Health Care Delivery Models and Nursing Practice Essay

Examine changes introduced to reform or restructure the U.S. health care delivery system. In a 1,000-1,250 word paper, discuss action taken for reform and restructuring and the role of the nurse within this changing environment.
Include the following:
1. 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.
2. 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.
3. 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.
4. 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.
You are required to cite to a minimum of three sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and relevant to nursing practice.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
You are required to submit this assignment to Lopes Write. Refer to the Lopes Write Technical Support articles for assistance.

Health Care Delivery Models and Nursing Practice

Part 1.

Nurses have traditionally responded to changes in health care laws and regulations, which affect the health care delivery system, with professional responsibility and innovation. They address health care concerns by engaging in integrated and professional activities with legislators, administrators, policymakers and other stakeholders.  Health Care Delivery Models and Nursing Practice Essay  The Public Protection and Affordable Care Act of 2010 (PPACA) is one such law that has impacted nursing practice to help address these concerns. PPACA addresses three objectives: ensuring that Americans have increased access to health care; improving the quality of health care; and reducing health care costs. It has three objectives: controlling insurance markets; preserving insurance coverage; and Medicaid expansion (Stanhope & Lancaster, 2016). PPACA presents a legislative framework that links payment initiatives to the concepts of resource availability, value in spending and quality of care. It makes use of nurses by identifying them as a resource that is uniquely situated to shape health care owing to understanding of patient care in different settings, proximity to the bedside, and team approach. The legislation places nurses’ priorities in addressing the health care delivery disconnect in the USA by initiating reforms that include imposing penalties on nurses who deliver low quality care, expanding regulations, and demanding quality reporting. The reforms and regulatory requirements have turned into a platform for nurses to share expertise on patient education and planning with the result being focus on population management and financial savings. The reforms are accompanied by an expanding nursing education and advanced nursing practice roles being expanded even as administrative skills and policy development are enhanced. This has resulted in more nurses taking on leadership positions (Stanhope & Lancaster, 2016).

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Part 2.

As the overall American population advances in age, medical therapies and health care interventions are become more expensive and sophisticated so that the population has a longer lifespan. However, these advances are achieved at significant financial costs so that their sustainability becomes questionable. In fact, there has been significant pressure to improve care quality while simultaneously reducing costs. In the USA, the health authorities understand this concern and have responded by adopting a patient-centered approach that places emphasis on quality measures and pay for performance. To be more precise, the pay for performance approach has been adopted as a measure for achieving both quality improvement and cost reduction. This is achieved by presenting financial incentives that improve adherence to best practices among nurses and other medical personnel. In this regard, adherence to best practice alongside patient outcomes act as a measure of performance on performance for pay. The pay for performance seeks to provide financial incentives for nurses to implement evidence-based practice and quality improvement. The assumption is that financial incentives can help in changing nurses’ clinical practice. As such, the expectations and responsibilities of nursing roles in quality measures and pay for performance is to implement evidence-based practice (LoBiondo-Wood, Haber & Titler, 2019).

Still, it is important to note that although quality measures and pay for performance have typically improved patient outcomes, there are instances when that decreases patient outcomes. This is seen when nurses focus on the measures associated with the financial incentives while ignoring the areas that are not being measured but have important implications for the patient outcomes. Besides that, focusing on the measures may improve documentation but reduce patient outcomes by misusing unnecessary therapies. For instance, early administration of antibiotics that is financially rewarding for the nurse but causing antibiotics misuse and increased resistance over time. Another concern is the possibility of high risk patients being ‘dumped’. This is particularly true for patients with complicated cases who nurses avoid because their health statistics may impair the statistics that determine their financial rewards (LoBiondo-Wood, Haber & Titler, 2019).

Part 3.

Health care is changing at a very rapid pace, and professional nursing leadership and management roles have been forced to evolve in response to these changes. The change highlights the need for nurse leaders and managers who are expected to apply unique skills to address the associated workflow complexities even as the patient moves through the whole care continuum. As health care systems evolve, prominence is being attached to primary care, community-based care and health promotion. This evolution has challenged nurse managers to shift from control to engagement and empowerment with a focus on leveraging the strengths of individual medical personnel (Cherry & Jacob, 2017). With the shift towards patient-centered care, nurse managers must now adopt management approaches that focus more on while moving away from problems, weaknesses and deficits. The change has emphasized business acumen and tangible skills development among nurse leaders. Nurse managers traditionally engaged in care coordination and clinical intervention. However, these roles are now changing so that nurse leaders may or may not need clinical expertise to fulfil their duties. To successfully lead change, they must develop business acumen and skills that allow them to make good judgements in well-informed and efficient ways. Some of the business skills required of them in the fulfilling management duties include critically appraisal of published research to ensure the credibility and quality of supporting data, use of data and statistics in making a point, and understanding strategic planning. These changes allow nurse leaders to fulfil their advocacy roles in promoting patient safety and quality of care as they present a unique nursing perspective in decision-making (Cherry & Jacob, 2017).

Part 4.

As the health care landscape continues to shift and medical personnel shortages become steeper, the practice of nursing and nursing roles are likely to change in two ways. Firstly, nurses are likely to become increasingly specialized. The demand for specialized nurses is increases in areas such as gerontology, obstetrics and psychiatry. The specialization enables nurses to become experts in the areas in which they provide care. The specialization and ensuing certification will help in assuring medical organizations and patients that the nurses are highly competent and knowledgeable in the specific health care area thus capable of improving health care efficiency and outcomes (Roux & Halstead, 2018). Secondly, nurses are likely to become more involved in telehealth, a technology that allows patients to leverage communication technologies gaining greater access to medical personnel.  The technology includes remote monitoring, and phone and video consults. The surge in telehealth will provide opportunities for nurses to engage in patient care, wellness checks and health promotion. This will be useful in critical care where nurses will be able to provide their professional services virtually, such as using video conferencing to consult with an expert or specialist in another state. On the wellness side, medical facilities are now integrating medical information from wearable devices into health records. Nurses will need to have technical knowledge on how to use these technologies in order to remain relevant in telehealth settings (Roux & Halstead, 2018).

References

Cherry, B. & Jacob, S. (2017). Contemporary Nursing: Issues, Trends, & Management (7^th ed.). Elsevier.

LoBiondo-Wood, G., Haber, J. & Titler, M. (2019). Evidence-Based Practice for Nursing and Healthcare Quality Improvement. Elsevier.

Roux, G. & Halstead, J. (2018). Issues and Trends in Nursing: Practice, Policy, and Leadership (2^nd ed.). Jones & Bartlett Learning.

Stanhope, M. & Lancaster, J. (2016). Public Health Nursing: Population-Centered Health Care in the Community. Elsevier.  Health Care Delivery Models and Nursing Practice Essay