NRS-440VN Health Care Delivery Models and Nursing Practice Solved
In a 1,000-1,250 word paper, discuss action taken for reform and restructuring and the role of the nurse within this changing environment.
Include the following:
Outline a current or emerging health care law or federal regulation introduced to reform or restructure some aspect of the health care 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 health care 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.
Health Care Delivery Models and Nursing Practice
There have been several changes in the United States healthcare system. These changes have been effected to improve the safety and quality of health care services. The purpose of this paper is to explore a health care reform introduced recently, its effects on the roles and responsibilities of nurses, and the impact on nursing practice, and describe how pay for performance and quality measures affect patient outcomes, arising management and leadership roles for the professional nurses.
Health Care Law Reforms
The Sustaining Excellence in Medicaid Act of 2019 (HR 3253) is a recent federal law that reforms the health care system in the United States. Debbie Dingell, the Michigan representative, introduced the bill to the 116th Congress on 13th June 2019. It was signed into law on 6th August 2020. The bill was intended to provide some extensions in some provisions to restructure the Medicaid program (Dingell, 2019). The bill allowed Medicaid appropriations through to the 2024 fiscal year. The bill also authorized the state to enablefraud units to examine and consider complaints launched by non-institutionalized patients. This is a vital reform as it removes disparities arising from ignoring complaints from such patients who legally qualify for cover under the Medicaid program.
Sections II and III of the bill discuss the extension of the community health services demonstration program and extension of protection for Medicaid recipients ofhome and community-based services against spousal impoverishment, respectively. At times, Medicaid denies cover to spouses from low socioeconomic backgrounds. The bill extends cover to such people, including those receiving community-based and home-based medical services. Besides these reforms, the bill requires drug manufacturers always to include the cost of generic drugs in the determination of prices. This is intended to reduce the wholesale acquisition cost for new drugs and biologicals. Furthermore, the bill allows rebate calculations by excluding drug manufacturers from the definition of wholesalers dealing with drugs.
The bill affects nursing practice and the roles and responsibilities of nurses. For instance, the bill extends Medicaid coverage to spouses and protects them from impoverishment. This reform extends the roles and responsibilities of nurses. The nurse should identify patients affected by spousal poverty, limiting their access to quality care and educating them on the changes. By doing so, the nurse would assist impoverished individuals in accessing safe and quality health care services. The bill also adds to the role of nursing advocacy. Cleveland et al. (2019) note that nurses contribute to stronger health care delivery systems through patient advocacy. The nurse should assist non-institutionalized patients in lodging complaints and assist them in appealing if the latter are denied services. In this way, nurses would help many patients to get social justice.
Quality Measures and Pay for Performance and the Effects on Patient Outcomes
Pay for performance (P4P) has been introduced in several health care systems. P4P is a model that offers financial incentives to health professionals and medical groups to meet specific performance measures(Kyeremanteng et al., 2019). This compensation approach is performance-based and aims at improving the delivery and quality of health services to patients. Failing to meet a particular result implies that a health practitioner does not receive the incentives associated with meeting the set target. Some penalty-based P4P incentivesprovide financial penalties to hospitals when medical complications arise following failure to institute the appropriate preventative measures(Kyeremanteng et al., 2019). The P4P model motivates nurses, physicians, and other health care professionals to offer high-quality services to their clients to meet specific performance criteria to receive the tied financial benefits. However, Kyeremanteng et al. (2019) observe there is a risk for poor patient outcomes associated with this model when it encourages patient dumping. This means that health professionals may concentrate more on patients with less complex health issues and with a higher likelihood of faster recovery while relegating patients with complex health issues to the periphery. This would lead to poor health outcomes for the neglected patients as they would lack timely and sufficient medical attention and services.
When such situations confront a nurse, they should apply the ethical principles in their practice. These include non-maleficence (to not harm), beneficence (to do good), justice, and autonomy (Varkey, 2020). The nurse should also encourage other health professionals and practitioners of the Hippocratic Oath, which binds them to the duty of saving patient lives. By adhering to the ethical principles, nurses would give all patients the necessary medical attention they require, irrespective of the complexity of their situations, and not based solely on motivation to attain specific set performance standards to achieve the financial incentives tied to them.
Professional Nursing Leadership and Management Roles
The emerging trends and diverse health care needs of the population have necessitated nursing roles to continue arising and evolving to continue responding to the trends. One of the emerging roles is the use of nursing informatics and technology in nursing. In health care settings, the use of technology has become ubiquitous. This has increasingly necessitated nurses to equip themselves with the knowledge and skills in technological advancements. For instance, the use of surgical robots in surgeries is a trend observed in some advanced health care settings. For the nurses to have fulfilling experiences and roles in such operations, they must be conversant with the use and operation of such robots.
Another advancement in technology is the use of bedside alert systems which alert nurses when patients leave their beds unattended. The patients also use them to notify nurses that the former needs urgent attention. Therefore, these bedside alert systems improve timely medical interventions and reduce the incidence of falls. The nurse leaders and managers are responsible for ensuring their nursing staff are technologically well-informed as part of their nursing roles. Additionally, nurses must also be aware of using electrical medical records, which have revolutionized clinical documentation. They must use the EMRs appropriately and comply with the provisions and regulations of the HIPAA.
Emerging Trends
One of the emerging trends is the use of robots in surgeries. Robot-assisted surgeries have been driven by robotic proliferation, machine and AI learning growth, and the rollout of 5G connectivity.Medical practitioners must know how these robots are set up and recognize situations where they malfunction. Therefore, nurses will be required to learn how these robots work, how they affect nursing roles and duties, and how to respond in an emergency, which can be life-saving.
Another trend observed in the health care settings is the increased use of telemedicine. Hyder and Razzak (2020) define telemedicine as the use of information technology and telecommunications to provide health services in a situation where a considerable physical distance exists between patients and health providers. Telemedicine will continue to enhance the nurses’ roles as communicators, reaching out to clients upon request through different telehealth systems. Nurses should communicate timely with patients, within the shortest time possible, and use simple messages. Therefore, nurses will be required to enhance their knowledge and skills on technology and the use of various platforms to communicate with patients. It is vital that nurses appropriately use devices used in telemedicine to avoid mistakes that could have adverse health outcomes.
Conclusion
Health care reforms have changed health policies that have improved the health care systems, seeing the provision of safer, more affordable, and higher-quality health services. The trends in the current health settings have necessitated nurses and other health professionals to update their knowledge and skills in various areas to keep up with those trends. Nurses should continue embracing technological advancements in health settings. Teaching institutions should also prepare students technologically to be well competent to provide safe and quality health services in increasingly complex technological health settings.
References
Cleveland, K., Motter, T., & Smith, Y. (2019). Affordable Care: Harnessing the Power of Nurses. Ojin.nursingworld.org. https://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-24-2019/No2-May-2019/Affordable-Care.html
Dalton, J. (2021). EMERGING HEALTHCARE INDUSTRY TRENDS #11: The Increasing Prevalence of Robot-Assisted Surgery. Thrive. https://thrivethinking.com/2021/08/10/robot-assisted-surgery/
Dingell, D. (2019, August 6). Text – H.R.3253 – 116th Congress (2019-2020): Sustaining Excellence in Medicaid Act of 2019. Www.congress.gov. https://www.congress.gov/bill/116th-congress/house-bill/3253/text
Hyder, M. A., & Razzak, J. (2020). Telemedicine in the United States: An Introduction for Students and Residents. Journal of Medical Internet Research, 22(11). https://doi.org/10.2196/20839
Kyeremanteng, K., Robidoux, R., D’Egidio, G., Fernando, S. M., &Neilipovitz, D. (2019). An Analysis of Pay-for-Performance Schemes and Their Potential Impacts on Health Systems and Outcomes for Patients. Critical Care Research and Practice, 2019, 1–7. https://doi.org/10.1155/2019/8943972
Varkey, B. (2020). Principles of clinical ethics and their application to practice. Medical Principles and Practice, 30(1), 17–28. https://doi.org/10.1159/000509119
The need to deliver quality and affordable care implores stakeholders to continually enact legislations to reform and restructure the health care delivery system with the aim of attaining better outcomes. Nurses are critical players in these reforms and restructuring since they are patient advocates. The new delivery models emerge to offer quality care at the greatest value for patients and stakeholders like nurses (Gott, 2018). The purpose of this paper is to examine changes aimed at reforming or restructuring health care delivery system through a current law or federal regulations. The paper also discusses effect of quality measures and pay for performance in patient outcomes and nursing practice. The essay also discusses professional nursing leadership and management roles in response to emerging trends and in patient safety and quality care promotion.
Current or Emerging Health Care Law or Federal Regulation
The need to improve nursing education and practice is critical to care provision in the U.S. health care system. Imperatively, the Nursing Workforce Reauthorization Act 0f 2019 is essential as it would update, reauthorize and enhance critical programs to help grow and support the nursing workforce as one of the largest labor force in the country. The Nursing Workforce Reauthorization Act of 2019 focuses on enhancing nursing education, practice and programs to retain nurses to meet the growing national demand due to an aging population and subsequent retirement of baby boomers’ nursing generation (Merkley, 2019). The law offers many programs to nurse practitioners to enhance nursing care, services and improve the overall wellbeing of these practitioners. The focus of this act is to provide more accountability to the nurse and improve scope of practice to allow increased satisfaction in the profession and lead to better retention rates.
The act will assist in aligning the nursing field within its profession as nurse get opportunity to advance their education and serve in both rural and urban areas, especially among underserved populations and communities. The act ensures that nurses will have increased skills to practice based on their level of education, training, and specialty. The act implores nurses to be more accountable in their role as primary care providers, especially in rural and underserved communities (Congress.GOV., 2019). The act ensures that the American nursing workforce is well positioned to meet care need now and in the future and can address access to care challenges in the populations where they serve.
Quality Measures/ Pay for Performance
Economic changes are essential for health care delivery in the country to remain sustainable while offering quality patient care. The Centers for Medicare and Medicaid Services (CMS) develops measures to lower the cost of care and increase access. Pay for Performance is a component of quality measures aimed at rewarding healthcare entities and providers that focus on quality care and enhancing patient outcomes. Pay for performance stresses the important of quality of care and not quantity which increases the possibility of using best clinical practices and supports promotion of good health. Pay for performance increases transparency while encouraging providers to remain accountable and enhance their overall reputation.
Using data on quality measures established in collaboration with the Agency for Healthcare Research and Quality (AHRQ), organizations and providers get financial rewards for enhancing patient care and reducing costs. Through the intervention, CMS can hold organizations and providers accountable for their shortcomings. The pay for performance is a value-based model and uses patient satisfaction and proven best practices as quality measures. Hospitals and providers report quality metrics to the public using the Hospital Consumers Assessment of Health Plan Survey (HCAHPS), and quality measures associated with falls, infections, morbidity, and mortality in different patient settings (Lee & Nathan, 2018). Providers and organizations use the Healthcare Effectiveness Data and information Set (HEDIS) for reporting these measures in outpatient settings.
Nurses, including advanced practice registered nurses (APRNs), leaders and administrators have direct influence on quality programs and patient outcomes. Nurses should know and understand the current concepts on quality that include a selection of quality measure, data collection and measurement, data reporting and effective evaluation (Gott, 2018). Nurses need to be aware of and understand as well as promoted their roles and the impact they have on high quality patient care and outcomes. They need to advocate for resources, foster a safety culture, participate in policy and decision making concerning best practices and lead in the implementation of quality initiatives.
Leadership and Management Roles and Emerging Trends
The nursing profession is in a strategic position in the health care reforms and transition taking place and development of effective patient care models. The advent of these novel care models that aim at preventive measures and health promotion across have led to emergence of new roles among nurses and other healthcare providers. These novel positions and managerial roles include being care coordinators, primary care providers, virtual care nurses, bundled care coordinators and working in retail clinics, especially in health care deserts in rural settings (Sarkar et al., 2020). All these roles are essential since patient care continues to become complex and extending beyond the confines of healthcare settings.
Nurses are becoming primary care providers and leading the provision of care in rural settings and among different patient populations, especially vulnerable populations and communities. As health care coaches and patient advocates, they help patients set wellness goals, especially those with chronic conditions. New roles like being patient navigators ensures that patients go through their complex care journeys with increased hope and better advice from nurse practitioners (Lee & Nathan, 2018). As such, nurse leaders and managers must be visionary and use evidence-based practice interventions to enhance care delivery a. The emerging act implores nurse managers to understand the financial implications of healthcare and care for communities in a more cost-effective manner than before.
Emerging Trends in Technology and Holistic Care
Different trends will continue to define healthcare provision and care plans in the healthcare system. Among these trends include the shift to nurses as primary care providers due to a decline in primary and specialty care physician, emerging technology’s increased use, and focus on holistic care interventions. The shift to APRNs and RNs is due to the need to maintain public health coverage and increase access, especially as states continue to change laws and increase the scope of practice authority for nurses. Emerging technology will continue to define, design, and shape care provision as more patients become reliant on telehealth and telemedicine through virtual nurses and physicians (Gott, 2018). The emergence of infectious diseases and the need for increased disease surveillance and control of such spread underscore the need for better preparation among health care providers, especially nurses.
Another trend is the emergence and development of Patient Centered Medical Homes (PCMH) as part of offering better access to holistic care. many of these settings are managed and staffed by advanced practice registered nurses (APRNs) and registered nurses (RNs) (Sasangohar et al., 2018). These trends imply that there will continue to be a shift in the entry level into nursing with more institutions requiring baccalaureate level to be hired by hospitals and the medical homes. The use of telehealth and telemedicine applications will imply that more nurses will specialize in nursing informatics.
Conclusion
Nurses are positioned strategically to transition patient care through advocacy, advanced education, training, policy making and leadership. Nurses must keep pace with emerging delivery models to offer safe, effective, and quality care for all patients and ensure that they get the best value outcomes. Nurses should understand the emerging trends and seek effective ways to prepare strategically as critical players in the current reforms.
References
Congress.GOV. (2019). H.R.728 – Title VIII Nursing Workforce Reauthorization Act of 2019.
https://www.congress.gov/bill/116th-congress/house-bill/728/actions
Gott, M. (2018). Telematics for health: The role of telehealth and telemedicine in homes and
communities. CRC Press.
Lee, J. S., & Nathan, H. (2018). Quality measurement and pay for performance. Surgical
Oncology Clinics, 27(4), 621-632. doi: 10.1016/j.soc.2018.05.003.
Merkley, J. (2019). Merkley, Burr Introduce Bipartisan Nursing Workforce Reauthorization Act
of 2019. https://www.merkley.senate.gov/news/press-releases/merkley-burr-introduce-bipartisan-nursing-workforce-reauthorization-act-of-2019
Sasangohar, F., Davis, E., Kash, B. A., & Shah, S. R. (2018). Remote patient monitoring and
telemedicine in neonatal and pediatric settings: Scoping literature review. Journal of medical Internet research, 20(12), e295. doi: 10.2196/jmir.9403
Sarkar, R. R., Courtney, P. T., Bachand, K., Sheridan, P. E., Riviere, P. J., Guss, Z. D., … &
Murphy, J. D. (2020). Quality of care at safety‐net hospitals and the impact on pay‐for‐performance reimbursement. Cancer, 126(20), 4584-4592. https://doi.org/10.1002/cncr.33137
Click here to ORDER an A++ paper from our Verified MASTERS and DOCTORATE WRITERS: NRS-440VN Health Care Delivery Models and Nursing Practice Solved
Health outcomes typically depend on health care delivery models and population-based interventions for healthy living. Progressively, as situations necessitate, massive changes have been introduced to reform or restructure the U.S. health care delivery system to ensure better services to individuals and communities. These reforms have prompted many changes in the practice environment hence the need for nurses to understand current and possible developments in the future. Their roles in the changing environments will also be changing as reform occurs. The purpose of this paper is to examine changes introduced to reform health care delivery and the nurse’s role in the changing environment.
Current Health Care Regulation for Reforming Health Care Delivery
Federal regulations have been instrumental in health care reform to ensure people get accessible and affordable care. When the COVID-19 pandemic broke out, access to care was hampered as the government provided many directives for reducing transmission, including restricting movement and physical interaction. Since people still required health care services for other illnesses amid the pandemic, the US Centers for Medicare & Medicaid Services (CMS) authorized waivers to expand telehealth services for Medicare beneficiaries. Approved in March 2020, these waivers allowed more use of telehealth services, including in-home visits and care services in urban areas (Suran, 2022). The CMS further allowed audio-only interaction via telehealth for some health care services.
Health care reforms have significant effects on nursing practice. According to Suran (2022), the waivers by the CMS in 2020 intensified the use of telehealth services, implying an increased demand for remote health care services. In response to the increased demand for remote care, health care organizations should implement the appropriate technological infrastructure to support telehealth and related technology-related services. As Ford et al. (2020) suggested, a robust technology infrastructure is crucial to prevent risks associated with telehealth in patient care, primarily security and privacy breaches. As these developments occur, health care organizations should also expect more demand for remote health care services hence the need to adjust their delivery models to accommodate appropriate changes.
The nurse’s role and responsibility include appropriate adaptation, supporting technology-driven practice, and promoting a culture of change in the workplace. According to Triana et al. (2020), telehealth use is hampered by negative attitudes, particularly among providers without the appropriate technological skills to implement it safely and effectively. To reduce possible risks, nurses should embrace teamwork when offering tech-based services. A culture change is necessary to ensure that nursing teams are more open to change and can readily embrace new technologies to support patient care. Importantly, nurses should encourage and support patients to embrace telehealth for higher outcomes.
Quality Measures and Pay-for-Performance
Quality measures include processes and outcomes for assessing whether health care services achieve the desired outcomes. As a result, health care professionals use quality measures to assess performance and make decisions that increase the probability of achieving the desired outcomes (CMS.gov, 2021). On this premise, quality measures are a foundation of high-quality care since they guide nurses in improving outcomes. Pay-for-performance (P4P) encourages value-based care. In P4P schemes, health care providers are incentivized based on how they meet predefined targets for quality care (Kyeremanteng et al., 2019). Consequently, providers intensify measures for positive patient outcomes to get maximum incentives.
Quality measures and P4P promote high care quality, which is a core objective of the nursing practice. As their role stipulates, nurses should always be committed to delivering comprehensive care. Accordingly, they should focus on value, efficiency, and quality, among other elements that define satisfactory care (Kyeremanteng et al., 2019). Nurses should expect more pressure from stakeholders and patients to provide a higher value as time advances. Their primary role is to use quality measures as the reference for continuous quality improvement. Nurses should also promote P4P by increasing value through practices that reduce adverse events and allow them to use health care resources efficiently.
Professional Nursing Leadership and Management Roles
The scope of nursing practice and professional roles changes gradually. In nursing leadership and management, health care leaders and managers are currently obligated to lead change in practice settings. This role typifies serving as change agents where nurse leaders identify practice problems, develop appropriate interventions, and lead the implementation process. The other critical role for nurse leaders and managers in the evolving practice is knowledge work. The role of a knowledge worker is characterized by gathering information and interpreting it systematically for improved health outcomes (McGonigle & Mastrian, 2021). These roles are pivotal in effective responses to emerging trends since they improve leaders’ readiness and responsiveness to change. For instance, change agents promote a culture of change to ensure organizations have the appropriate climate and resources for supporting new practices. As knowledge workers, nurse leaders use their theoretical and analytical knowledge to identify health care patterns and respond appropriately. Since each role encourages quality improvement and practice change, there is a higher chance of improved patient safety and high-quality care after implementing innovative practices.
Emerging Trends and Nursing Transformation
Nursing is an evolutionary practice that evolves progressively to address current and emerging patient care demands. Concerning emerging trends, increased use of technologies, such as artificial intelligence and telehealth, a nursing shortage, and the adoption of value-based practice dominate nursing. In response, nursing practice and roles must transform to respond to the upcoming trends effectively. One of the possible ways that nursing will transform in the next five years is an increased inclination toward technology-driven and data-driven practices. Currently, data analytics allow health care professionals to identify trends to provide the most possible patient-centered care (Batko & Ślęzak, 2022). Over time, there will be more use of artificial intelligence and remote patient care to ensure people in rural and remote locations are diagnosed and treated timely and cost-effectively. The other potential transformation of nursing is a team-based practice in health care settings. Teamwork promotes interprofessional collaboration, which will allow nurse practitioners to achieve the goals of value-based care.
Conclusion
Health care delivery models affect how nurses work, practice goals, and care processes. Federal regulations and health care laws continue to influence care delivery models, and more changes are expected in the future. In the current practice, federal regulations through the CMS have allowed more use of telehealth services by authorizing waivers. As technology evolves, nursing practice is expected to be more data-driven and technology-centered. Effective adoption of tech-based services requires organizations to invest in robust technological infrastructure to support innovative practices.
References
Batko, K., & Ślęzak, A. (2022). The use of big data analytics in healthcare. Journal of Big Data, 9(1), 3. https://doi.org/10.1186/s40537-021-00553-4
CMS.gov. (2021). Quality measurement and quality improvement. https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/MMS/Quality-Measure-and-Quality-Improvement-#:~:text=Patient%20and%20families%20use%20quality,likelihood%20of%20desired%20health%20outcomes.
Ford, D., Harvey, J. B., McElligott, J., King, K., Simpson, K. N., Valenta, S., … & Lenert, L. A. (2020). Leveraging health system telehealth and informatics infrastructure to create a continuum of services for COVID-19 screening, testing, and treatment. Journal of the American Medical Informatics Association, 27(12), 1871-1877. https://doi.org/10.1093/jamia/ocaa157
Kyeremanteng, K., Robidoux, R., D’Egidio, G., Fernando, S. M., & Neilipovitz, D. (2019). An analysis of pay-for-performance schemes and their potential impacts on health systems and outcomes for patients. Critical Care Research and Practice, 2019, 8943972. https://doi.org/10.1155/2019/8943972
McGonigle, D., & Mastrian, K. (2021). Nursing informatics and the foundation of knowledge. Jones & Bartlett Learning.
Suran, M. (2022). Increased use of Medicare telehealth during the pandemic. JAMA, 327(4), 313-313. doi:10.1001/jama.2021.23332
Triana, A. J., Gusdorf, R. E., Shah, K. P., & Horst, S. N. (2020). Technology literacy as a barrier to telehealth during COVID-19. Telemedicine Journal and E-health : the Official Journal of the American Telemedicine Association, 26(9), 1118–1119. https://doi.org/10.1089/tmj.2020.0155
Population health issues change over time due to lifestyle changes, exposure to new risks, health access, and other factors. Effective response to health concerns requires profound changes in health practice and care models to ensure patients receive care that matches their needs. Health care delivery models commonly focus on access, payment structures, and strategies to improve effectiveness and efficiency. Due to their central role in patient care, nurses should understand models emerging from health care reforms and restructuring. Therefore, the purpose of this paper is to examine current changes to reform the U.S. health care delivery system and the nurse’s role within the changing environment.
Current Reform and Effects on Nursing Practice and the Nurse’s Role
Reforms seeking to improve care access to rural communities are critical for addressing health care disparity. One such reform is the National Health Service Corps (NHSC) program. As a state loan repayment program, NHSC promotes physician practice in rural communities by encouraging providers to work in rural areas. According to Waldrop and Gee (2022), clinicians under the NHSC program can receive up to $50,000 in federally-funded loan repayments to encourage them to provide primary, dental, and mental health care in rural communities. This reform is founded on the principle that high student debts are why many health practitioners opt to work in urban areas instead of less populated rural settings.
Health care reforms significantly affect the nursing practice and the nurse’s role and responsibility. As a global health concern, health care staff shortages decrease access to care in rural areas, leading to poor health outcomes (Smith, 2022). The implication is that encouraging nursing professionals to work in rural communities through the NHSC is essential for higher outcomes in nursing practice. The program will reduce inequality in terms of health professionals, risk factors, and disease burden that rural residents experience. The nurse’s role and responsibility are also affected by reforms. Typical outcomes include expanded nurse practitioner autonomy and a higher responsibility to lead change in rural settings. Autonomy expands the nurse’s scope of practice, while change leadership helps organizations to implement innovative practices to address health challenges affecting rural communities.
Effects of Quality Measures and Pay-for-Performance on Patient Outcomes
Nursing professionals should have an innate desire to achieve high patient outcomes. Quality measures quantify care processes, outcomes, and systems to determine practitioners’ and organizations’ ability to provide high-quality care (CMS.gov, 2023). Their result-oriented nature guides nursing practitioners in improving patient outcomes by bettering procedures to maximize value. Mathes et al. (2019) described pay-for-performance as a model that rewards health care providers for meeting predefined quality targets. Hence, the model motivates health professionals to increase care quality and efficacy to achieve high rewards. While doing so, high patient outcomes are achieved since high care quality that prevents readmissions, health complications, and morality is a foundation of optimal patient outcomes.
Quality measures and pay-for-performance foster outcome-driven and value-based care. In this case, they ensure nursing procedures and workplace culture are designed to maximize outcomes and ensure patients get the value of care. For instance, teamwork and innovative practices to reduce hospital-acquired infections maximize value by reducing costs associated with treating such infections (Haque et al., 2020). Accordingly, nurses are expected to embrace procedures that maximize value and be open to change as situations necessitate. Their responsibilities also expand since they must lead change and implement evidence-based practice (EBP), among other strategies for improving the value of care. The expanded role ensures that nurses’ responsibilities are not restricted to primary caregiving. Instead, nurses serve as leaders and innovators to ensure health care services align with patients’ expectations.
Emerging Professional Nursing Leadership and Management Roles
As an evolving practice, nursing prompts numerous changes in leadership and management roles. One of the emerging roles dominating nursing leadership and management is knowledge working. As knowledge workers, nurse leaders respond to inspiration and change in an information and high-tech health care era (Joseph & Huber, 2021). The other role characterizing current practice is strategic management. Effective leadership and management should recognize emerging opportunities, potential risks, and appropriate adaptation. In nursing, strategic management is essential for responding to technological, societal, and political changes (Figueroa et al., 2019). Knowledge working and strategic management characterizes forward-thinking leadership, typical in organizations that embrace innovation and are committed to improving outcomes.
Knowledge working and strategic management are crucial in response to emerging trends and in promoting patient safety and quality care in healthcare settings. According to Figueroa et al. (2019), health leadership should provide organizational direction and set priorities for improved health services. Since emerging trends like technology and virtual care come with significant risks, strategic leaders help organizations to respond effectively. Such leaders can also identify areas where maximum effort should be devoted to maximize benefits. Knowledge working is a foundation of evidence-based practice since it encourages leaders and nursing professionals to utilize new knowledge to improve processes and outcomes. To promote evidence-based practice, nursing leaders create a culture of inquiry, which supports the integration of evidence in informing leadership and management (Sevy Majers & Warshawsky, 2020). Evidence improves problem-solving, hence better care quality and comprehensive response to patient safety concerns.
Emerging Trends and Potential Transformation of Nursing Practice and Roles
Emerging trends in health care demonstrate the need for adaptation to ensure patient needs are effectively addressed. Such trends include virtual care and the use of artificial intelligence (AI). As Stamenova et al. (2022) observed, the need for virtual care increased after the COVID-19 pandemic and never dropped below 50%. These trends will impact the nursing practice and roles in terms of resources and approaches to care within the next five years. In agreement with Jin et al. (2020.), health care organizations require stable telemedicine infrastructure to support virtual care. Therefore, organizations must update their systems and skills to support virtual care and artificial intelligence for safe and high-quality care. Nurses will also be centrally involved in promoting technology-driven care and evaluating outcomes. Interprofessional collaboration will also be emphasized since nursing informaticists and other professionals should work together to succeed in virtual care and other aspects of health technologies.
Conclusion
Health care delivery models change continually amid changes in population health issues, work dynamics, laws, and other factors. As discussed in this paper, the NHSC for promoting health care access in rural areas is a crucial reform in the last five years, influencing nursing practice significantly. The law is crucial in reducing access inequalities by ensuring rural communities access health care services promptly. As such changes occur, nursing practice must respond to emerging trends such as virtual care and AI. Effective response is necessary for health care organizations to maximize opportunities that emerging trends present, like improved efficiency and effectiveness.
References
CMS.gov. (2023). Quality measures. https://www.cms.gov/medicare/quality/measures#:~:text=Quality%20measures%20are%20tools%20that,quality%20goals%20for%20health%20care.
Figueroa, C. A., Harrison, R., Chauhan, A., & Meyer, L. (2019). Priorities and challenges for health leadership and workforce management globally: a rapid review. BMC Health Services Research, 19(1), 1-11. https://doi.org/10.1186/s12913-019-4080-7
Haque, M., McKimm, J., Sartelli, M., Dhingra, S., Labricciosa, F. M., Islam, S., Jahan, D., Nusrat, T., Chowdhury, T. S., Coccolini, F., Iskandar, K., Catena, F., & Charan, J. (2020). Strategies To Prevent Healthcare-Associated Infections: A Narrative Overview. Risk Management and Healthcare Policy, 13, 1765–1780. https://doi.org/10.2147/RMHP.S269315
Jin, M. X., Kim, S. Y., Miller, L. J., Behari, G., & Correa, R. (2020). Telemedicine: Current impact on the future. Cureus, 12(8), e9891. https://doi.org/10.7759/cureus.9891
Joseph, M. L., & Huber, D. (2021). Leadership and nursing care management-e-book. Elsevier Health Sciences.
Mathes, T., Pieper, D., Morche, J., Polus, S., Jaschinski, T., & Eikermann, M. (2019). Pay for performance for hospitals. The Cochrane Database of Systematic Reviews, 7(7), CD011156. https://doi.org/10.1002/14651858.CD011156.pub2
Sevy Majers, J., & Warshawsky, N. (2020). Evidence-based decision-making for nurse leaders. Nurse Leader, 18(5), 471–475. https://doi.org/10.1016/j.mnl.2020.06.006
Smith, J. G. (2022). Rural nursing health services research: a strategy to improve rural health outcomes. Journal of Advanced Nursing, 78(8), e97-e98. https://doi.org/10.1111/jan.15305
Stamenova, V., Chu, C., Pang, A., Fang, J., Shakeri, A., Cram, P., Bhattacharyya, O., Bhatia, R. S., & Tadrous, M. (2022). Virtual care use during the COVID-19 pandemic and its impact on healthcare utilization in patients with chronic disease: a population-based repeated cross-sectional study. PloS One, 17(4), e0267218. https://doi.org/10.1371/journal.pone.0267218
Waldrop, T., & Gee, E. (2022). How states can expand health care access in rural communities. CAP. https://www.americanprogress.org/article/how-states-can-expand-health-care-access-in-rural-communities/