US Healthcare Delivery System

US Healthcare Delivery System The practice of nursing is continually changing over time, and more changes are anticipated shortly. The change is inevitable and is seen as an advancement in nursing roles and responsibilities in care delivery. In the past, nurses worked as patient attendant or assistants to the physician. However, the nursing role has diversified to the extent that they can practice independently in some states. In this paper, the expected changes and growth bin the nursing practice will be discussed. It will also provide some feedback from other nurses concerning healthcare reform.

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How the Practice of Nursing is Expected to Grow and Change The advancement of the nursing profession is core to the progression of healthcare delivery. The healthcare system in the US is being reformed to improve care delivery and access to care while cutting on the costs of healthcare expenditures. Hence, the restructuring of the healthcare system is expected to impact several health professionals including nurses. As part of the reform, the role of nurses in providing care is expected to increase with more focus placed in community settings rather than in hospitals. Also, more emphasis is placed on managing chronic conditions hence nurses’ role will be reduced in acute care settings.

With strategies to decrease the length of hospital stay for patients, nurses find new roles in ensuring the continuity of care. This involves ensuring a smooth transition from hospital settings to their homes or other care settings. Nurses will continue with conducting follow up visits, assessing and even attending to patient needs from their homes. Also, continuity of care especially among chronically ill patients away from hospital settings will be essential. Nurses will be involved in helping such patients manage their conditions as well as prevent unnecessary hospital visits.

Nursing roles are also expected to extend to accountable care organizations (ACOs).

These organizations am at cutting the costs of care delivery while upholding good quality and safe care practices (Everett, 2013). The ACO bring together different care professionals to work collaboratively in providing cheaper services. In a multi-disciplinary setting, nurses often have several roles to play. More importantly, they coordinate care between the disciplines and act as intermediaries between patients and other care providers. Since nurses interact more with patients more compared to other specialists, they are educators and communicators of care and

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treatment plan to patients and families (Everett, 2013). They ensure that quality and safe care is provided in ACOs. Medical homes is another setting where the nursing roles are expected to increase remarkably. These homes provide care especially to chronically ill patients mostly after being discharged from hospitals. It is within the scope of nursing to provide holistic care that focuses on several aspects that influence the health of a patient. In medical homes, nurses will be in a position to provide integrated holistic and patient centered care (Tomcavage, Littlewood, & Sciandra, 2012).

Another care setting that nurses are set to benefit from is the nurse-managed health clinics. These clinics are managed and run by nurses and provide essential medical services to patients. Nurses have the ability, skills and required training to provide primary medical services to clients independently (Sutter-Barrett, Sutter-Dalrymple, & Dickman, 2015). Most states have already licensed nurses to operate independently or with minimal supervision. The scope of practice for the nurse who works independently varies with different states. Some states allow for nurses to diagnose patients and prescribe medications independently without the involvement of a physician (Sutter-Barrett et al., 2015).

Feedback Form Other Nurses on Healthcare Reform Nurses explicit different reactions to the anticipated healthcare reforms. Some are happy about it; some are worried while other have little knowledge of the impact of the reform on their careers. The greatest fear among nurses is the reduction of their roles in hospital settings which is a possible threat to their practice. However, this change is expected to create more opportunities for nurses in community settings. The reform aims at reducing the length of hospital stay in a bid to cut on costs. Nurses are particularly concerned about the effect this will have on care

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transitions. They argue that patients will have limited time to adjust to their new settings and may also negatively affect their continuum of care.

Positively, the changes will help nurses serve more in community settings; promoting their health, preventing diseases and reducing hospitalization cases. The reforms also provide a great opportunity for nurses to advance their roles in healthcare delivery. The reform is an ideal opportunity for nurses to take up new roles and positions in healthcare delivery and practice fully according to their scope of training. This is in line with the IOM future of nursing recommendations that calls on nurses to practice to the full extent of their education and training.

Generally, the nurses play a great role in the healthcare system and their profession is expected to be affected by the healthcare reforms. The reforms are important as it aims at reducing healthcare costs, promote population health and ensure safety and quality of healthcare services. Nurses are still expected to be crucial members of the healthcare system.

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References Everett, L. (2013). Accountable care organizations: the role of APNs. Nurse Leader, 11(6), 4546. doi: http://dx.doi.org/10.1016/j.mnl.2013.09.004 Sutter-Barrett, R., Sutter-Dalrymple, C., & Dickman, K. (2015). Bridge care nurse-managed clinics fill the gap in healthcare. The Journal of Nurse Practitioners, 11(2), 262-265. doi: http://dx.doi.org/10.1016/j.nurpra.2014.11.012 Tomcavage, J., Littlewood, D., & Sciandra, J. (2012). Advancing the role of nursing in the medical home model. Nursing Administration Quarterly, 36(3), 194-202. doi: 10.1097/NAQ.0b013e3182588b6a