The Healthcare system in the US is faced with a bewildering array of inefficiency on employers, workers, consumers, and taxpayers. The implication for this is a change in how care services are delivered via professionals like nurses. The nursing profession has seen a significant transition; for instance, in the 1980s, there was a change in registered nursing staffing that resulted in a change in nursing care to be solely availed by high skilled workers. Healthcare organizations have been re-structuring workforces to cut costs and establish nursing care models, including teams of registered leaders and assistive personnel. As such, healthcare models are vital in better service delivery as they guide operations for managing changes now and in the future. The purpose of this paper is to examine an introduced reform in the US healthcare delivery system and the role of nurses within change management.
A Current Healthcare Law
The enactment of the Affordable Care Act (ACA) induced a significant shift in numerous aspects of US healthcare. In this regulation, the country took big steps to enhance the quality of care and control the costs of services in the industry. According to (), the ACA legislation sought to expand care coordination, improve quality and lower costs attributed to prescriptions, vast diagnostic tests, or unnecessary hospitalizations. Under this bill, nurses’ roles and responsibilities have been impacted as professionals are positioned to lead and be change agents within healthcare sectors. to achieve high improved care with minimal costs as expected by the ACA, nurses are ingredient in this change as their roles must conform to new paradigm. The Legislation supports value-based purchasing, pay for performance and savings agreement. The system focused by the act is that which rewards caregivers based on measurable quality outputs as well as patients’ experiences. In that way, nursing practices have to adapt to deliver desired outcomes, with the integration of enhanced skills set. Furthermore, nurses re expected to partners with patients and families for a broad scope or understanding of the social environment and attain patient-defined health outcomes.
Quality measures Effects on Outcomes.
The Healthcare delivery system has evolved from fee for services to other forms like paying for the performance (P4P). The latter is a form of a program based on quality, client satisfaction, and the use of services for patients’ benefits. The aim of this initiative is to impact efficiency, quality, and add an overall value to promoting patients’ health outcomes. Under P4P programs, professionals in the healthcare industry are provided with financial benefits based on performance measures. As such, the system affects patient outcomes when most professionals give their best care services for better pay- a win-win situation. Studies point out that the design of P4P and quality measures help drive away unnecessary hospitalizations and improve the quality of care, but conclusively, this has not been proven to improve patient outcomes. P4P has shown improvement in the process of care but have little impact on the outcomes of patients.
P4P and quality measures influence nursing practice as they matter to nurses. For instance, quality measures allow healthcare organizations to benchmark their performance against other providers and present consumers with a common metric of evaluating the quality of organizations. Measures that matters for nurses include outcomes and processes. Outcome measures give a look at the way a facility’s performance change over time. For nurses, the differences are essential, especially in the acute care field- where there is no direct control over the total outcome of care. However, nurses can control people’s actions taking that influence outcomes like mortality rate. On the other hand, process measures are tied to caregiving activity, and thus they are very actionable. Nurses can address process measure that shows a certain number-baseline follows a recommendation for a particular therapy. Thereafter, nurses may use the baseline to come up with a way of addressing interdisciplinary issues. The expectations of the nursing role in P4P and quality measures is to deliver safe and quality care as per the reward. However, professionals should not prioritize safety and efficiency instead of being motivated by payment. A big responsibility of the nursing role in this situation is to use quality measures to drive evidence-based care. In that, the overall healthcare industry will be paying for value.
Professional Nursing Leadership and Management Roles
The nature of nurses’ work is transitioning dramatically in that, in the re-structure healthcare systems, these professionals assume certain roles for a wide range of patients. The roles include new responsibilities for public health, interprofessional partnership, and coordination of care. Nursing education is the main reagent in impacting nurses’ unique skills to work effectively in the transformed service delivery models. New job titles are coming up mainly in coaching, informatics designs, geriatric care, and in the management of patient care transition. Under the merging trends in healthcare, nurses are employed as boundary tools to connect patients with services in healthcare as well as in community settings. As highlighted by the Institute of Medicine (IOM), nurse workers are called to collaborate as interprofessional teams. In that way, there is a platform for evidence-based information, which is exchanged among professionals- reaching to better clinical decisions. Consequently, patient safety and quality care in the diver population is promoted. Emerging roles for nurses require the application of skills in new ways and the development of knowledge. Under the role of population health, nurses have long played the role of formulating, implementing, and controlling programs to advance population health through disease promotion and prevention. In interprofessional cooperation, nurses play a vital role in developing systems that ensure that primary care clients get the best specialist consultations, nutrition, therapy, and counseling.
Change in Nursing Roles and Practice
In line with the set goals by the IOM on the future of nursing, one way in which the practice and roles of nursing will transform is increased leadership. Almost every advanced nurse will be a leader in various fields, with respect to the changing demographic. Nurses have been an integral part of care in the clinical setting, but recently there has been increased chances for leadership. The nurses are called upon to meet the needs of the growing population, and job titles that fall into the change are nurse manager, nurse leader, executive, and administrators. Typically, through effective leadership, the nursing workforce will meet the demand of the upcoming patient population and appropriately deal with emerging issues.
Another way of change in the practice of nursing is the growing use and role of informatics. Technology is evolving or advancing with time, and so will the skills of nurses to integrate into the new changes. The amount of health data will be collected and disseminated through technology devices. The change bears significant impact in nursing practice as informatics changes the way nurses will record and communicate information about patients, communities, interventions, or diseases. Also, care coordination and development of evidence-based practice will transition along with technology change.