Evolving Practice of Nursing and Patient Care Delivery Models
Health care system is fundamental to the continued growth and development of any country. For a country to succeed in other areas such as the economy, a healthy labor force is needed. Therefore, any government is responsible for making sure that healthcare is available to all citizens at an affordable cost. Every stakeholder in the caregiving system such as doctors and nurses play a vital role in the continuous success of the healthcare system. Over time, owing to the increased use of technology and increased population, nursing practices, and patient care delivery models have evolved significantly. For instance, the past was characterized by the use of acute hospitals to perform emergency minor surgeries. During the contemporary time, the minor surgical procedures are carried out in doctors’ offices or outpatient operation facilities (Pilon et al., 2015). Additionally, the increasing number of population and increased mortality rate has given rise to a large portion of the aging group. Hence, there has been increasing demand for primary caregiving and nursing homes which in turn translates to increased demand in the number of nurses required (Wakerman et al., 2017). To meet the ever-increasing need of caregiving, minimize cost and improve service quality, new methods and technology are being incorporated in nursing programs such as continuum of care, medical homes, nurse-managed health clinics, and accountable care organizations (ACO).
Continuum of care entails a notion that incorporates health care delivery models to guide and track a patient’s condition over a period of time, such as from birth till death (Wakerman et al., 2017). The process is undertaken through a much detailed concentration on patient’s care on every level such as independent caregiving, rehabilitation, and all other forms of dependent caregiving. Through the process of continuum of care and patient agrees to be administered with any vital caregiving necessary such as taking prescribed drugs. Every healthcare model, for instance, medical homes, have adopted the idea of continuum of care.
When medical homes were introduced in 1967, their main goal was to provide intensive and essential medical care to children with special needs (David et al., 2015). Over time they have evolved to include all children and adults. Medical homes are designed to provide primary care to patients wherever they are. They integrate comprehensive working of all doctors, other staff such as nurses, to provide coordinated care to all patients. The model works to foster a trusting relationship between all staff and patients in order to realize their goal of maximum caregiving. Medical homes further aim to reduce the number of hospitalized patients as care is provided in all right areas by the right people and at the correct time (David et al., 2015). Additionally, medical homes essentially increase the quality of caregiving and make healthcare accessible at all times. Through the visible success and importance of medical homes, different health organizations have supported the model.
Accountable care organization (ACO) involve the coming together of a number of healthcare providers such as nurses, doctors, and hospital to provide cost-free high-quality healthcare services (Wakerman et al., 2017). The model entails the cost sharing of all the involved healthcare providers in the provision of primary caregiving. ACO’s main goal is to provide health care at an effective cost to patients in centers occupied by the undeserving and less privileged. Moreover, it prides itself in medical error minimization in the Medicare program. End results of the development and continued success of ACO are characterized by a reduction in hospital visits and overall hospitalization.
Nurse-managed healthcare (NMHCs) are medical centers run by a registered nurse. They are designed to counter the problem of increased demand in primary caregiving which is not met by corresponding insufficient supply. NMHCs aim to maximize the quality of caregiving while minimizing profits (Pilon et al., 2015). Therefore, the cost of getting primary health care at the centers is significantly low compared to hospitals in the same area. Furthermore, the NMHCs aim to educate people more about self-health care provision, campaign for health promotion and prevent the occurrence of diseases (Pilon et al., 2015). Through the achievement of objectives, healthcare has been affordable to the target population, hospitalization has reduced, and the quality of caregiving has improved.
In conclusion, the health care system is faced by various challenges such as increased cost in primary care provision, increased demand and the increased occurrence of chronic illnesses. To solve the challenges new healthcare systems and strategies are fundamental. The development of new models such as NMHCs, ACO, continuum of care, and medical homes have greatly helped in solving problems in the healthcare system.
Feedback from Colleagues
As I shared my presentation of the invention of new models in the health care system with my colleagues I got both positive and negative feedback. They all agreed that the replacement of acute hospitals is essential for the reduction of healthcare cost. Moreover, there was a unanimous agreement that there is a need for new models in the health care system as the world is ever-changing, economically, population and technologically. Also, all of my colleagues approved that continuum of care is the backbone of all models. Owing to continuum of care, it is easier to predict illnesses and avoid them. As the models develop and succeed, there will be improved quality of healthcare provision, minimization of caregiving cost, accessibility and continued coordination of healthcare providers. Consequently, illnesses’ occurrence will significantly reduce, and also the number of hospitalizations.
Most of my colleagues agreed that medical homes play a vital role in healthcare system. According to them, the model ensures that the future of the health care system is secured as it enables the rising demand in caregiving to be met. Moreover, the coordination between all tea players enhances the provision of high quality healthcare services. Medical homes further help in treatment and prevention of chronic illnesses. However, two of my colleagues expressed concerns about the medical homes. According to them, the model is faced with the challenge of insufficient resources to cater for all patients. According to past research, there is often lack of funds to pay physicians thus in many cases the centers face shortages in the number of caregivers. Also, the centers require significant amount of funds to maintain which in many cases is always a problem. Therefore, lack of resources may hinder the provision of healthcare services.
As per my ACO description, most of my colleagues agreed that the model helps significantly in proving high-quality healthcare at a reduced cost. Moreover, the medical errors have declined in the hands of ACO and so have medical replicas. However, one nurse raised a concern that ACO faces the challenge of a proper management structure. According to him, the model lacks the needed leadership for its continued success. He further argues that the system is only effective in the short run but is most likely to fail over time. Also, inappropriate management will lack proper investment decisions that will result in the misappropriation of funds. Another nurse also argued that many physicians refuse to volunteer at the centers. Consequently, the model may lack adequate caregivers to tend to all patients.
All of my colleagues agreed that NMHCs are fundamental to the future of healthcare delivery. As per their views, health education provided is essential in ensuring that patients take good care of themselves and in turn will reduce the rate by which they become sick. Also, nurses are the core of any health care system, thus the model will ensure that the quality of care provided is improved. The model will further increase the accessibility of health care services to all citizens.
In conclusion, despite the few concerns raised about the invented models, all my colleagues agreed that they are important for the future of all health care practices. The models not only help in easing the growing demand for primary care but also help in improving the quality of the healthcare system. Additionally, healthcare services are further made accessible to every citizen including the undeserving ones. The players in the model should, therefore, find ways to solve all the challenges that arise. For instance, the needed leadership in ACOs should be appointed who will help govern the model for success. Every model is important as they each play an important unique role that when all are implemented in the society, makes the provision of primary caregiving better.
David, G., Gunnarsson, C., Saynisch, P. A., Chawla, R., & Nigam, S. (2015). Do patient‐centered medical homes reduce emergency department visits?. Health services research, 50(2), 418-439.
Pilon, B. A., Ketel, C., Davidson, H. A., Gentry, C. K., Crutcher, T. D., Scott, A. W., … & Rosenbloom, S. T. (2015). Evidence-guided integration of interprofessional collaborative practice into nurse managed health centers. Journal of Professional Nursing, 31(4), 340-350.
Wakerman, J., Humphreys, J., Wells, R., Kuipers, P., Entwistle, P., & Jones, J. (2017). A systematic review of primary health care delivery models in rural and remote Australia 1993-2006. Retrieved from: https://openresearch-repository.anu.edu.au/bitstream/1885/119218/3/full_report_14960.pdf
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