NUR-514 Topic 1 DQ 1 Evolution of the U.S. health care system
NUR-514 Topic 1 DQ 1 Evolution of the U.S. health care system
Consider the evolution of the U.S. health care system. Discuss how the shift to value-based health care has impacted delivery of care and the role and responsibilities of the advanced registered nurse. Project what major evolving trends in the health care delivery system will affect nursing practice and how advanced registered nurses will influence the direction of health care.
NUR-514 Topic 1 DQ 1 Evolution of the U.S. health care system example
Three of the top trends in healthcare include top healthcare trends affecting nursing include value-based healthcare, the growing use of Telehealth, and an aging population (Mensik, 2023). Although it is not often included in the top trends for healthcare, the trend currently having the most significant impact in my work setting is the need for more qualified nurses. Nursing shortages are affecting healthcare worldwide. Currently, there are approximately 23 million nursing working in healthcare around the world (Muabbar & Alsharqi, 2021). The American Nurses Association (ANA) estimates that an additional 1.1 million nurses are needed to close the gap in healthcare (Muabbar & Alsharqi, 2021).
Nurses comprise the largest group of staff in healthcare and approximately 40% of healthcare operating costs (ANA, n.d.). Nurses are often the easiest group to target for cuts to reduce costs. Reducing nursing staff impacts patient safety, well-being, and outcomes (ANA, n.d.). Patient safety and outcomes are directly affected by nursing staff levels. Maintaining adequate staffing levels is essential in reducing mortality rates and length of stay and avoiding preventable incidents such as falls (ANA, n.d.). The aim of decreasing healthcare costs by cutting nursing staff can lead to increased costs as a result of patient injury, increased length of stay, and adverse patient outcomes.
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Another impact of nursing shortages is the creation of a snowball effect. As nursing staff levels decrease, job dissatisfaction, burnout, and the intention to leave the profession increase (Muabbar & Alsharqi, 2021). Research has found that most nurses reported being moderately dissatisfied with their job (Muabbar & Alsharqi, 2021). The increased workload and lack of support result in feeling demoralized and dissatisfied. These feelings then lead to nurses’ intentions to change careers. The situation is a vicious circle. As the number of nursing staff falls, it causes an increased workload that accelerates the number of nurses leaving the profession NUR-514 Topic 1 DQ 1 Evolution of the U.S. health care system.
Reference
ANA. (n.d.). Nurse Staffing Crisis. ANA. https://www.nursingworld.org/practice-policy/nurse-staffing/nurse-staffing-crisis/
Mensik, H. (2023). Top healthcare trends of 2023. Healthcare Dive. https://www.healthcaredive.com/news/top-healthcare-trends-2023/642270/.
Muabbar, H., & Alsharqi, O. (2021). The impact of short-term solutions of nursing shortage on nursing outcome, nurse perceived quality of care, and patient safety. American Journal of Nursing Research, 9(2), 35-44.
NUR-514 Topic 1 DQ 1 Evolution of the U.S. health care system sample 2
The Patient-Centered Medical Home (PCMH) was the first value-based care payment model developed in 1967 (DeCoudres, 2022). The idea of value-based healthcare had grown over time but was brought to the forefront again in the 2000s with legislation such as the Affordable Care Act (ACA) (DeCoudres, 2022). Value-based healthcare is focused on offering quality care rather than an increased quantity of patients. Value-based healthcare aims to deliver and maintain the health of all individuals creating better public health, lower healthcare costs, and improved outcomes (Teisberg, 2019).
The top healthcare trends affecting nursing include value-based healthcare, the growing use of Telehealth, and an aging population (Mensik, 2023). While value-based care places the focus on improving patient outcomes through patient-centered care, it also creates some often overlooked challenges for nurses. One such challenge is the increased demand for timely documentation of all care in the electronic medical record (EMR) (Brooks, 2020). Telehealth supports value-based care by making care more accessible to those in rural areas or with transportation challenges. Learning to care for patients via video or telephone as opposed to face-to-face has created new challenges for nurses that were not previously considered. Providers, including advanced practice nurses, require further information and education on care for patients remotely.
References
Brooks, A. (2020). What impact does value-based care have on nurses? Rasmussen University. https://www.rasmussen.edu/degrees/nursing/blog/value-based-care-nursing/
DeCoudres, N. (2022). What is the history of value-based care? Arcadia. https://arcadia.io/resources/what-is-the-history-of-value-based-care.
Mensik, H. (2023). Top healthcare trends of 2023. Healthcare Dive. https://www.healthcaredive.com/news/top-healthcare-trends-2023/642270/.
Teisberg, E., Wallace, S., & O’Hara, S. (2019). Defining and implementing value-based health care. Academic Medicine, 95(5), 682–685. https://doi.org/10.1097/acm.0000000000003122.
NUR-514 Topic 1 DQ 1 Evolution of the U.S. health care system sample 3
Value-based healthcare is a form of reimbursement that ties payments for care delivery to the quality of care provided and rewards providers for both efficiency and effectiveness. This form of reimbursement has emerged as an alternative and potential replacement for free-of-service reimbursement, which pays providers retrospectively for services delivered based on bill changes or annual fee schedules. Value-based health care implies that payment for medical care is dependent on positive patient outcomes. The goal is to contain the cost of medical care while reducing complications for patients (Mason, 2021). There are many positive things that come from value-based healthcare such as patients applying less money for better care. This allows patients to have less out of pocket expenses related to healthcare for better health. It provides must show outcomes of patient care as it forces providers to provide better care to patients. This will eventually lead to better patient outcomes and better health promotion. The advanced registered nurse will provide care to the patient if they are working in a nurse practitioner role that requires billing to take place. This will affect the care they give the same way it affects providers because it will be outcome based. Initiatives have been created for the advanced registered nurse to provide better patient care, therefore increasing positive outcomes for patients and reducing the amount of money that is required to be paid by the patient or by the insurance (Schrandt, Hustler, Humbyrd, & Decamp,2017) NUR-514 Topic 1 DQ 1 Evolution of the U.S. health care system.
Many registered nurses have either switched careers or registered from the healthcare due to frustrations. The number of students taking this career has declined and this is a serious threat to the future of nursing. Transformation of nursing is essential to ensure patients are satisfied with the quality of services offered by nurses.. Advanced registered nurse can help create a favorable working environment by working closely with newly qualified nurses, mentoring them so they don’t feel overwhelmed or frustrated by lots of new things and increasing responsibility (Gottlieb,2016).APRNs can advocate for scheduling flexibility which will help the healthcare staff to manage bustling work routines together with home life and educational opportunities. Retaining nurses’ happiness with regards to planning will create an environment that is more positive and enable the health centers to hold quality nurses (Buchan & Calman,2020). NUR-514 Topic 1 DQ 1 Evolution of the U.S. health care system
References:Mason,D.(2021).The nursing profession: Development, Challenges, and Opportunities. Public Health and Robert Wood Johnson Foundation Anthropology.
Schrandt, K., Hutsler, L.,Bosc,J.,Humbyrd, C.,& Declamp, M,(2020).Increase in healthcare Disparities: The Unintended Consequences of value-based medicine; lesson from the Total Joint Bundled Payments for Care Improvements.
Buchan & Calman (2016).Global health care issues and proposed solutions.Diversity and Equality in health and care,15(2), 93-94.
Gottlieb,M.L.,& Huber, D.L.(2016),Clinical leadership development and education for nurses: prospects and opportunities.Journal of healthcare leadership, pp7,55.Retrieved from https://www.ncbi.nih.gov/pmc/articles.PMC5740995 NUR-514 Topic 1 DQ 1 Evolution of the U.S. health care system
