people sick. These approaches will therefore require the use of automation (Hines, 2010, p. 76).
Notably, the emergence of the concept of the patient centered home is a result of the high problems of poor coordination, high cost and poor quality of care. According to the ACO, the patient-cantered medical home which is seemingly a model of care where patients have direct relationships with providers coordinating a cooperative team of professionals in healthcare, will take several  responsibilities. To start with, patient-centered medical homes will take joint responsibility for the care that is provided to patients and also arrange for proper care with other needed qualified providers. Therefore, these medical-centered homes and nurse-managed health clinics are aimed at improving care and lowering costs
Automation will allow organizations to better assess health status, population needs, demographics and resource utilization. In terms of caring for the whole population, they will be required to think critically and not just for the sake of particular patients who constantly seek care. Health Care Delivery Models and Nursing Practice Essay Hospitals will have procedures decreased and revenue shifted from two ambulatory care as admissions and as part of ACOs and healthcare systems they will share in the savings. Providers, on the other hand will continue competing with each other and work together to exchange health information and coordinate care (Porter, 2011, p. 111). Organizations operational levels will change their structure and their workflow to adopt new types of reporting and automation tools in order to implement ACO proposals. These proposals will therefore require interactive participation of leadership and setting clear goals. Health Care Delivery Models and Nursing Practice Essay

Nursing has always been an important and significant part of the landscape in health care (Snodgrass, 2004). That holds true today and will continue to hold true into the future, but it is undeniable that the future of nursing is also changing. There are four areas where nursing is evolving: continuity of care, accountable care organizations, medical homes, and nurse-managed health clinics. The continuity (or continuum) of care is far different than it was in the past, due to the fact that people are living much longer and managing their illnesses and conditions very differently than they did years ago (D’Antonio, 2010). Because length of life and quality of life are both important, the way nurses are trained to care for patients now involves more options for those patients in the form of procedures and medications about which both the nurses and the patients need to be informed (Judd, 2009). The continuum of care moves through many decades of a person’s life, and from the pediatrician all the way through to a nursing home or other elder-care setting (D’Antonio, 2010). Health Care Delivery Models and Nursing Practice Essay