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Evolving Practice Patient Care Delivery Models Nursing

EvolvingPractice Patient Care Delivery Models: Nursing

EvolvingPractice and Patient Care Delivery Models: Nursing

Inthe field of healthcare, there are several nurses, for instance, homehealth nurses, nurse practitioners, and school nurses, who workeither in clinics, community health centers, and or hospitals. Healthcare makes the basic background of a country’s economy onlyif the entire nations’ medical industry systems are standard.Therefore, reorganization of the whole American health system willbring in various alterations in the manner with which nurses willlook after their patients(Quill etal.,2013). However,many health practitioners have no clue on how to apply the necessarychanges, and how the changes will affect their practice.

HowNurse Practice is Expected to Grow and Change to Facilitate QualityHealth Care

AccordingtoAuerbach (2013),when the reforms are introduced, several opportunities will becreated, and the duty of nurses expanded to include the redesigningof the delivery systems. Thus, it is vital for every nurse to participate in bringing about the changes within the healthcare system,as they are part of the employees of such institutions (Quilletal.,2013).For better healthcare delivery to patients in every part of thenation, changes in the health care system should conform and provideimprovements in delivery care. For instance, nurses’ duties shouldbe extended up to the community level, rather than limiting to thehospital sections that will ensure every patient, including those atthe community setting, access healthcare. Consequently, thecaregivers will move from the hospital environment to the communalsettings to meet the well-being needs of people outside theinstitutional atmosphere (Auerbachetal.,2013).

Theconcept of continuum of care brings several healthcare systems tocollaborate in ensuring that the patients recover when undermedication over a long period. Under that concept, there will be aclear structure for better administration, decision making, andhealthcare delivery to all patients in the country (Quilletal.,2013).Therefore, health professionals will ensure continuity of care to allthe sick with several conditions until they are fully recovered.Through the help of nurses, the quality of healthcare delivery willnot be discussed as patients undergo a transition from one healthcaresetting to the other. Furthermore, the concept of continuum of carewill ensure careful coordination, hence minimizing disruption in caredelivery, since the majority of nurses will get involved in differenthealthcare settings (Auerbachet al., 2013).

Additionally,introducing the concept of Accountable Care Organization (ACO) willfacilitate smooth management and coordination of the medicalhealthcare beneficiaries (Auerbachetal.,2013).Therefore, the care payments will combine with the high-qualityupgrading of the health care, thus reducing the overall service cost(Huber2013).The ACOs will serve approximately 5,000 people thus, enoughhealthcare providers must be recruited by the organization.Additionally, the institutions will be utterly reliable regardingcare delivery with the help of nurses, cost, and quality of thebeneficiaries (Quilletal.,2013).

Furthermore,the expansion of medical homes will guarantee the provision ofmedical care for both children and adults, especially those withspecial concern needs. Similarly, it will advance continuity of care,particularly for individuals suffering from severe conditions such aschronic illness. Therefore, nurses will deliver medical services inthe expanded homes adjoining the communities that receive minimalattention from the healthcare providers. Similarly, the establishmentof health homes in various states will assist the medicalbeneficiaries suffering from severe conditions to get medicalattention (Quilletal.,2013).The medical practitioners should manage health homes to ensure thatthe needy community members are secured with respect to wellbeing(Huber2013).

Finally,the expansion and funding of the Nurse-Managed Health Clinics (NMHC)will ensure that nurses take leadership responsibilities as well asthe authority to carry out the physicians’ duties, such as medicineprescription (Auerbachetal.,2013).Also, nurses working within NMHC will give care to vulnerable and theunderestimated communities. Consequently, health professionals,especially nurses, will reform their practice approaches due to theavailability of adequate funds and power to enable them to deliverhealthcare to the communities better. Furthermore, they will assumethe roles they were not allowed to carry out initially (Quilletal.,2013).

NursesFeedbacks Regarding the Proposed Areas of Change

Aftersharing my presentations with my three nurse practitioners, they haddifferent impressions concerning the proposed reforms on thehealthcare systems. Some of the responses I received were verysupportive of the healthcare changes, while some contradicted thesuggestions. One of the nurses agreed to the changes saying thattheir duties would vary from outdated task oriented to outcomeoriented. Additionally, nurses will work together with other partnerslike the physicians for quality care delivery, both from hospitalssetups to communal settings. Furthermore, nurses will create strongerand lasting relationship bond between themselves and patients, asthey carry out important leadership responsibilities, for instancehandling interdisciplinary teams (Blais2015).Regarding communal setup, the first respondent concurred that healthcare providers will be adaptive, self-oriented, independent-mindedand even critical thinkers since physicians will not supervise them(Quilletal.,2013).Therefore, they will account for the managing majority of thecommunal-based healthcare facilities, thus carrying out all theoperations of the centers. According the respondent, the changes inhealthcare system will ensure positive outcomes in health caredelivery by nurses as they will develop more and new skills whilehandling more tasks. Subsequently, through the establishment of ACOs,NMHC, medical, and health homes besides continuity of care, nurseswill have the chance to play a direct duty in patient recovery andtheir quality of their health (Huber2013).

Besides,another nurse welcomed the healthcare reforms wholeheartedly as itwould allow them to fully participate in changing the entirehealthcare system. Similarly, the nurse acknowledged that theestablishment and expansion of the NHMC, ACOs, Medical and healthhomes will accommodate the smooth delivery of preventive services,and treatment for severe health conditions such as the chronicillness. Similarly, the introduction of ACOs will enhance lowering ofpatients’ costs while advancing the quality of health care deliveryreceived by the patients (Auerbachetal.,2013).Additionally, health and medical homes will allow nurses to providepatient-centered care to patients with chronic illness at thecommunity level. Therefore, the reforms will reduce obstacleshindering nurses to deliver quality services. To attain the changesin the healthcare, the respondent pointed out that nurses will haveto participate in implementing the reforms, since the rising numberof patients will require more health professionals to handle them,particularly at the communal level. Subsequently, physician problemswill be answered as nurses will perform their responsibilities, whilethe available physicians will handle more complicated cases that needtheir skills as primary care roles will be done by nurses (Quilletal.,2013).The entire practice will enhance health professionals to acquire newskills from one another leading to patients’ recovery andsatisfactory. The chance to manage nurse-managed health centers willfurther allow nurses to play an important role to meet the healthcarestandards based on the number of patients.

However,another nurse did not welcome the reforms but instead, got worriedconcerning how the changes would affect the system and nursespractices negatively.For instance, the primary challenge the nurse pointed out was that,nurses based in hospital settings always attend to many patients.Subsequently, the Affordable Care Act 9 (ACA) ensured every Americacitizen enrolled in health insurance plans, increasing the number ofpatients seeking medical attention (Quilletal.,2013).Therefore, the nurse added that they would be exhausted andfrustrated as a result of the communal shifts, and that would affectthe quality of health care delivery to the patients (Blais2015). However,the nurse acknowledged the assertions by Auerbachetal.(2013) that fundingnurses to further their educations as outlined by the ACA will helpto counter the shortage of nurses.


Fromthe above arguments, it is envisaged that the implementation ofhealth reforms will have both positive and negative impacts on thenursing practices. However, nurses are considered as paramountpersonnel in the health profession as they make significantcontributions in healthcare delivery. However it is clear that someof the nurses are not familiar with the consequences the reformsmight bring to their nursing practice. Thus, awareness is requiredamong the nurses through education, as that would make themunderstand the necessity for the improvements, and how they canexploit the opportunities for the benefit of all the players,including the patients and the institution as a whole.


Auerbach,D. I., Chen, P. G., Friedberg, M. W., Reid, R., Lau, C., Buerhaus, P.I., &amp Mehrotra, A. (2013). Nurse-managed health centers andpatient-centered medical homes could mitigate expected primary carephysician shortage.&nbspHealthAffairs,&nbsp32(11),1933-1941.

Blais,K. (2015).&nbspProfessionalnursing practice: Concepts and perspectives.New York, U.S.: Pearson.

Huber,D. (2013).&nbspLeadershipand nursing care management.Amsterdam, Netherlands: Elsevier Health Sciences.

Quill,T. E., &amp Abernethy, A. P. (2013). Generalist plus specialistpalliative care—creating a more sustainable model.&nbspNewEngland Journal of Medicine,&nbsp368(13),1173-1175.