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[ANSWERED 2023] Discuss the access, cost, and quality of quality environments, as well as recent quality initiatives

Last Updated on 06/05/2023 by Admin

Discuss the access, cost, and quality of quality environments, as well as recent quality initiatives (See Chapter 24 and Table 24.1). Student is to reflect on the relationship

Discuss the access, cost, and quality of quality environments, as well as recent quality initiatives (See Chapter 24 and Table 24.1). Student is to reflect on the relationship

Discuss the access, cost, and quality of quality environments


Discuss the access, cost, and quality of quality environments, as well as recent quality initiatives (See Chapter 24 and Table 24.1). Student is to reflect on the relationship between quality measures and evaluation and role development. In addition, describe this relationship and note how the role of the APN might change without effective quality measures.

Expert Answer and Explanation

Access, Cost, and Quality for APNs

The three aspects of accessibility, cost, and quality work hand in hand in the delivery of optimum care to patients. The traditional framework of nursing has always been based upon the ability of the nurse to meet the needs of the patients while at the same time staying within the limits of the practice (Miranda et al., 2018). Nurses began as care providers that spent the majority of their careers at the bedside. Comprised of main women, traditional nursing majored in the identification of an individual in society who would be able to be compassionate and provide services to the sick.

Over time, the nursing industry changed with pioneers such as Florence Nightingale, who championed for the better working environment and improved safety measures for nurses (Joel, 2018). Healthcare professionals have transformed over time and can now lead different actions while creating the desired outcome (Miranda et al., 2018). In the modern era, nurses have been accorded the role of championing access cost and quality of care. This paper will analyze the three attributes of access, cost, and quality of environments and other quality initiatives in relation to overall development.

Overview of Access, Cost, and Quality

According to Joel (2018), access, as used in the healthcare setting, is the ability of a patient or any person within the community to obtain health and care or any other related medical service. The aspect of access is also used to define the ability of a patient or any member of a community to afford medical care through the use of insurance covers of the out-of-pocket payment model (Joel, 2018). The concept of accessibility is a key aspect as it creates a means for a different aspects of the addressed and individuals to lead a healthy and quality life. Cost can be categorized into two related but different components.

The first of the two is that cost pertains to the ability of a person to pay for medical services if and when they are required (Joel, 2018). The second concept of cost is the capacity of the service provider to meet the needs of the patients once they are able to afford the care. The correlation makes it possible for care providers to meet the needs of the patients and also be prepared for any issues that patients might be presented with (Joel, 2018). The issue of cost is controversial since it leads to an ethical concern of whether providers would deny patients the needed care if they do not have the financial capacity or cover the issue.

Through cost, the issue of quality can be substantiated and analyzed in detail. As a consequence, Joel (2018, P. 370) describes quality as the degree to which the provided services increase the probability of attaining the desired outcomes. Quality is a fundamental aspect of any organization and can be used to measure the effectiveness of care and overall patient outcome. The book describes quality as dependent on knowledge evidence from previous scientific and verifiable research.

Be that as it may, the three components of access, cost, and quality are interrelated where one of the attributes is correlated with the other. Healthcare professionals and any other player in the healthcare field need to ensure the attributes are addressed as a group and not individually (Joel, 2018). For instance, focusing on cost alone can have a negative impact on quality or accessibility. Focusing on accessibility would also increase discrepancies in quality since care providers will be overwhelmed by the sudden changes in the number of patients streaming the facility. The correlation requires that the three issues are addressed simultaneously for optimum outcomes.

Impact of Access, Cost, and Quality on the Environment

Over time, the nursing industry has grown to become a complex and patient-centered industry. As a result, the nursing environment has to meet the standard of operations required for an effective workflow. Access, cost, and quality each affect the quality of the nursing environment in different ways. Joel (2018, P. 371) contends that with the growth in the demand for quality in the healthcare sector, there is a need to include the attribute of accessibility.

Quality of care is not efficient if the patients cannot be able to access the said care in the first place. The healthcare environment comprises different care providers, staff, and coordinators. Each of the stakeholders is expected to provide services to the best of their knowledge, expertise, and education. The services would be able to satisfy the attribute of quality and ensure that the healthcare environment satisfies the standards needed for quality (Joel, 2018).

Access is important to all patients, which can be acquired conveniently by subscribing to an insurance plan. Insurance covers act as facilitators of quality care since they are able to provide the desired medical care when and if they are required. Joel (2018, P. 370) addresses the issues around underinsured and uninsured individuals and how they may not acquire the desired quality of care due to the limitation of access. In this regard, the presence of quality medical services but a limited number of patients with the capacity to afford the care leads to cost implications.

Private medication provides quality services with the anticipation of profits in the end. When a high number of the population cannot afford the medication, there is a possibility of losses and no return on investment. To help curb the loss, the prices can be increased to the few that can manage, which further creates a rift, in the three attributes (Joel, 2018, P. 371). As an APN, one should pay attention to the varying issues and how they can impact the delivery of care within the facility can help advice the patient or the facility accordingly.

As a nurse, one spends the majority of the time with the patients and can act as an advocate between the patient and the higher management of the facility (Joel, 2018, P. 371). An APN needs to be cognizant of the different issues affecting the accessibility, cost, and quality of care from both the societal and hospital points of view. Awareness of cost can help create a balance on the cost of care depending on the flexibility of ability of the patients and ensure proper access to quality care.

Recent Quality Initiatives

There have been recent initiatives in relation to access, cost, and quality with the high number of national initiatives put in place to help support the future of healthcare. In retrospect, quality efforts are prospected to remain an integral part of the future of the healthcare system. Through proper quality initiatives and definitions, health care systems are able to meet their cost and accessibility parameters. Joel (P. 371) signifies that issues such as performance expectations have to be defined when addressing the issue of quality as it forms the basis of national health care organizations. The

Institute of Medicine provides an overview of different objectives that form the basis of the recent initiatives that are taken as a means of ensuring quality in the healthcare sector. One of the objectives is that there is a need for the collection and gathering of data with the purpose of informing quality efforts (P. 371). Research-based care and quality initiatives are focused on the use of evidence to make decisions and improve the outcome of care. Evidence has the capacity to increase the overall outcome of care and, by extension, overall quality.

The IOM also addresses the need to assess the performance of individuals or healthcare facilities based on current or prevailing standards. Ensuring that the current standards of practice and internal policies are addressed makes it possible for the nurse to facilitate quality care to the patients (P. 371). An APN needs to be familiar with current standards of practice to ensure that care delivery is conducted within the required limits.

The other quality strategy that can be used to ensure quality and efficiency of care is constant development through the communication of decisions and choices. Communication about the areas of concern and what can be done can be conducted by an APN who would advocate for the needs of the community (Joel, 2018, P. 372). The communication would help identify the issues that might undermine the efficiency of care while at the same time ensuring internal development.

On the other hand, the management can also communicate their choices to the nurses, who would implement the new measures with ease. The strategies would cumulatively help address the health care needs of the community. APNs can monitor and report on the efficiency of the adopted models and recommend desired changes based on the local level understanding (Joel, 2018, P. 372).

Interdisciplinary collaboration can help achieve the desired quality of care and also focus on the creation of a balance between access, cost, and quality in the health care environment. The role of the APN might change without effective quality measures since they will be forced to first deal with the complications at hand before coming down to the delivery of care. Compromise of quality can lead to medication errors, low patient satisfaction, and a possible increase in mortality rates.


This paper analyzed the three attributes of access, cost, and quality of environments and other quality initiatives in relation to overall development. From the analysis, access, cost, and quality are interrelated, and compromise on one can lead to negative consequences on the Others. It is important that an APN be cognizant of the three attributes as how they apply in the health care environment and advocate for better changes through the recent initiatives.


Joel, L. A. (2018). Advanced practice nursing: Essentials for role development. 4th e.d. FA Davis.

Miranda N. M. V. D., Rewa, T., Leonello, V. M., & Oliveira, M. A. D. C. (2018). Advanced practice nursing: a possibility for Primary Health Care?. Revista Brasileira de Enfermagem71, 716-721.

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