This paper educates nurses about how the practice of nursing is expected to grow and/or change by discussing the concepts of continuity or continuum of care, Accountable Care Organizations (ACO), medical homes, and nurse-managed health clinics. Finally, it presents feedback from my three nursing colleagues, namely Mary, Nick, and James.
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Changes in the US Nursing Practice
People pursue careers in the nursing profession with the objective of participating in ensuring that patients recover from sicknesses. This aim underlines the significance of implementing various changes in nursing practice to ensure that its primary goal is attained quickly. One of the major changes in nursing practices is patient-centered care. In this exercise, nurses set health goals together with the patients before seeking proactive strategies for realizing them. In today’s nursing practice, a high emphasis is given to the quality and safety of patients and care, administration of evidence-based care, incorporation of technology in care delivery, the rise of medical homes, and the creation of Accountable Care Organizations (ACOs). The nursing practice has also been called upon to embrace the continuity or continuum of care. The number of nurse-managed health clinics has also been rising. This section discusses four of these evolving nursing models.
Accountable Care Organizations (ACO)
ACOs comprise a harmonized team of clinical officers who offer care to groups of ailing people who are assigned to them. The ACOs bring together healthcare providers such as doctors and nurses who accept taking accountability for the quality of care delivered, costs incurred, and medical beneficiaries who were traditionally enrolled in free-for-service care programs (McClellan, McKethan, Lewis, Roski, & Fisher, 2010). The aim of establishing ACOs is to increase efficiency while at the same time lowering the cost of medical care in the US. Indeed, the Affordable Care Act aims at reducing the escalating costs of healthcare in the US by encouraging groups of health care providers, including nurses, doctors, and medical facilities to establish networks that coordinate care for patients. Such systems gain eligibility to bonuses upon delivering efficient care.
Medical homes offer patient-centered care. They comprise a team of care providers who offer comprehensive and continuous health care to different patients by principally focusing on optimizing their outcomes (Homer, Klatka, Romm, 2008). Medical homes aim at increasing the accessibility to care, raise the health satisfaction of patients and their families via medical care, and/or improve patients’ wellbeing (Homer et al., 2008). Medical homes are a way of organizing primary care by coordinating and communicating with patients and their folks with the main objective of transforming care delivery system to suit the clients’ (patients) demands.
Nurse-managed Health Clinics
Health care is now a necessity, rather than a privilege. From this reasoning, the US government endeavors to guarantee quality health care accessibility to all people. Consequently, nurse-supervised health facilities are established to offer medical care in metropolitan and countryside regions that have restricted convenience to alternative healthcare. Using nursing frameworks, the facilities avail medical services to susceptible persons.
Continuity or Continuum of Care
Healthcare is a continuous service. Continuity or continuum of care implies a system that directs and/or follows sick people within a specified period via all-inclusive arrangements of medical services that run at all stages of care giving. Services may include housing, home care, ambulatory care, and extended care. Integrating mechanisms include management and planning, coordination of care, systems for information integration, and case-based financing.
Summary of Nurses’ Responses
Nursing is a profession within the healthcare industry. Its primary concern includes protecting, promoting, and optimizing health. Nursing professionals achieve this goal through the prevention of illness and injury. Nursing services are vital when it comes to alleviating affliction through the diagnosis and treatment of people. Consistent with these objectives, nursing care models have been undergoing a tremendous evolution that has led to improved patient care.
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After presenting the discussion of the changing nursing care models, the three nurses, Mary, Nick, and James, had different opinions and evaluations of the presentations. They also added their ideas about the areas of discussion. Nick summed up that the four models also focus on increasing the accessibility of care while optimizing care delivery system. For example, he argues that ACOs have the goal of reducing costs. With high costs of health care, Nick suggests that more people may not have access to quality health care.
ACOs have the responsibility of managing costs and ensuring quality care delivery for them to earn more bonuses. The goal of ACOs is to ensure that all care units and practices such as home care, hospitals, physicians, nurses, and doctors work harmoniously to eliminate unnecessary spending. James believes that this nursing model is the way to go now and in the future since it guarantees quality care delivery for all Americans. Unlike James and Nick, Mary is worried about the effectiveness of the ACOs in delivering low-cost quality care. While I agree with Nick and James’ response, Mary’s concerns are equally valid. Indeed, while ACOs may aid in resolving the challenge of inefficiency in systems of payment by rewarding health care providers better, McClellan et al. (2010) reckon that they may lead to consolidation of the healthcare industry. This situation may lead to some providers charging people more, especially when a given network of care providers dominates a particular geographical area.
Nick addresses the issue of home care and nurse-managed health clinics. He asserts that clinical nursing practitioners have functioned as facilitators for a long time in health care delivery. According to him, the clinics have a close association and affiliation with non-profit-generating organizations, universities, and/or nursing schools. He quotes Wilson et al. (2013) who note that the facilitation role and the integration of care have now become invaluable tasks. However, leadership support is now proving critical in maintaining the integrity of the nursing profession and commitment of clinical nurses in their work (Wilson et al., 2013). Consistent with these claims, Nick asserts that the objective of the two nursing models should be on how future nursing leadership can develop to become a primary driver of the success of health care facilities through the development of effective policy frameworks that guarantee quality care at low costs. Mary and James concur with Nick. The three nursing colleagues agree that the continuity of care complies with the objective of ensuring consistent quality care to all people, despite their socio-economic status or any other demographic difference.
The three nursing colleagues’ responses concur with my research on healthcare reforms. The reforms aim at increasing the quality of care and managing costs of care effectively. For example, the ObamaCare has been a representation of the impeccable dogmatic renovation of the American medical schemes since 1965 when various policies such as Medicaid were developed. The central driving force for the health care plan is the need to avail affordable healthcare to all Americans while at the same time minimizing the number of uninsured Americans (Antos, Wilensky, & Kuttner, 2008). Consistent with this concern, ACOs and medical homes ensure affordable and quality health care. Nurse-managed health clinics help in addressing the health needs of vulnerable and uninsured Americans. Hence, the three models correspond to the health care reforms that aim at increasing the accessibility to quality care as Nick, James, and Mary reveal.
To increase accessibility of quality care at low costs, health care reforms such as ObamaCare endeavor to provide mechanisms, for instance, offering subsidies, tax credits, and mandates to individuals and/or employers. The goal is to boost the health insurance coverage. The plan has some additional reforms aimed at improving healthcare outcomes coupled with streamlining the healthcare delivery (ObamaCare Facts, 2012). ObamaCare places an obligation for insurance businesses to ensure that all claimants are wholly taken care of at similar terms, notwithstanding their gender and pre-existing state of affairs. After the implementation of the plan, the Congressional Budget Office (2010) estimated that the ObamaCare had the capacity to cut down Medicare expenses coupled with potential healthcare shortfalls. This goal corresponds to the objective for which ACOs, medical homes, and nurse-managed health clinics, and continuity of care models are established to achieve.
Health care reforms are necessary to increase accessibility to quality care at low costs. Consistent with this concern, models for the Practice of Nursing and Patient Care Delivery in the US have been changing. The paper discussed continuity or continuum of care, Accountable Care Organizations (ACO), medical homes, and nurse-managed health clinics as four central changes that correspond to the concerns of health care reforms such as the ObamaCare.
Antos, J., Wilensky, G., & Kuttner, H. (2008). The Obama Plan: More Regulation, Unsustainable Spending. Health Affairs, 27(6), 462-470.
Congressional Budget Office. (2010). Reconciliation Act of 2010 (Final Health Care Legislation). Web.
Homer, J., Klatka, K., & Romm D. (2008). A review of the evidence for the medical home for children with special health care needs. Pediatrics, 122(4), 922–937.
McClellan, M., McKethan, N., Lewis, L., Roski, J., & Fisher, S. (2010). A National Strategy to Put Accountable Care into Practice. Health Affairs, 29(5), 982–990.
ObamaCare Facts. Facts on Obama Health Care Plan. Web 2012.
Wilson, L., Orff, S., Gerry, T., Shirley, B., Tabor, D., Caiazzo K., & Rouleau, D. (2013). Evolution of Innovative Roles: The Clinical Nurse Leader. Journal of Nursing Management, 21(1), 175–181.