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Healthcare Delivery Models and Nursing Practices

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Healthcare Delivery Models and Nursing Practices

 

 

Healthcare Delivery Models and Nursing Practices

The Healthcare system is evolving and transforming such that it does not just focus on curative services but also how diseases can be prevented, and people’s wellness improved. Besides, new healthcare reforms have an approach to the development of delivery models, which are seeing the change in nurse roles, for example, from acute to community health care (Dillon, Dolansky, Casey & Kelley, 2016).  An example of these models is the patient protection and affordable care act (PPACA) that was established in 2010 to support services like medical homes, nurse-managed clinics, payments programs, and ACOs. With the enactment of healthcare models like ACA, health has changed a lot from traditional to modern care services delivery. Models of healthcare guide system operations and facilitate change management. To better promote safe and quality healthcare services, laws as well as system like pay for performance, nursing leadership or governance are vital in managing current and future nursing practice. The purpose of this paper is to examine changes introduced to restructure the US health care delivery system.

An Emerging Healthcare Law

One current or emerging healthcare policy that has been introduced to reform some aspects of care delivery is the Title VIII Nursing Workforce Reauthorization Act of 2019 (“Congress.Gov,” 2020). The bill with reference number H.R.728 was introduced by a congress member and seek to help with re-authorization programs. Specifically, the law re-authorizes repayment of loans as well as scholarships for nurses, giving advanced education grants for nurses, grants for nurse workforce diversity and nurse practices, quality, and retention grants (“Congress.Gov,” 2020). The effect of this bill is reforming the workforce capacity and help in improving professional competency of workers. Currently, there is short of nurse professionals. By enactment of this bill, there is an assurance that individuals interested in pursuing a nursing career they have access to quality education or training. As a result, there will be an impact on healthcare delivery to patients as professionals increase in the US care system. Additionally, the bill will enable the promotion of welfares of the American nurse workforce.

The shortage of healthcare workers has caused a significant impact in rural areas, whereby reaching care services to marginalized groups has been a considerable challenge. However, with an increase in the number of nurses, professionals will be in positions to offer individual healthcare delivery to people in remote places. The bill target support to the learning institutions that provide training for practice in medically underserved areas. Nurses have a vital role in promoting the proposed change. Professionals are obligated to identify and give guidance to people interested in pursuing a nursing career—for instance, nurse partners with school counselors to provide advice to students.

Quality Measures and Pay for Performance

Quality measures and pay for performance (P4P) affects patient outcomes through the motivation of workers (Conrad et al., 2018). Typically, healthcare systems have evolved from free for service to models of payments that are based on quality, satisfaction, and utilization of services for people’s benefit. As such, the initiatives aim to provide efficiency, quality, and add value to overall healthcare. Physicians and nursing professionals are motivated to give quality care because payment is based on their performance. In that way, they try their best to deliver better services- an advantage to patient outcomes. Incentives are issues to healthcare workers if they meet the needs of patients.

On the contrary, many healthcare workers who oppose this reform posit that quality measures upon which payment is based can be confronted by the severity of diseases or behaviors of patients. The measure of quality and P4P impact nurse practices such that they are expected to not only attend to many patients but also provide quality care to meet the test scores of payments. In this way, it means that professionals who treaty less compliant patients or sicker populations are likely to have low scores on outcome measures irrespective of their effort to give quality care. In this situation, where nurses or professional pay is based on their performance or outcome, there high expectations that patient care must be standard and free from harm (Mak, 2018). The nursing role in this circumstance is to provide the best care adhering to patient safety.

Professional Nursing Leadership and Management Roles

The new professional nursing leadership and managerial roles that have risen include care coordination, health coaching, navigations, and care management. The roles have emerged in conjunction with the change to patient-centered care at homes and accountability under ACA as well as reimbursement trend. Usually, a function like care coordination serves as case management, and coordinators are at the core of case management practices- an emerging trend in the healthcare system. In nursing service delivery and social work (Boamah, Laschinger, Wong & Clarke, 2018). Professional roles like case management are vital to helping serve a diverse population of patients.

Health coaches, for instance, have an essential role in the emerging trend of recruiting millennial healthcare workers. With this, these professionals must ensure new nurses as well integrated to healthcare practices; they must ensure professionals possess the required skills to deal with a diverse patient population. Most importantly, professional nursing leadership and management role like coaching must ensure workers are not only integrated into modern expertise but also utilize evidence-based approaches. As a result, patient safety is assured. Care coordinators and managers facilitate the delivery of services to all patients irrespective of their backgrounds, and this is not better attained without proper leadership and planning.

Future Nursing Practice and Roles

One way in which practice and nursing roles will transform in the next five years is an emphasis on interdisciplinary skills. Since the healthcare needs of patients are many, nurses have now started to learn multidisciplinary skills to deal with a wide range of disciplines, such as social issues. In that way, I predictable that role of nurses and practices will transform from specialization to interconnectedness to serve the needs of individuals at once. In that way, many professionals will see increased opportunities for leadership.

The second trend to see in five years is nurses working beyond the retirement age. In the recent situation, there is a nurse shortage issue, and this has resulted in the need to have nurses work beyond the retires period. The increasing patient population is one of the factors that nurses remain in their work resuming respective or integrative roles after a long period of experience. Healthcare projection shows patients’ health becoming more and more complex, demanding high skills and knowledge. Other issues like recessions make the nurse feel more secure in their jobs and work for an extended period.

To sum up, this paper has looked at the restructuring and changes within the health care system in the US and discuss the workforce re-authorization in nursing as a current health care law. Also, it has been pointed out that quality measures and pay of performance have significant impacts on patients and nursing roles. With the current shift in demographics, professional nursing leadership and management roles have changed, and practice swill transforms further in the future, given the complexities in care delivery.

 

 

References

Boamah, S. A., Laschinger, H. K. S., Wong, C., & Clarke, S. (2018). Effect of transformational leadership on job satisfaction and patient safety outcomes. Nursing outlook66(2), 180-189.

Congress.Gov. (2020). H.R.728 – 116th Congress (2019-2020): Title VIII Nursing Workforce Reauthorization Act of 2019. Congress.gov. Retrieved 24 June 2020, from https://www.congress.gov/bill/116th-congress/house-bill/728.

Conrad, D. A., Milgrom, P., Shirtcliff, R. M., Bailit, H. L., Ludwig, S., Dysert, J., … & Cunha-Cruz, J. (2018). Pay-for-performance incentive program in a large dental group practice. The Journal of the American Dental Association149(5), 348-352.

Dillon, D. L., Dolansky, M. A., Casey, K., & Kelley, C. (2016). Factors related to successful transition to practice for acute care nurse practitioners. AACN advanced critical care27(2), 173-182.

Mak, H. Y. (2018). Managing imperfect competition by pay for performance and reference pricing. Journal of Health Economics57, 131-146.

 

 

 

 

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