Evolving Practice of Nursing and Patient Care Delivery Models
Write an informal presentation (500-700 words) to educate nurses about how the practice
of nursing is expected to grow and changes. Include the concepts of continuity or
continuum of care, accountable care organizations (ACO), medical homes, and nurse-
managed health clinics.
Share your presentation with nurse colleagues on your unit or department and ask them to
offer their impressions of the anticipated changes to health care delivery and the new role
of nurses in hospital settings, communities, clinics and medical homes.
In 800-1,000 words summarize the responses shared by three nurse colleagues and discuss
whether their impressions are consistent with what you have researched about health
EVOLVING PRACTICE OF NURSING AND PATIENT CARE DELIVERY MODELS 2
Evolving Practice of Nursing and Patient Care Delivery Models
Registered Nurses and BSN play a critical role in the delivery of healthcare to patients.
Regardless of the role they play, they are as well faced with a myriad of challenges that require
immediate address. The field of nursing is growing and changing every day and, therefore,
nurses must be abreast with the new developments and changes to remain effective in their duty.
The paper exemplifies on the shared impressions about anticipated changes to healthcare
delivery and the new roles of nurses in communities, hospital, clinical, and medical homes
settings. The paper further discuses whether these views are consistent with the findings
pertaining to health reform.
The colleagues noted that the medical care in US has been marred with extremely high
costs and poor quality as well as fragmented delivery. The high cost of accessing quality
medication has hindered many people from receiving quality healthcare, and this has
compromised healthcare. However, with the new reforms in the healthcare, nurses are optimistic
of new changes. They have already begun experiencing positive outcomes in terms of delivery of
services. The new concepts of integrated healthcare delivery have been developed including,
Accountable Care Organizations (ACOS) and patient centered medical homes that will to greater
extent impact positively on the field of nursing. Accountable care organizations are partnerships
between the healthcare providers and aim to coordinate and manage patient care. The aim of this
program is to ensure that quality care is delivered at reduced cost to help control huge amount of
The Accountable Care Organizations groups include hospitals, nursing homes, physical
groups, and home health cares services. The alliances are created through contracts that create a
circle of service agreements aimed at bringing patient care under one umbrella. This concept
EVOLVING PRACTICE OF NURSING AND PATIENT CARE DELIVERY MODELS 3
ensures that health care costs are low as services are provided at one single corporate structure
hence, eliminates duplication of services.
The nurses also postulated that the new changes will ensure provision of better care to all
the individuals. The six dimensions of quality including effectiveness, safety, patient
centeredness, timeliness, efficiency, and equity are guaranteed (Longworth, 2013). With home
based care, nurses are in a better position to provide quick and effective care to patients.
Healthcare is no longer going to be provided at the acute care centers, but the changes will see
more people get better and quick healthcare in their homes. Citizens are also going to receive
better services through education on the major causes of illnesses, health, poor nutrition,
substance abuse, physical activity, and poverty among many others. This means that preventive
measures are going to be embraced such as physical examination and vaccinations, including
influenza and polio among others, thereby helping to improve the quality of life.
The nurses as well agreed that integrated delivery system models are very effective in
cost savings and at the same time improving quality of care. Through these changes and
reforms, hosipital admissions will reduce and visits to emergency departments will as well come
to a minimum, hence, saving costs. The group health cooperative of Puget was able to reduce
the total costs of health by $10 per member in every month and recorded 16% reduction in new
hospital admissions as well as 29% reduction in emergency visits (Longworth, 2013). This
statistics is a clear indication that indeed with the emergence of these new concepts in nursing,
quality is guaranteed at a lower cost.
Indeed, the impression elicited by the nurse colleagues is consistent with the studies on
health reforms. Government and other stakeholders in the health sector have instituted various
changes in health to help enhance the quality of services. The government through such policies
EVOLVING PRACTICE OF NURSING AND PATIENT CARE DELIVERY MODELS 4
such as Affordable Care Act aims at ensuring that all the members of the U.S can access quality
health care at an affordable cost (Daemmrich, 2013). Through partnerships with insurance
companies such as Medicare and Medicare, many citizens will get the opportunity to access to
According to Longworth (2013), the concept of ACOs, which was spawned by Elliott
Fisher in 2006 aimed at improving coordination of care within the Accountable Care
Organizations (Longworth, 2013). It was also intended to reduce fragmented care, control the
costs of accessibility to care, and improve the outcome. This resonates with the colleagues’
impression of the new reforms of ensuring that quality care is provided at an affordable cost.
Nurses have the responsibility to ensure that they improve the quality of care of their patients. In
doing so, they must at all times ensure that they adhere to the professional codes of ethics and
legislations. Even as these reforms in healthcare are implemented, it will require that nurses
undergo further training to equip themselves with more skills to help in management of different
diseases. ACO’s will require increase in the number of nurses to render their services to the
members of the communities (Kelly, 2011). They will as well be required to embrace technology
and innovation to handle health problems in the society.
In conclusion, nurses must be always be updated on the new developments in health
profession. They have a greater role to play in healthcare and must be able to address the new
changes and challenges they face. They must adhere to ethical standards in their execution of
duties and must at all times ensure that they promote positive healthcare. The new reforms in the
healthcare such as integrated patient centered care and ACOs have become important and are
revolutionizing this sector. Nurses must be ready to adapt to these changes in order to help
EVOLVING PRACTICE OF NURSING AND PATIENT CARE DELIVERY MODELS 5
transform and impact positively on the quality of healthcare among the members of the
Daemmrich, A. (2013). U.S. healthcare reform and the pharmaceutical market: Projections
from institutional history. Pharmaceuticals Policy & Law, 15(3/4): 137-162.
Kelly, E. (2014). Patient care delivery and integration: Stimulating advancement of ambulatory
care pharmacy practice in an era of healthcare reform Am J Health Syst Pharm,
Longworth, D. (2013). Accountable care organizations, the patient-centered medical home, and
health care reform: What does it all mean?