Evolving Practice of Nursing and Patient Care Delivery Models.

TOPIC: Evolving Practice of Nursing and Patient Care Delivery Models.

As the country focuses on the restructure of the U.S. health care delivery system, nurses will continue to play an important role. It is expected that more and more nursing jobs will become available out in the community, and less will be available in acute care hospitals.

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.

Evolving Practice of Nursing and Patient Care Delivery Models.

A cliché that is often mentioned in light of progress is “The only permanent thing is change.” This is meant to encourage people to be prepared for changes in different aspects of their lives. Healthcare is one of these sectors and as time progresses, reforms take place every now and then to ensure that the manner in which nurses deliver care to their patients is in tandem with findings that are being made by researchers in the area. The reforms are necessitated by the fact that the proposed alterations promise to bring about improvements in the lives of the patients through the work of these nurses. Over the next decade there are several reforms are bound to be implemented in the healthcare sector. These include the continuum of healthcare programs, Accountable Care Organizations (ACOs), Nurse- Managed health clinics and also Medical Homes. 

Accountable Care Organizations are formed through the collaborative efforts of hospitals, specialized doctors and primary care givers who commit to accepting joint responsibility for the delivery of quality healthcare to their patients as well as the management of the costs. Members who have signed on to the ACO benefit financially through bonuses if the organizations register significant monetary savings (Rittenhouse et al, 2009).  The aspects of quality and cost control are managed by the ACO through their promotion of quality practices as well as efficient treatment procedures whose costs are moderate. The payment the ACO receives is pegged on how well this is accomplished. Nurses fit into this under the category of primary care givers and they can do a lot in the area of quality.

Nurse-Managed healthcare clinics are healthcare establishments that are administrated by qualified nurses unlike the past when doctors were the only healthcare professionals allowed to manage them. The difference of these facilities from the traditional physician managed establishments is that the entire operation is influenced by a professional who is well aware of patient care during the recuperation process intimately rather than a physician who will have limited face time with the patients (Hansen-Turton et al, 2010). This is part of the process of bringing nurses into the leadership of the healthcare sector.

The continuum of healthcare programs is a concept that advocates for a more long-term perspective when it comes to the consideration of healthcare delivery to patients. This is a paradigm shift from the current model of healthcare which only focuses on real-time healthcare challenges that patients are facing. The continuum of healthcare programs are designed in such a manner that they ensure the patient receives medical services well into their old-age. The implication of this for nurses is that they need to widen the scope of their skills so as to specialize in the care of a specific age group rather than operating generally across the age groups.

Medical Homes can be defined as patient-centric healthcare facilities that have been designed to ensure the patient gets the best in terms of healthcare and personalized attention from highly qualified personnel who ensure procedures being conducted are actually geared at ensuring quality for the patients being treated. These are all to be configured in a way that ensures value addition for the patients receiving treatment in these medical homes (Nutting et al, 2011). The relevance of this to future nurses is the fact that it will demand an effective aptitude for industry best-practices. 


Rittenhouse, D. R., Shortell, S. M., & Fisher, E. S. (2009). Primary care and accountable care—two essential elements of delivery-system reform. New England Journal of Medicine361(24), 2301-2303.

Nutting, P. A., Crabtree, B. F., Miller, W. L., Stange, K. C., Stewart, E., & Jaén, C. (2011). Transforming physician practices to patient-centered medical homes: lessons from the national demonstration project. Health affairs30(3), 439-445.

Hansen-Turton, T., Bailey, D. N., Torres, N., & Ritter, A. (2010). Nurse-managed health centers. AJN The American Journal of Nursing110(9), 23-26.