Evolving Practice of Nursing and Patient Care

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
Write a speech of 500-700 words to educate nurses about how the practice of nursing is
expected to grow and shift. Include the concepts of continuity or continuum of care,
accountable care organizations (ACO), medical homes, and nurse-managed health
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Evolving Practice of Nursing and Patient Care

Thank you for offering me an opportunity to speak on the evolving practice of patient
care and nursing. The future of nursing and patient care is characterized with changes;
nursing profession in the United States is one of the biggest segments among the workforce
of the health care (Brennan et al, 2009). Nurses work hard in addressing the needs of the
patients; the government of the United States has been concerned on restructuring United
States health care delivery system. Nurses in the health care play a critical role and will
continue to play a critical role in the community and in the acute care hospitals.
As you all know that the world is facing changes with modernization, the health care
is also receiving its share of changes. U.S. health care system is experiencing diverse
challenges, which has accelerated the need of reforms (Davidson, 2010). It is estimated that
millions of persons will be affected, who are insured and uninsured. The Obama
administration and Congress are considering different avenues of addressing at the current
challenges in the system (Shi & Singh, 2012). A significant number of Americans have no
insurance on health, a model that contributes on the inefficiency and poor quality of the

health care. Uninsured persons in the United States often resolve to poor health outcomes as a
result of higher costs involved in treating health complications (Brennan et al, 2009).
The gap in the American health care system will be addressed through restructuring
the United States health care delivery system in ways to reflect on communities being
delivered with personalized health care as compared to the acute care in the health care
facilities. The beauty of the reforms is that the system cannot work without engaging nurses.
Continuity of the health care spans both at the organizational and disciplinary boundaries
(Davidson, 2010). Health care providers will have the responsibility of evaluating the
continuity in a rigorous model, which will enhance better communication within the new
system (Shi & Singh, 2012).
Accountable Care Organization (ACO) is an organization offering healthcare with
care delivery models and payment models. ACO has been influential in reductions and
metrics in regards to reimbursements. ACO engages diverse payment models identifying with
fee for service with symmetric or asymmetric shared savings and capitalization among others.
Accountability of ACO is pegged on third party payers and patients in making sure that the
patients get appropriate, efficiency and quality health care.
Medical homes are taking shape in the twenty first century, it is also identifies with
PCMH (Patient Centered Medical Homes), physicians are involved in the delivery of the
health care in a team model. The main goal of medical homes is to attain maximized
outcomes of the health care in the United States (Davidson, 2010). Medical homes
collaborate with diverse health care providers in making sure that the patients are addressed
in the right model, which encourages coordination. Nurses are influential in the running of
medical homes.
Nurse Managed Health Centers is the future of health care in the United States, it has
been noted that areas with limited access to the hospitals, nurse managed health clinics have

proved productive and efficient in the delivery of health care in the United States (Brennan et
al, 2009). The underserved areas will enjoy the benefits pegged on nurse managed health
centers, it is estimated that underinsured and uninsured patients in the United States will
benefit from the system. More and more nurse managed health clinics will coordinate with
nursing universities, schools and independent organizations. It is evident that restructuring
United States health care delivery system will foster benefits to the nurses. Thanks you for
your time as we support the global changes in the health care delivery.


Brennan, N. et al. (2009, August). Improving Quality and Value in the U.S. Health Care
System. Retrieved October 22, 2013,
Davidson, S. (2010). Still Broken: Understanding the U.S. Health Care System. Palo Alto,
California: Stanford Business Books.
Shi, L. & Singh, D. (2012). Essentials Of The U.S. Health Care System. Burlington,
Massachusetts: Jones & Bartlett Learning.