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The health care delivery system in the U.S. has undergone significant changes within the past decades to meet the ever-growing demand for medical care. Economic, social, and cultural factors, along with emerging technologies, influence patient care services. As primary care providers, nurses are affected by the transformation and expected to take up advanced roles to shape the future of healthcare (Salmond & Echevarria, 2017). This paper aims to discuss changes implemented to reform the U.S. health care delivery system and the role of nurses in the altering environment.
Emerging Health Care Law and Nursing Practice
The increased demand for medical care and emerging challenges in the industry require the restructuring of some aspects of the health care delivery system. The Affordable Care Act (ACA), introduced in 2010, was a reform law aiming to enhance the nations health care delivery and provide a comprehensive system for fair health coverage (Mulligan & Castañeda, 2018). Under the ACA, the demand for, as well as the pressure on nurses has grown. To provide effective care, advanced education is needed to ensure appropriate training for medical personnel and positive outcomes for patients. Upon the adoption of the ACA, the country faced a shortage of nurses, followed by long working hours, lower-quality care, and higher burnout rates (Salmond & Echevarria, 2017). Hence, the changes shaped nurses responsibilities, placing them at the forefront of health care promotion.
As a result of changing health care system, it is crucial for nurses to understand the driving factors for the transformation and obtain the competencies required to fulfill the leading role in health care transformation. According to the United States House of Representatives (2019), an additional 203,700 nurses will be needed every year to meet demand, filling newly created positions, and replacing retiring nurses (Background section, para. 1). Among the recently introduced regulations, Title VIII Nursing Workforce Reauthorization Act of 2019 was introduced to improve nurses training, education, and practice (United States House of Representatives, 2019). It offered more opportunities for nursing personnel to adhere to current tendencies, take leading roles and increase their own well-being. Title VIII Nursing Workforce Reauthorization Act is expected to expand the range of nursing courses, increasing the number of graduates who possess advanced qualifications and are able to take up managerial responsibilities. Furthermore, the regulation aims to increase nursing workforce diversity and improve access to medical personnel in rural and underserved areas. Meeting professional standards and complying with regulations is crucial in the light of the changing health care delivery system.
Quality Measures and Pay for Performance
The primary goals of the U.S. healthcare system are to ensure quality medical care and reduce the cost of inadequate services. For instance, patient harm, such as impairment, disability, lost productivity, and mortality rates can result from poor medical services (Salmond & Echevarria, 2017). Hence, quality measures are implemented to quantify processes involved in health care provision and evaluate performance. They include patient satisfaction, timeliness of care, readmissions, hospital-acquired infections (HAIs), nurse-to-patient ratios, number of board-certified practitioners, and other measures. Such an approach not only helps allocate resources effectively, reducing staff burnout but also provides a number of benefits affecting patient outcomes. In particular, reduced cost, improved health of the nation, enhanced patient care, and the shift to a value-based model are among the main advantages of the quality measures approach.
The pay-for-performance approach is another tactic utilized to improve the quality of patient care. Hospitals are provided with financial incentives for accomplishing objectives, while health care institutions that fail to meet the requirements are penalized (Salmond & Echevarria, 2017). Pay-for-performance offers such advantages as promoting positive patient outcomes, emphasizing quality of care, supporting safe and efficient clinical practices, and employing qualified practitioners. Furthermore, this value-based model reduces the number of medical errors and readmissions, ensures sufficient staffing, and eliminates nurses burnout.
Quality measures and pay-for-performance affect nursing practice, implying expanded responsibilities of the nurses role. In particular, they are at the forefront of adopting recommended clinical practices and promoting patient care. In this regard, a nurse can act as a patient advocate, improving satisfaction with health care services to ensure quality measures are met. The nursing personnel are responsible for following medical care standards and adhering to nursing ethics. Furthermore, ensuring data transparency in quality measures is vital for overall performance.
Professional Nursing Leadership and Management Roles
As can be seen, the emerging health care laws and tendencies in the nursing practice shape and advance the responsibilities of nurses. Nursing leadership and management roles have become essential to the promotion of patent care and safety. In particular, nurse leaders are expected to be well-informed about the latest healthcare research, improve the efficiency and reduce the cost of operations, mentor team members, and delegate tasks effectively (Salmond & Echevarria, 2017). At the same time, nurse managers are involved in overseeing operations and health record systems, supervising teams, optimizing the provision of care, designing a budget, and employing nursing staff (Salmond & Echevarria, 2017). Besides, nurses can promote a safe environment within health care organizations. Communicating with various stakeholders and acting as a role model for other employees constitute other essential tasks in nursing leadership and management roles. Overall, the new responsibilities are dictated by emerging trends aiming to improve the quality of health care. Nurses have a pivotal role in the implementation of changes in diverse medical care settings.
Emerging Trends in Nursing Practice
Nursing is a fast-evolving profession that implies continuously emerging trends affected by numerous factors, such as the aging population, the shortage of personnel, and the appearance of advanced technology. In response to socio-demographic and economic determinants, new trends are likely to impact nurses roles within the next five years. For instance, increased specialization is expected, which refers to emphasized professionalism in a particular area of medicine in which the nurse provides care (Salmond & Echevarria, 2017). Such a tendency aims at improving health care quality and implies the need for effective education for the nursing personnel, and offers career advancement opportunities. Another emerging trend is telehealth services, which have become even more relevant in the context of the ongoing COVID-19 pandemic. Telehealth nurses acquire new responsibilities and are expected to communicate with patients, coordinate care teams, and ensure the efficiency of the clinical services provided via technologies.
To conclude, the U.S. health care delivery system continues to transform in response to daily challenges and an altering environment. In this regard, the role of nurses undergoes significant changes, placing the primary care providers at the frontline of healthcare. The growing demand for nursing personnel and the restructured medical care system define the need for competent specialists able to undertake advanced practices and take up leadership and management responsibilities in the changing environment.
References
Mulligan, J. M., & Castañeda, H. (Eds.). (2018). Unequal coverage: The experience of health care reform in the United States (Vol. 2). New York University Press.
Salmond, S. W., & Echevarria, M. (2017). Healthcare transformation and changing roles for nursing. Orthopedic nursing, 36(1), 12-25. Web.
United States House of Representatives. (2019). Title VIII Nursing Workforce Reauthorization Act of 2019. Web.
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