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Healthcare Delivery Models and Nursing Trends


Nurses have evolved from being specialized doctors’ assistants to becoming a vital part of maintaining patients’ health. The scope of their responsibilities has expanded, thus making nursing practice more sophisticated and challenging. Almost any change in terms of health care reform directly or indirectly influences the nursing industry, so practitioners must be flexible enough to handle the changing demands.

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Emerging Health Care Reforms and Nurse’s Role

“Medicare for All” is one of the primary topics in the health care industry today. If passed, the bill will establish a universal health care system for all U.S. residents. Four years after the adoption of “Medicare for All”, all private insurance companies will be banned and all government medical programs will be canceled (Woolhandler & Himmelstein, 2019). The federal government will pay all medical expenses for Americans, including pharmaceuticals, dental care, hearing care, and others (Pollack, 2015). Thus, the federal government will become the sole payer of all medical costs.

It could be anticipated that the federal government, as a single-payer, will negotiate with pharmaceutical companies and collectively discuss fair prices for the American people. Funding will be provided through the use of the Medicare, Medicaid, and Children’s Health Insurance Program funds, an increase in income tax, the introduction of an excise tax on wages and income from self-employment, a tax on all other types of income, and a tax on operations with stocks and bonds (Pollack, 2015). Details, however, are not yet provided, so it is not possible to say to what extent the taxes will rise.

Nurses are the ones who work tirelessly to defend the needs of patients. They are vital in protecting public health because their responsibilities stretch from assuring correct diagnoses to the progressive teaching of the society about crucial health concerns (Potter, Perry, Stockert, & Hall, 2017). The current health care system is an obstacle to many nurses because they are withheld from doing their jobs due to the inability of many patients to pay for specific procedures. A single-payer system would increase the number of patients and thus raise the workload of each nurse. The role of nurses will become even more critical, and the demand for them will rise. The nursing industry must be ready to overcome the challenges that may emerge.

Pay-For-Performance and Patient Outcomes

When modernizing health care systems in the world, the necessary attention is often not paid to one of the most critical structural components in the scheme of medical care delivery – patient outcomes. In recent years, however, the situation has begun to change gradually. One of the main directions of institutional changes in the organization of health systems is currently the search for new mechanisms for paying for the activities of health care providers, stimulating them to improve the quality of care. Pay-per-performance (P4P) is one example of such initiatives and is an attempt to improve patient outcomes.

P4P could lead to an increase in the quality of medical care, although it would be associated with high financial costs. Even a slight increase in the quality of medical services could mean a decrease in the prevalence rate of diseases among a wide range of people. The results of past studies, however, show that there is no consistent improvement in the quality with the adoption of P4P (Mendelson et al., 2017). In terms of patient outcomes, neither decrease nor progression was identified (Mendelson et al., 2017). There is, however, an improvement related to the processes of care in ambulatory settings, which means P4P positively affects the nursing practice.

In these circumstances, nurses must now also concentrate on the quality measures related to patient health outcomes. This could mean the development of appropriate nursing practices that intervene with the activities of specialized doctors and other health care providers. Receiving training that will allow nurses to augment their professional capabilities and responsibilities is also an option because they will get a chance to have a direct impact on the health outcomes of patients.

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Nursing Leadership and Patient Safety Outcomes

The development of nurse leaders is essential because of the increasing complexity of healthcare delivery settings and expected resignations of current leaders. Despite this necessity, there is no adequate leadership roadmap, and it is a significant challenge in the nursing industry. Organizations now think of proper planning through finding and teaching prospective nurse leaders as an indispensable business strategy (Dyess, Sherman, Pratt, & Chiang-Hanisko, 2016). By 2020, there could be a shortage of around 60,000 nurse leaders according to workforce predictions (Dyess et al., 2016). Not only is there a strong business case for timely and organized transitions in organizations, but emerging nurses now look for these career opportunities when searching for a job.

Leadership is essential not only from organizations’ but also from patients’ perspectives. Safety and quality of health services is a fundamental priority of any patient care institution. There is also evidence that leadership, particularly transformational, in workplaces facilitates better working conditions and contributes to better patient safety outcomes and quality care for patients (Boamah, Laschinger, Wong, & Clarke, 2018). These improvements are achieved through the creation of supportive environments for nurses, increasing job satisfaction, and encouraging nurses to participate in the decision-making process (Boamah et al., 2018). The outcome is better working conditions in which nurses can provide the best service and ensure patients’ safety.

The health care industry and especially nursing is being heavily influenced by many changes our society is going through at the moment. Changes are shaping not only the requirements for registered nurses, which are very high and demand active participation in decision-making but also nursing education (Cherry & Jacob, 2016). Nurses need to have a proper understanding of how particular changes and trends affect the health outcomes of patients. Rapid development in the technology of patient care and increasing levels of domestic abuse and violence are two but not only examples of current changes that have a direct impact on nursing in general (Cherry & Jacob, 2016). These trends give insight into what issues need to be solved and how nursing education should be approached in the coming years.

Much is being demanded from nurses, but this situation will only worsen, and nurses will have to acquire additional skills and engage themselves in continuous learning to stay competitive. As the number of diseases and sick people grow, so does the technology of health care delivery (Cherry & Jacob, 2016). This fact means that nurses will need to be able to successfully adopt new technology by receiving additional training. The rising rates of domestic abuse and violence are another challenge. It will undoubtedly shape nursing education programs because nurses will have to learn not only how to deliver physical care but also to provide mental support (Cherry & Jacob, 2016). Prospective nursing education programs will also shift from teaching things one needs to memorize to educating how to think like a nurse, and how to collect relevant information that will be useful when making decisions.


Patient health outcomes are directly related to nursing performance, thus making the job of nurses critical. Many studies have been conducted to assess the relationship between how well nurses do their job and the quality of delivered medical services. The results are anticipated: nurses play a significant role in the health care delivery pipeline. Therefore, nursing education, training, and nursing leadership are crucial parts of the health care industry.


Boamah, S. A., Laschinger, H. K. S., Wong, C., & Clarke, S. (2018). Effect of transformational leadership on job satisfaction and patient safety outcomes. Nursing Outlook, 66(2), 180-189.

Cherry, B., & Jacob, S. R. (2016). Contemporary nursing: Issues, trends, & management. Beijing, China: Elsevier Health Sciences.

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Dyess, S. M., Sherman, R. O., Pratt, B. A., & Chiang-Hanisko, L. (2016). Growing nurse leaders: Their perspectives on nursing leadership and today’s practice environment. The Online Journal of Issues in Nursing, 21(1). Web.

Mendelson, A., Kondo, K., Damberg, C., Low, A., Motúapuaka, M., Freeman, M.,… Kansagara, D. (2017). The effects of pay-for-performance programs on health, health care use, and processes of care: A systematic review. Annals of Internal Medicine, 166(5), 341-353.

Pollack, H. (2015). Medicare for All – if it were politically possible – would necessarily replicate the defects of our current system. Journal of Health Politics, Policy and Law, 40(4), 923-931.

Potter, P. A., Perry, A. G., Stockert, P., & Hall, A. (2016). Fundamentals of nursing. St. Louis, MO: Elsevier Health Sciences.

Woolhandler, S., & Himmelstein, D. U. (2019). Medicare for All and its rivals: New offshoots of old health policy roots. Annals of Internal Medicine, 170(11), 793-795.

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