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Discuss how the shift to value-based health care has impacted delivery of care and the role and responsibilities of the advanced registered nurse.

Discuss how the shift to value-based health care has impacted delivery of care and the role and responsibilities of the advanced registered nurse.

NUR 514 Topic 1 DQ 1

Consider the evolution of the U.S. healthcare system. Discuss how the shift to value-based health care has impacted delivery of care and the role and responsibilities of the advanced registered nurse. Project what major evolving trends in the health care delivery system will affect nursing practice and how advanced registered nurses will influence the direction of health care.

The U.S. healthcare system has evolved and continues to make the shift from disease-oriented approach to a more proactive primary care and patient-centered model where providers focus on quality and not quantity of care delivered. The system has evolved from the belief in Germ Theory of disease which advanced that diseases arose from natural phenomena like ailments and faulty environment. The main goal during this era was the reduction of the number of deaths and treat the symptoms to restore health (Constable et al., 2022). The second era entailed an increased focus on treatment of chronic conditions whose prevalence has surged today making them consume significant levels of healthcare resources. The main goal of this stage has been prolonging a disability or life of the affected individual. The phase of chronic conditions and identification of multiple risk factors is now being replaced by an era of value-based care where providers get compensated based on the level of quality care they offer to patients in diverse settings and clinical practices (Salmond & Echevarria, 2018). The value-based model entails a shift where providers focus on implementation of primary care interventions to improve the quality of care offered.

The shift to value-based care has impacted care delivery and the role and responsibilities of advanced practice registered nurses (APRNs) (Dolce et al., 2020). This means that the APRNs have increased responsibilities to offer patient education and provide specialized care based on their different areas of specialization. The shift also means that nurses become patient care coordinators ensuring the collaboration between physicians and other professionals in inter-professional teams to deliver patient-centered care. They also integrate primary, specialty and acute care in multidisciplinary teams and offer patient education to enhance primary care.

Major evolving trends in the healthcare delivery that will impact nursing practice include increased integration of technology, and rising need for cultural diversity as patients seek care across the care and age continuum due to their conditions (Jivraj et al., 2021). The emphasis on primary care interventions will also impact the nursing practice while APRNs will impact care direction through their specialties and increased focus on value-based care.

References

Constable, M., Mulkey, M., & Aucoin, J. (2022). Hospital value–based purchasing: How acute

care advanced practice nurses demonstrate value. Journal of the American Association of Nurse Practitioners, 34(1), 12-17. DOI: 10.1097/JXX.0000000000000606.

Dolce, M. C., Barrow, J., Jivraj, A., Pham, D., & Da Silva, J. D. (2020). Inter-professional

value‐based health care: Nurse practitioner‐dentist model. Journal of Public Health Dentistry, 80, S44-S49. DOI: 10.1111/jphd.12419.

Jivraj, A., Barrow, J., & Listl, S. (2021). Value-based oral health care: implementation lessons

from four case studies. Journal of Evidence Based Dental Practice, 101662.

DOI: 10.1016/j.jebdp.2021.101662.

Salmond, S. W., & Echevarria, M. (2017). Healthcare transformation and changing roles for

nursing. Orthopedic nursing, 36(1), 12. doi: 10.1097/NOR.0000000000000308

 

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           Value-based care has been increasingly prevalent in the American healthcare system in recent years, marking a major progression in this regard. This shift has significantly impacted the delivery of healthcare services, necessitating adjustments to the duties and responsibilities of advanced registered nurses (ARNs). Value-based healthcare deviates from the conventional fee-for-service paradigm by emphasizing patient outcomes together with the effectiveness and quality of therapy (Kraus et al., 2021). Following the fact that they support patient-centered care approaches, chronic illness management, and preventative care, ARNs are essential in this changing landscape. In order to enhance patient outcomes and keep healthcare expenditures under control, they frequently take on more significant roles as leaders in care teams, managing patients and coordinating efforts. Delivering value-based care requires ARNs to be involved in care coordination, patient education, and assisting patients in navigating the complicated healthcare system.

In the future, various alterations in the healthcare system system are anticipated to have a greater influence on nursing practice and ARNs’ roles. The use of telemedicine and technology in healthcare delivery is one such development. The COVID-19 pandemic has hastened this integration considerably, and ARNs will use digital tools more frequently for data-driven decision-making, virtual consultations, and remote monitoring (Blumenthal et al., 2020). Furthermore, in order to address the socioeconomic determinants of health, ARNs will need to collaborate with community organizations and public health agencies, given the increased focus on population health and community-based care. Furthermore, through their advocacy work and active participation in leadership roles in the healthcare industry, ARNs will be crucial in defining healthcare policy as they continue to develop. In conclusion, the move to value-based healthcare is changing the role of ARNs, and because of their advocacy, adaptability, and commitment to enhancing patient outcomes and the healthcare system as a whole, they will continue impacting the whole course of healthcare delivery.

 

 

References

Blumenthal, D., Fowler, E. J., Abrams, M., & Collins, S. R. (2020). Covid-19—implications for the health care system. New England Journal of Medicine383(15), 1483-1488. https://www.nejm.org/doi/full/10.1056/NEJMsb2021088

Kraus, S., Schiavone, F., Pluzhnikova, A., & Invernizzi, A. C. (2021). Digital transformation in healthcare: Analyzing the current state-of-research. Journal of Business Research123, 557-567. https://doi.org/10.1016/j.jbusres.2020.10.030

As healthcare has evolved in the U.S. there have been huge alterations in policy and practice. While there have been many changes, one of the most significant has been the shift towards value-based healthcare which focuses on outcome and quality of care rather than a service for a fee. Having a more value based focus allows improvements of “the experience of care, improving the health of populations, and reducing per capita costs of health care”(Berwick, D. 2008). This value based healthcare provides better overall care and outcomes for patients. Advance practice nurses have been instrumental in this transition to value-based care and often are the leaders in creating positive change in patient outcomes.

With advanced practice nurses leading the way to change in the future, there will probably be an increase in telehealth visits and technology as well as more leadership and nurse-led policies as a result of needed change post pandemic. Another change that will affect the care of advanced practice nurses will be burnout of nurses which nurse leaders will have a pivotal role in preventing by implementing “models of nurse-led care; reimagined nursing-sensitive performance measures; new and sustained efforts for promoting diversity, equity, and inclusion; payment policies that reflect nurses’ value; as well as innovative organizational and institutional approaches that enable flexibility and recognize nurses’ contributions” (Barnes, H. 2020). Advanced practice nurses will need to be the root of this change to reduce burnout so that nurses can perform better and safer care for their patients.

The value-based shift in healthcare has positively altered the delivery of care in the U.S. and the participation of the Advanced practice nurse is vitally important because of their focus on quality improvement and patient-centered care. As the healthcare setting grows and evolves, advanced practice nurses will be guides and leaders to help implement change with nurse-led policies, burnout, and the increase of technologies and telehealth.

 

References

 

Barnes, H., Richards, M. R., McHugh, M. D., Matsolf, G. R., & Hinton Walker, P. (2020). The nursing workforce in US hospitals: Implications for practice and policy. The Online Journal of Issues in Nursing, 25(2), 2.

 

Berwick, D. M., Nolan, T. W., & Whittington, J. (2008). The triple aim: Care, heath and cost. Heath Affairs, 27(3), 759-769