Evolving Practice of Nursing and Patient Care Delivery Models

Evolving practice of nursing and patient care delivery models
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Health reforms are often implemented with the goal of improving quality and reducing spending. The health reforms are also crucial to developing a well-educated nursing workforce that is integral to improving the quality of care. Policy makers involves scarce resources to improve health outcomes and evidence for the effectiveness and efficiency of the health initiatives increases more support to achieve the desired outcomes (Kunic & Jackson, 2013). Health care reforms supporting Patient- Centered Medical Homes, nurse-managed clinics and Accountable Care Organizations (ACOs) will increase the quality of health care, but there is a need to utilize best evidence to implement the most appropriate provisions and health policies.
Patient- centered access is one of the quality standards that indicate improved provision of medical care. The Patient- Centered Medical Homes (PCMH) model differs from usual care where there is emphasis bringing together the patients in medical groups, companies, health plans and the state health systems (Kunic & Jackson, 2013). This helps to promote implementation of the model and valuate results. There was feedback that the option is associated with limited improvements in quality, with no hospital, emergency department, ambulatory care, or total cost reduction. However, the approach has resulted in increased research and the results of implemented projects are evaluated to determine the improvement in the quality of service delivery and patient satisfaction as well as lower health costs per patient
The PCMH has the potential to improve health outcomes in primary care as there is focus on comprehensive primary care, care coordination to enhance care and complete primary care health provision. Since there is increased care coordination, the model is likely to reduce costs and improve outcomes. Nonetheless, one of the challenges remains that, evaluation has shown mixed results on whether there are better outcomes. In a study by Maeng et al (2015) savings in inpatient care when the model was adopted indicated that the approach is poetically beneficial to bring long-term improvement in care because of lower costs and improved quality of care.
The Affordable Care Act (ACA, of 2010) emphasized the need for integrated care and the nurse-managed clinics or centers are one such model, but the approach may not necessarily be financially sustainable. The respondents indicated that nurse-managed clinics (centers) offer access, affordability, and quality to the health care environment but agreed about questionable financial sustainability of the health care managed clinics. I disagree with this position and the literature shows that when properly implemented the model improves access to underserved communities, and there is emphasis on achieving financial independence. However, since there are few clinics that receive full reimbursement from the providers for services this affe...