Examine changes introduced to reform or restructure the U.S. health care delivery system. In a 1,000-1,250 word paper, discuss action taken for reform and restructuring
Examine changes introduced to reform or restructure the U.S. health care delivery system. 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 within the last 5 years 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 in response to upcoming trends or predicted issues in health care.
You are required to cite a minimum of three sources to complete this assignment. Sources must be published within the last 5 years, appropriate for the assignment criteria, and relevant to nursing practice.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.
Expert Answer and Explanation
Trends and Issues in Healthcare Today
The US healthcare system has undergone tremendous reforms since it was developed. Some of the laws that have been passed to improve US healthcare include the Affordable Care Act of 2010, HIPAA, Medicare, Medicaid, and many more. These laws have improved the healthcare system and made the role of nurses clear. The purpose of this assignment is to discuss action taken for reform and restructuring and the role of the nurse within this changing environment.
Current Law
The US Congress has passed many laws regarding the US healthcare system. One such law is the Autism Collaboration, Accountability, Research, Education and Support (CARES) Act of 2019. The law expands and reauthorizes the provisions introduced first in the Combating Autism Act of 2006 (Congress.Gov, 2019). The Autism CARES Act ensures support for prevalence tracking, services, research, and other government activities in the improvement of care among people with autism.
The law increases yearly authorized federal spending on autism activities to $369.7 million through 2024. The law aims to improve the entire lifespan of people with autism spectrum (Congress.Gov, 2019). This law was enacted to restructure healthcare delivery among people with autism. It aimed to improve the quality of care provided to patients with autism.
The Autism CARES Act will affect nursing practice by promoting evidence-based care when dealing with people with autism. The law provides support for prevalence tracking and research regarding autism services (Congress.Gov, 2019). It affects nursing practice by promoting evidence-based practice and high-quality care services in the treatment of patients with autism. The role of nurses based on the law is to engage in research activities that aim to improve the quality of life of people with autism.
The responsibility of nurses is to ensure that people with autism receive care that is supported by research and evidence-based. Nurses are also responsible for ensuring that the added funds are used as intended. The law will also affect nursing practice by supporting the inclusion of knowledge about autism in nursing education.
Impact of Quality Measures and Pay-for-Performance on Patient Outcomes
Quality measures are significant, especially in nursing practice. For a healthcare service to be of high quality, it should be patient-centred, safe, effective, timely, and equitable (Zarowitz et al., 2018). Quality measures affect patient outcomes by identifying what to be done to improve patient outcomes and provide high-quality care. One of the patient outcomes is patient experience. The nurse can improve the patient experience by providing safe, effective, and timely care.
In summary, quality measures affect patient outcomes by providing ways for how nurses can achieve these outcomes. pay-for performance, also known as performance-related pay is a care delivery system where healthcare professionals are paid based on their performance. This delivery system affects patient outcomes by ensuring that healthcare professionals achieve what patients envision from the treatment plan (Kyeremanteng et al., 2019). Pay-for-performance ensure that patients get value for their services.
Quality measures and pay-for-performance affect nursing practice by directing how nurses should conduct their duties. The role of nurses in these situations is to ensure that patients achieve the best and high-quality care. Nurses also have the role of working together with other healthcare professionals and patients to provide the best care. For instance, nurses need to work with patients in developing a care plan that fits their needs of the patient.
Nursing Leadership and Management Roles
Nursing management and leadership are vital in nursing practice. New professional nursing management and leadership roles have emerged to respond to emerging trends in promoting patient quality and safe care in diverse healthcare settings. One such role is education and training. Nurse leaders and managers have the role to educate junior nurses and training them about emerging issues in nursing.
Nurses need requisite knowledge to handle emerging trends in healthcare such as covid-19 pandemic and other problems. As such, the role of education is vital in ensuring that nurse knowledge to implement emerging trends (Noh et al., 2020). The second role is policy development. Nurse managers and leaders also have the role to develop and implement policies that support emerging trends.
One of the emerging trends is the use of electronic health records to manage patient data. Nurse managers and leaders have the role to create policies which direct how the technology can be used to improve the quality of care. The third role is advocacy. Nurse leaders and managers have the role to advocate for patients and fellow nurses to ensure that there are enough resources that can be used to provide care.
Nurse advocacy ensures that patients have a voice in care provision. The last role is managing financial and human resources. The nursing profession needs human and financial resources to address emerging trends. The role of nurse leaders is to ensure that there are sufficient financial and human resources to address emerging trends.
Emerging Trends
The world is changing and new trends are emerging thus, nurses need new ways to respond to the predicted issues or upcoming trends in healthcare. One of the ways nursing practices is changing to respond to upcoming trends is value-based care. Value-based care is a type of care delivery model in which healthcare providers, including physicians, hospitals, nurses, and other healthcare professionals are paid based on patient health outcomes (Teisberg et al., 2020).
In value-based care agreements, healthcare providers are rewarded for helping patients achieve care outcomes, live healthier lives, and reduce the incidences and effects of chronic disease in an evidence-based way. Value-based care can help nurses deal with emerging health problems such as obesity and chronic diseases (Ramkumar et al., 2019).
The second way the practice of nursing is emerging is to deal with emerging trends in nursing informatics. Nursing informatics will help nurse deal with upcoming trends in the next five years. One of the emerging problems nursing informatics will solve is big data. Big data is complex data to deal with and includes EHRs, real-time alerting, and medical imaging. Nursing informatics will help in managing big data and use it to improve care.
Nursing informatics will also help nurses develop knowledge in applying healthcare information in nursing care. Backonja et al. (2022) noted that the primary goal of nursing informatics is to analyze a wide variety of healthcare data to identify solutions that will allow nurses to provide higher quality care in addition to finding solutions to enable nurses to provide cost-effective care.
Conclusion
The Autism CARES Act will improve healthcare delivery by improving care delivery in people with autism. The law aims to promote autism can by ensuring that patients with autism receive evidence-based care. Quality measures and pay-for-performance affect patient outcomes by ensuring that patients achieve their care goals. The role of nurses is to ensure that the outcomes of patients are achieved based on the measures. The roles that help nurse leaders and managers respond to new trends include education and training, advocacy, policy development, and managing financial and human resources. The emerging nursing practices that will help nurses tackle emerging trends include value-based care and nursing informatics.
References
Backonja, U., Langford, L. H., & Mook, P. J. (2022). How to support the nursing informatics leadership pipeline: Recommendations for nurse leaders and professional organizations. CIN: Computers, Informatics, Nursing, 40(1), 8-20. doi: 10.1097/CIN.0000000000000827
Congress.Gov. (2019). Autism Collaboration, Accountability, Research, Education, And Support Act Of 2019; Congressional Record Vol. 165, No. 151. https://www.congress.gov/congressional-record/volume-165/issue-151/senate-section/article/S5609-3
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. https://doi.org/10.1155/2019/8943972
Noh, J., Oh, E. G., Kim, S. S., Jang, Y. S., Chung, H. S., & Lee, O. (2020). Development and evaluation of a multimodality simulation disaster education and training program for hospital nurses. International Journal Of Nursing Practice, 26(3), e12810. https://doi.org/10.1111/ijn.12810
Ramkumar, P. N., Haeberle, H. S., Bloomfield, M. R., Schaffer, J. L., Kamath, A. F., Patterson, B. M., & Krebs, V. E. (2019). Artificial intelligence and arthroplasty at a single institution: real-world applications of machine learning to big data, value-based care, mobile health, and remote patient monitoring. The Journal of arthroplasty, 34(10), 2204-2209. https://doi.org/10.1016/j.arth.2019.06.018
Teisberg, E., Wallace, S., & O’Hara, S. (2020). Defining and implementing value-based health care: a strategic framework. Academic Medicine, 95(5), 682. https://doi.org/10.1097%2FACM.0000000000003122
Zarowitz, B. J., Resnick, B., & Ouslander, J. G. (2018). Quality clinical care in nursing facilities. Journal of the American Medical Directors Association, 19(10), 833-839. https://doi.org/10.1016/j.jamda.2018.08.008
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FAQs
Healthcare Reform Definition
Healthcare reform encompasses a broad spectrum of changes aimed at improving the accessibility, affordability, and quality of healthcare services. These reforms can take various forms, including legislative changes, policy adjustments, and innovative healthcare delivery models. The ultimate goal of healthcare reform is to ensure that every individual has access to high-quality healthcare services without facing financial hardship.
Nurses’ Role in the Healthcare Delivery System
Nurses play a vital role in the healthcare delivery system as frontline caregivers who provide essential medical services to patients. They are often the first point of contact for individuals seeking healthcare assistance and serve as advocates for patients’ well-being. Nurses are responsible for administering medications, monitoring patients’ vital signs, providing emotional support, and educating patients and their families about medical conditions and treatment plans.
Nurses’ Role in Healthcare Reform
Nurses play a crucial role in driving healthcare reform efforts due to their unique position within the healthcare system. They possess valuable insights into the challenges faced by both patients and healthcare providers, allowing them to identify areas in need of improvement. Nurses advocate for policy changes that prioritize patient safety, increase access to care, and enhance the quality of healthcare services. Additionally, nurses actively participate in interdisciplinary teams to develop innovative healthcare delivery models that promote efficiency and effectiveness.
Was the Healthcare Improvement Act of 2021 Passed?
The Healthcare Improvement Act of 2021, aimed at addressing various shortcomings in the healthcare system, garnered significant attention and debate among policymakers. However, due to political gridlock and differing ideological perspectives, the act failed to pass through the legislative process. Despite the setback, nurses continue to advocate for meaningful healthcare reform measures that prioritize patient well-being and address systemic challenges within the healthcare system.
Nurses Who Advocated for Healthcare Reform
Numerous nurses have been instrumental in advocating for healthcare reform throughout history. Florence Nightingale, often regarded as the founder of modern nursing, revolutionized healthcare practices by emphasizing the importance of sanitation and hygiene in patient care. More recently, nurses like Dr. Mary Wakefield, former Administrator of the Health Resources and Services Administration, have played key roles in shaping healthcare policy and driving reform initiatives.
An Example of Moral Hazards in Healthcare Finance
Moral hazard in healthcare finance refers to situations where individuals or healthcare providers may engage in risky behavior knowing that they are protected from the full financial consequences of their actions. One example of moral hazard is overutilization of healthcare services by individuals with comprehensive insurance coverage. In such cases, patients may seek unnecessary medical treatments or procedures, leading to increased healthcare costs and inefficiencies within the system.
Insurance Coverage Reform Approaches to Making Healthcare Available
Several approaches to insurance coverage reform aim to improve the availability of healthcare services and reduce financial barriers for patients. These include:
- Universal Healthcare: Implementing a single-payer or government-funded healthcare system that provides comprehensive coverage to all citizens, ensuring access to essential medical services regardless of income or employment status.
- Expansion of Medicaid: Increasing eligibility criteria for Medicaid coverage to include more low-income individuals and families, thereby extending healthcare benefits to vulnerable populations who may otherwise lack access to affordable care.
- Health Savings Accounts (HSAs): Promoting the use of HSAs, which allow individuals to save pre-tax dollars for medical expenses, thus empowering patients to take control of their healthcare spending and make informed decisions about their health.
- Telemedicine Expansion: Expanding access to telemedicine services, which enable patients to consult with healthcare providers remotely, thereby increasing convenience and accessibility, particularly for individuals residing in rural or underserved areas.
In conclusion, nurses play a pivotal role in advocating for healthcare reform initiatives that prioritize patient well-being and address systemic challenges within the healthcare system. By actively engaging in policy discussions, driving innovation in healthcare delivery, and providing compassionate patient care, nurses continue to shape the future of healthcare and ensure that it remains accessible, affordable, and of the highest quality for all individuals.
The Impact of Quality Measures on Patient Outcomes
Quality measures in healthcare play a crucial role in assessing and improving patient outcomes. These measures encompass various aspects of care, including patient safety, effectiveness, timeliness, efficiency, and patient-centeredness. By evaluating healthcare processes and outcomes, quality measures help identify areas for improvement and drive efforts to enhance the overall quality of care delivered to patients.
How Does Quality Measures Affect Patient Outcomes?
Quality measures directly influence patient outcomes by promoting evidence-based practices, reducing medical errors, and ensuring the delivery of high-quality care. When healthcare providers adhere to established quality standards, patients experience better clinical outcomes, including reduced mortality rates, decreased complication rates, and improved overall health status. Additionally, quality measures facilitate transparency and accountability within the healthcare system, allowing patients to make informed decisions about their care and fostering trust between patients and healthcare providers.
How Does Pay for Performance Affect Nursing Practice?
Pay for performance (P4P) initiatives tie financial incentives to the achievement of specific quality metrics and performance targets. While P4P programs aim to improve the quality of care and incentivize healthcare providers to deliver optimal outcomes, they can also impact nursing practice in several ways. Nurses may experience increased pressure to meet performance goals, leading to heightened stress and burnout. Additionally, P4P programs may inadvertently incentivize providers to focus on meeting targets rather than addressing individual patient needs comprehensively. However, when implemented thoughtfully, P4P initiatives can stimulate collaboration among healthcare team members and drive improvements in patient care delivery.
How Does Quality Nursing Care Affect Patient Outcomes?
Quality nursing care is fundamental to achieving positive patient outcomes across the healthcare continuum. Nurses serve as advocates for patients, coordinating care, and providing holistic support throughout the healthcare journey. When nurses deliver high-quality care that is evidence-based, patient-centered, and culturally competent, patients experience improved clinical outcomes, enhanced satisfaction with their care experiences, and better overall health outcomes. Quality nursing care also contributes to reducing hospital readmissions, preventing complications, and promoting patient safety.
How Can You as a Nurse Improve the Patient’s Quality of Care That Affects Health Outcomes?
As a nurse, there are several strategies you can employ to enhance the quality of care provided to patients and positively impact their health outcomes:
- Promote Effective Communication: Establish open and transparent communication with patients and their families, ensuring that they are informed and involved in decision-making processes related to their care.
- Adhere to Evidence-Based Practices: Stay updated on current evidence-based guidelines and best practices in nursing care, and integrate them into your clinical practice to ensure the delivery of high-quality, safe, and effective care.
- Collaborate with Interdisciplinary Team Members: Work collaboratively with other healthcare professionals, including physicians, therapists, and social workers, to develop comprehensive care plans tailored to meet the individual needs of patients.
- Provide Patient Education and Support: Empower patients with knowledge and resources to manage their health effectively, including medication management, self-care techniques, and lifestyle modifications.
- Monitor Patient Progress and Outcomes: Regularly assess patient responses to treatment interventions, monitor for potential complications, and adjust care plans accordingly to optimize patient outcomes.