Discussion: Health Care Delivery Models and Nursing Practice
Discussion: Health Care Delivery Models and Nursing Practice
Assessment Description
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:
Outline a current or emerging health care law or federal regulation introduced within the last 5 years 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.
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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 in response to upcoming trends or predicted issues in health care.
You are required to cite a minimum of three sources to complete this assignment. Sources must be published within the last 5 years, appropriate for the assignment criteria, and relevant to nursing practice.
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Health Care Delivery Models and Nursing Practice
Healthcare reforms are governmental policies that affect health care delivery in a county, state, or country. They seek to widen the population that has access to health care, improve access to health care specialists, improve the quality of care, and reduce healthcare costs. The purpose of this paper is to discuss healthcare reform and the nurse’s role within the changing environment.
Health Care Law Introduced To Reform the Health Care Delivery System
The SUPPORT Act of 2018 is an example of a recent federal regulation enacted to reform the healthcare delivery system in the US. It amends the Controlled Substances Act by expanding the conditions a practitioner must meet to offer medication-assisted treatment (MAT). It also expands the available options for a physician to be regarded as a qualifying physician (Musumeci & Tolbert, 2018). In addition, the SUPPORT Act abolished the period for a nurse practitioner (NP) or physician assistant (PA) to be regarded as a qualifying practitioner and changed the definition of a qualifying practitioner. Besides, the Act permits a pharmacy to dispense prescribed controlled substances to a practitioner’s registered location for maintenance or detoxification treatment to be administered under specific conditions by a practitioner.
The SUPPORT Act significantly affects nursing practice since it provides practitioners greater flexibility in providing MAT. Besides, it expands the privilege of prescribing buprenorphine in office-based patient settings to other qualifying practitioners, including NPs, CNs, CRNAs, and CNMs (Musumeci & Tolbert, 2018). The nurse’s role and responsibility with respect to this regulation include providing access to case-management services for patients. This includes providing referral and follow-up services for programs that provide financial support or support the provision of services like behavioral, medical, social, employment, housing, educational, and other related services. Furthermore, the SUPPORT Act requires the nurse to provide MAT, including all FDA-approved drugs, behavioral therapy, and counseling services.
How Quality Measures and Pay for Performance Affect Patient Outcomes
Quality measures are used to evaluate and compare the quality of health care organizations and are categorized as structure, process, or outcome measures. They are benchmarks that enable healthcare organizations to assess the utilization of resources to support improvement and collaborative efforts with fact-based data (Doyle et al., 2019). Quality measures help healthcare organizations drive towards evidence-based practice (EBP) and paying for value, which improves the quality of care and, ultimately, patient outcomes. For instance, structure measures enable health organizations to maximize the effectiveness of the systems and facilities they have in order to deliver the best possible care to their patients (Doyle et al., 2019). Process measures present evidence that inspires providers to follow the best clinical practices to improve patient outcomes.
Pay-for-performance (P4P) programs offer financial rewards or penalties to individual health care professionals, groups of providers, or institutions based on their performance on quality measures. P4P programs affect patient outcomes by driving health providers and organizations to improve the quality of patient care, minimize unnecessary utilization of expensive health services, and improve patient outcomes (Kyeremanteng et al., 2019). P4P programs have been associated with enhanced processes of care, which eventually improve patient outcomes.
Quality measures impact nursing practice since nurses are required to use patients’ needs and evidence-based clinical practice to establish a measure’s specifications and exclusions. Nurses are aware that their actions have a significant impact on patient outcomes. Thus, they are expected to control individual actions they take to influence outcomes such as morbidity and mortality rates (Doyle et al., 2019). P4P also affects nursing practice since adequate remuneration improves nurses’ performance and healthcare quality (Kyeremanteng et al., 2019). Nurses, individually and jointly, deal with the complex issues related to P4P. The nurse is responsible for being aware of their role in any P4P by improving the quality of nursing care for compensation with financial incentives.
Professional Nursing Leadership and Management Roles That Have Arisen
The roles of nurse leaders and managers have evolved to accommodate the changing healthcare landscape. They are now required to employ advanced knowledge and skills to manage the increased complexity of the changing landscape. Besides, nurse leaders and managers have a new crucial function in creating healthy work environments in healthcare organizations (Ens et al., 2018). This has been driven by the growing evidence of the positive impact of healthy work environments in improving staff satisfaction, patient outcomes, retention, and organizational performance.
Nurse leaders have also assumed the role of local champions, where they work directly to engage the staff through team building, coaching, and regular communication to promote staff retention. Nurse leaders and managers are also tasked with quality improvement in patient care settings. They are now expected to place greater emphasis on performance measurement and engage in data collection to monitor multiple aspects of a unit’s or organization’s performance (Ens et al., 2018). Furthermore, nurse managers now have financial management roles, and they need to understand how finances function in their respective organizations and manage the financial side of the nursing department.
Emerging Trends
The emerging trends in healthcare include the growing role of informatics and an increased emphasis on population health. Technological advances have increased the amount of health care data collected through information technology, including patient portals, electronic health records, and wearable devices. The trend will significantly impact nursing practice and nurses’ roles since it will change how nurses document and communicate patient information (Pepito & Locsin, 2019). Besides, it will change how nurses coordinate patient care and the development and implementation of EBP in nursing practice. The increased use of informatics will create positions for nursing professionals who want to fully focus on the relationship between nursing and data, leading to roles like nursing informatics analyst and informatics specialist.
There is an increasing emphasis on population health, a comprehensive care approach focusing on the health outcomes of a group of individuals. Nurses will be expected to take roles in population health by using their expertise to help the health care system respond to patient needs on the individual and population levels. Nurses in the future will be expected to identify problems that should be addressed on a wide scale and connect individuals with various services provided in communities (Edmonson et al., 2018). Besides, they will be involved in developing strategies that improve health outcomes and save patient and organization costs by preventing health problems before more costly interventions are needed.
Conclusion
The SUPPORT Act of 2018 provides practitioners greater flexibility in providing MAT and expands the conditions a practitioner must meet to offer MAT. Quality measures help to improve patient outcomes by ensuring patient safety, identifying areas where interventions might enhance care, and identifying how and where performance improvements should be made. Nurse managers and leaders must now think past the traditional way and expand their perspective to focus on patients’ journey along a care continuum. The growing role of informatics and increased emphasis on population health will transform nursing practice by introducing new roles to nurses in information technology and planning population health approaches.
References
Doyle, J., Graves, J., & Gruber, J. (2019). Evaluating Measures of Hospital Quality: Evidence from Ambulance Referral Patterns. The review of economics and statistics, 101(5), 841–852. https://doi.org/10.1162/rest_a_00804
Edmonson, C., McCarthy, C., Trent-Adams, S., McCain, C., & Marshall, J. (2018). Emerging global health issues: A nurse’s role. Online Journal of Issues in Nursing, 22(1). https://doi.org/10.3912/OJIN.Vol22No01Man02
Ens, B., Bazylewski, S., & Duchscher, J. B. (2018). Emerging Nursing Leadership Issues. Leadership and Influencing Change in Nursing.
Kyeremanteng, K., Robidoux, R., D’Egidio, G., Fernando, S. M., & Neilipovitz, D. (2019). An Analysis of Pay-for-Performance Schemes and Their Potential Impacts on Health Systems and Outcomes for Patients. Critical care research and practice, 2019, 8943972. https://doi.org/10.1155/2019/8943972
Musumeci, M., & Tolbert, J. (2018). Federal legislation to address the opioid crisis: Medicaid provisions in the SUPPORT Act. Henry J Kaiser Family Foundation.
Pepito, J. A., & Locsin, R. (2019). Can nurses remain relevant in a technologically advanced future?. International journal of nursing sciences, 6(1), 106-110. https://doi.org/10.1016/j.ijnss.2018.09.013
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