Health Care Delivery Models and Nursing Practice
In May 2020, the federal government and several states temporarily loosened the restriction of practice for Nurse Practitioners (NPs) to maximize the number of clinicians available for treating patients with COVID-19 (AANP, 2020). NPs were approved to provide specific medical services for patients with Medicare coverage at skilled nursing healthcare facilities. Previously, access to these services was only through physicians. Increasing the NP’s clinical autonomy has been a long-time goal for the AANP. Although the changes are temporary, the government should have contemplated the COVID-19 impact; and need to consider this now when transitioning healthcare to a post-pandemic era. NPs are now faced with a rare opportunity to educate other persons on the merit of their role and advocate for the legislative changes to be made permanent. .
Quality measures are the tools used in quantifying processes in healthcare, perceptions by patients, outcomes, and organizational systems or structures linked to the ability to offer high-quality healthcare and relate to one or multiple healthcare quality goals(Adirim, Meade, & Mistry, 2017). These goals include timely, equitable, patient-centered, efficient, safe, and effective care. The outcome measures offer a look at a high level at the Performance of healthcare facilities change over time and how the healthcare facility fairs compared to its peers. The measures offer information on the result of service provided to a patient. Process and structure measures are also evaluated for the evaluators to uncover the causes impacting different outcomes (Adirim, Meade, & Mistry, 2017).
Pay for Performance is also called the value-based payment and comprises the payment model, which is attached to provider performance, financial incentives, or financial disincentives (Kondo et al., 2016). While the system uses fee-for-service, it also encourages providers to focus on value-based care because it ties metric-driven outcomes to reimbursement and patient satisfaction’s proven best practices, thus aligning quality and value with payment. Using nurse-sensitive quality measures can aid the healthcare industry in ensuring evidence-based practice and payment for the value provided. Structural measures can aid hospitals in maximizing the facilities and systems’ effectiveness that they have in place in providing the best care possible to patients (Kondo et al., 2016).
As quality measures evolve, developers of measures continue to discover ways of reducing hospitals’ and caregivers’ burdens. By utilizing electronic clinical quality measures, for example, developers closely tie EHR information to quality measurements. Such efforts can minimize double entries, thus ensuring that data entry measure is aligned smoothly into the workflow. The burden can also be significantly reduced by minimizing the total number of tracked measures to those that make a significant impact (Kondo et al., 2016).
Nurse managers and leaders are highly skilled professionals who provide the highest quality healthcare. Although management is a requirement in both positions, and so too leadership skills, the responsibilities and job descriptions differ. Both the nurse managers and leaders aim to provide care in a meaningful and efficient way. Nurse leaders focus more on patient care, while nurse managers work in the background on daily duties and operations.
According to Bianchi et al. (2018), a nurse leader is in charge of nurse teams and makes decisions while directing initiatives on patient care. These have advanced clinical knowledge and focus on improving patient health outcomes. Some of the main responsibilities of the nurse leader include patient advocacy and education; reducing costs by improvement on efficiency; development of treatment plans that improve patient and care outcomes; diagnostic test ordering and reviewing; direct care provision to patients; providing the team with the tools and knowledge to achieve their goals in patient care; reduction of RN turnover rates; staying up to date on advances in healthcare research; and working at shortening the hospital stay and reduction in readmission rates of patients. Nurse leaders ought to communicate well with their teams and delegate tasks efficiently. It is a must for nurse leaders to be compassionate and empathetic since they work with patients. Effective nurse leaders also require to have strong critical thinking and problem-solving skills.
Moore, Sublett, and Leahy (2016) opine that nurse managers, on the other hand, are not ideally involved in the direct care of patients; instead, they focus on daily operations’ management and staff supervision. The position calls for the nurse to understand how businesses are run because they are tasked with budgeting for the department. The main responsibilities of a nurse manager include overseeing the daily operations; supervision and provision of training to team members; working with different stakeholders in optimizing care and meeting the requirements of the budget; handling any issues that are escalated between the healthcare providers and patients; budget design and management; overseeing reimbursements including insurance; overseeing the EHRs; nurse staff hiring and evaluation; and collaboration with other managers in achieving optimal patient outcomes. Nurse managers should be capable of juggling multiple priorities and effectively communicating and working well with different stakeholders. The managers should also be task-oriented and able to advocate for staff and serve as mentors.
Bilingual nurses will become valued even more than they currently are (Chang, Hutchinson, & Gullick, 2019). The population in the US is becoming increasingly diverse, and according to a 2015 report, there was a minimum of 350 languages spoken in the US (US Census Bureau, 2015). Spanish is the second most widely spoken language in the US, with 13% of the population speaking the language. Bilingual skills are gaining increasing value among nurses even as the patient demographics become more diverse.
Another trend is the focus that is increasingly given to holistic care. Holistic care is a method of the whole treatment of the patient. This type of care recognizes each patient’s unique environmental, spiritual, emotional, mental, and physical weaknesses and strengths. There is growing evidence of the benefits of holistic care. In 2017, patients receiving holistic care in Swedish healthcare facilities reported they were satisfied with the accessibility and quality of holistic care (Eriksson et al., 2018). These results were replicated in patients with colostomies in a 2020 study conducted in Hong Kong. Patients who received care reported better outcomes than those who received standard care (Zhang et al., 2020).
References
AANP (2020, September 16). Coronavirus disease 2019 (COVID‐19) policy and practice updates. AANP. https://www.aanp.org/advocacy/advocacy-resource/coronavirus-disease-2019-covid-19-policy-updates.
Adirim, T., Meade, K., & Mistry, K. (2017). A new era in quality measurement: developing and applying quality measures. Pediatrics, 139(1).
Bianchi, M., Bagnasco, A., Bressan, V., Barisone, M., Timmins, F., Rossi, S., … & Sasso, L. (2018). A review of the role of nurse leadership in promoting and sustaining evidence‐based practice. Journal of Nursing Management, 26(8), 918-932.
Chang, H., Hutchinson, C., & Gullick, J. (2019). Pulled Away: the experience of bilingual nurses as ad hoc interpreters in the emergency department. Ethnicity & health, 1-20.
Eriksson, I., Lindblad, M., Möller, U., & Gillsjö, C. (2018). Holistic health care: Patients’ experiences of health care an Advanced Practice Nurse provides. International journal of nursing practice, 24(1), e12603.
Kondo, K. K., Damberg, C. L., Mendelson, A., Motu’apuaka, M., Freeman, M., O’Neil, M., … & Kansagara, D. (2016). Implementation processes and pay for Performance in healthcare: a systematic review. Journal of general internal medicine, 31(1), 61-69.
Moore, L. W., Sublett, C., & Leahy, C. (2016). Nurse managers’ insights regarding their role highlight the need for practice changes. Applied nursing research, 30, 98-103.
US Census Bureau (2015). Census Bureau Reports at Least 350 Languages Spoken in U.S. Homes. Census.gov. https://www.census.gov/newsroom/press-releases/2015/cb15-185.html
Zhang, X., Gao, R., Lin, J. L., Chen, N., Lin, Q., Huang, G. F., … & Li, H. (2020). Effects of hospital‐family holistic care model on the health outcome of patients with permanent enterostomy based on the theory of ‘Timing It Right’. Journal of clinical nursing, 29(13-14), 2196-2208.
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Question 
Health Care Delivery Models and Nursing Practice
Examine changes introduced to reform or restructure the U.S. healthcare delivery system. In a 1,000-1,250 word paper, discuss action was taken for reform and restructuring and the role of the nurse within this changing environment.
Include the following:
Health Care Delivery Models and Nursing Practice
- Outline a current or emerging healthcare law or federal regulation introduced to reform or restructure some aspect of the healthcare delivery system. Describe the effect of this on nursing practice and the nurse’s role and responsibility.
- 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 healthcare 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.
You are required to cite 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 LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.