U.S. Healthcare Delivery System

U.S. Healthcare Delivery System

Over the past years, various changes have been introduced to reform and restructure the U.S. healthcare delivery system. The reforms aim at improving service delivery. Furthermore, the reforms have led to changes in the governance of the healthcare system and the accessibility to services. This paper explains how the Nursing Workforce Reauthorization Act of 2019 has reformed some aspects of the healthcare delivery system.

Current Healthcare Law

An example of a current healthcare law introduced to reform the healthcare delivery system is the Title VIII Nursing Workforce Reauthorization Act of 2019. The Act aims at improving nursing practice in various ways. The first provision is advancing nursing education in nursing training institutions, including academic healthcare facilities (Act, 2019). This will increase the number of trained and registered nurses. The number of nurse specialists will also increase because the enrollment for post-graduate programs (master’s and doctorate) will increase.

The Act also aims at repaying education loan programs for nursing students practicing in facilities with nursing shortages. The repayment will be achieved through the National Nurse Service Corps (GovTrack, 2021). The Act advocates for the provision of retention grants to support nurses at various levels. This applies to nurses pursuing degree programs, those in healthcare facilities, those at the associate level, and those found in non-profit organizations (GovTrack, 2021). Furthermore, grants will be provided to develop and facilitate accredited internships, fellowships, and residency programs (GovTrack, 2021). This will be accomplished in concert with accredited nursing training institutions. The Act also advocates for loan forgiveness of up to 85 percent for higher-degree nursing students who lecture at nursing schools.

Title VIII Nursing Workforce Reauthorization Act of 2019 has various effects on nursing practice and the role of nurses. The Act will lead to the creation of new facilities and the expansion of existing nursing training facilities (GovTrack, 2021). This will increase the number of qualified applicants who are enrolled for nursing education. Consequently, the number of trained nurses will increase. In addition to trained nurses, the number of nursing specialists will increase.

The increase in the nursing workforce will improve the quality of service delivery to patients. The ratio of nurses to patients will be optimized when the nursing workforce increases. This will lead to a decrease in burnout and stress levels reported in understaffed healthcare facilities. The incidences of medication errors will reduce when nurse-to-patient ratios are optimized. The level of job satisfaction will also increase. The roles and responsibilities of nurses will change significantly. The number of nursing specialists and advanced nursing practice nurses will increase. These specialists are involved in the diagnosis, interpretation of laboratory results, prescription, and patient education. Therefore, nurses are likely to adopt advisory and consultative roles. This will be accomplished by collaborating with other healthcare providers.

Effect of Pay for Performance and Quality Measures

Pay for performance occurs when healthcare providers or healthcare facilities are rewarded or penalized based on their performance. Quality measures are used to evaluate the performance. Quality measures evaluate patient outcomes, service delivery, and the structure of the organization (Kim et al., 2017). Pay for Performance emphasizes the value of a service. Ideally, the system is expected to improve the quality of services provided by healthcare providers, promote evidence-based practice and improve patient outcomes.

Studies have revealed that Pay for Performance leads to the improvement of process for care outcomes. Some of the processes for care outcomes include prompt initiation of therapy, appropriate selection of treatment plans, increased rates of screening, and increased evidence-based practice (Kim et al., 2017). This is expected to improve patient health outcomes. The incidences of hospital readmissions are likely to be reduced due to the improvement in patient health outcomes.

Pay for Performance has impacted nursing practice in various ways. It has promoted evidence-based practice in nursing care (Kim et al., 2017). Based on the evaluation of quality measures, adjustments are made to select the best practice or treatment plan. Evidence-based practice increases the quality of services delivered to patients. To achieve evidence-based practice, nurses use quality measures, conduct intensive research, and work in concert with other healthcare providers. Pay for Performance has also led to increased levels of accountability among nurses. Nurses should collaborate with colleagues and other healthcare providers to achieve organizational performance levels.

Professional Nursing Leadership and Management Roles

Professional nursing leadership and management roles have arisen over the past years. The first role is creating and promoting a healthy workplace environment. Emerging trends reveal that most nurses are dissatisfied with their workplace environment (Harvey et al., 2019). Dissatisfaction in the nursing workforce lowers the quality of service delivery to patients. This workforce is not motivated to engage in research and evidence-based practice. The cases of medication errors are likely to be high in these healthcare facilities. Patient morbidity and mortality rates and re-admission rates are high in settings with medication errors (Harvey et al., 2019). Furthermore, dissatisfaction with the workplace environment is likely to make nurses quit their jobs, leading to understaffed facilities.

The creation of a healthy workplace environment improves job satisfaction levels. This will promote interprofessional collaboration, research, and evidence-based practice. Evidence-based practice ensures that the best treatment plan is selected for the management of patients (Harvey et al., 2019). Patient health outcomes are improved when evidence-based practice is upheld. Employees working in a healthy environment have increased productivity rates and are not likely to quit their jobs. This improves the overall performance of the healthcare facility and patient satisfaction with service delivery (Harvey et al., 2019). Professional nurse leaders can establish a healthy work environment through policy formulation, regular training, coaching, and advocating for open and effective communication. This creates an organizational culture of collaboration and mutual respect.

The second role is advocating for quality improvement. Professional nurse leaders and managers should focus on improving the quality of services delivered in various healthcare facilities (Harvey et al., 2019). Quality improvement can be achieved by working in concert with hospital administrations and creating appropriate policies. The policies should advocate for Pay for Performance practice. This will encourage accountability, interprofessional collaboration, and evidence-based practice. When all healthcare facilities uphold evidence-based practice, the quality of service delivery will improve significantly. Quality services ensure patient safety by improving their health outcomes.

Emerging Trends

Emerging trends in healthcare involve both technological changes and service delivery transformations. Healthcare practice is shifting towards Pay for Performance practice that aims to achieve a high value of care. This can be achieved by adopting different models, such as the collaborative care model (Tsekleves & Cooper, 2017). Technological advancements in the healthcare setting are on the rise. Examples of such advancements include artificial intelligence, data analytics, and blockchain technology (Tsekleves & Cooper, 2017). Technological advancements help healthcare providers to deliver accurate and timely services to patients. The other emerging trend is the use of precision medicine. It works based on differences in individual’s lifestyles and genomes. It can promote preventive care.

Nursing and nursing roles will transform to respond to emerging trends. IT specialist nurses will be needed to respond to the technological changes. Nursing practice will shift to become evidence-based practice. Evidence-based practice will be used to achieve high-value care. Nursing will embrace research and interprofessional collaboration to achieve evidence-based practice.

Conclusion

Title VIII Nursing Workforce Reauthorization Act of 2019 is an example of a current healthcare law introduced to reform the healthcare delivery system. Pay for Performance leads to the improvement of patient and process for care outcomes. Some of the processes for care outcomes include prompt initiation of therapy, appropriate selection of treatment plans, increased rates of screening, and increased evidence-based practice. Emerging trends in healthcare involve both technological changes and service delivery transformations. Nursing practice will incorporate IT training and an evidence-based approach in response to emerging trends.

References

GovTrack.us (2021). H.R. 728 – 116^th Congress: Title VIII Nursing Workforce Reauthorization Act of 2019. Retrieved from https://www.govtrack.us/congress/bills/116/hr728

Harvey, G., Gifford, W., Cummings, G., Kelly, J., Kislov, R., Kitson, A., Pettersson, L., Wallin, L., Wilson, P., Ehrenberg, A. ( 2019 ). Mobilizing Evidence to Improve Nursing Practice : A Qualitative Study of Leadership Roles. (2019). 21–30.

Kim, S. J., Han, K. T., Kim, S. J., & Park, E. C. (2017). Pay-for-Performance Reduces Healthcare Spending and Improves The Quality of Care: Analysis of Target and Non-Target Obstetrics and Gynecology Surgeries. International Journal for Quality in Health Care, 29(2), 222–227. https://doi.org/10.1093/intqhc/mzw159

Tsekleves, E., & Cooper, R. (2017). Emerging Trends and the Way Forward in Design in Healthcare: An Expert’s Perspective. Design Journal, 20(sup1), S2258–S2272. https://doi.org/10.1080/14606925.2017.1352742

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Examine changes introduced to reform or restructure the U.S. healthcare 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.

U.S. Healthcare Delivery System

Include the following:

Outline a current or emerging healthcare law or federal regulation introduced to reform or restructure some aspect of the healthcare 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 healthcare 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.
You are required to cite a minimum of three sources to complete this assignment. Sources must have been 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 7 Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

4 different sources within the last 5yrs are needed!

Sources material!

Improving Patient Experience and Reducing Cost by Measuring Outcomes | Executive and Continuing Professional Education | Harvard T.H. Chan School of Public Health

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5069435/
HSPH.harvard.edu improving patient experience and reducing cost

CMS.gov reducing costs protecting consumers,

Reducing Costs, Protecting Consumer: The Affordable Care Act on the One Year Anniversary of the Patient’s Bill of Rights (cms.gov)