Evolving Practice of Nursing and Patient Care Delivery Models

There have been notable changes in the U.S. system of health care, which no longer just focuses on the curative care but health and preventing diseases as well. Consequently, the new healthcare reform is characterized by an approach focused on the creation of healthcare delivery models with the changing role of nursing to community health care from the previously predominant acute care settings. Continuity implies that delivery takes place when care is provided at all stages and levels and over a period of time. Three elements make up the changing health care delivery system. These components are

the accountable care organizations, medical homes, and health centers managed by nurses. The 2010 Affordable Care Act supports new payment policies, as well as the establishment of health clinics managed by nurses, medical homes, and Accountable Care Organizations (Bartels, Gill & Naslund, 2015). The legislation has resulted in transformation from the traditional approach to treatment to wellness and preventive care. The role of nurses has also changed from front-line health care givers to the care coordinators and integrators. Today, nurses help in providing underserved people with health services. All the health models center upon the continuity or continuum of care, implying that they involve an integrated care system that tracks and guides patient over time using a broad range of health services provided at every level of care.

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Accountable Care Organizations

Accountable care organizations consist of providers of health care, hospitals, and physicians who, on their own accord, provide Medicare patients with high quality and coordinated care. Accountable care organizations make up the new unit established by the Affordable Care Act; the 2010 law that introduced massive health reforms. The law requires accountable care organizations to take care of the quality and cost of care that patients receive (Shortell et al., 2015). These organizations primarily aim to deliver excellent and flawless care to patients at the appropriate time, particularly those who are chronically ill. Accountable care organizations consist of specified group of suppliers and providers that the Affordable Care Act has approved to promote active participation of physicians and physician associates, clinical nurse specialists, and nurse practitioners. In accountable care organizations, nursing leadership is accentuated, implying that registered nurses can develop improvement initiatives and lead in quality assurance. NRS-440V Week 2 Evolving Practice Of Nursing And Patient Care Delivery Models

Medical Homes

Patient-centered medical homes work in the same manner as Accountable Care Organizations. Their aim is to deliver primary care that is ample, accessible, patient-centered, synchronized, managed, and established upon safety and quality.  The medical home is a framework rather than a final destination that helps achieve excellence in primary care, which implies that patients can receive care in a manner that addresses all the needs of the patient at the appropriate time and in the apposite place (Patient-Centered Primary Care Collaborative, 2019). This model solves the problem of health care costs and relies on the work of primary providers of care, including licensed nurse-midwives, NPs, and physicians. Since nurses are front-line healthcare providers, they have a critical role in this model because they participate actively in referring patients who require specialized care, disease prevention, health promotion, as well as ordering and interpreting laboratory tests or studies.

Nurse-Managed Health Centers

Health centers managed by nurses constitute an important model in healthcare reform. They were established by Affordable Care Act. They are engaged in the promotion of primary care, control of chronic illnesses in the rural areas and medically underserved parts of the U.S., as well as disease prevention. The management of these centers is done by all the nurse clinicians, nurse midwives, nurses in public health, and specialists in clinical nursing. These professionals provide numerous health services that mostly focus on deserving communities, including diagnosing and prescribing to illness, referral to specialists, as well as post- and pre- natal care (Auerbach et al., 2013). In this care model, the nurse-managed clinics help in enhancing access to primary care for vulnerable populations or medically underserved communities. Similarly, the model boosts up nursing leadership and practice for nursing students because the centers maintain workforce and patient data and serve as important clinical training sites. NRS-440V Week 2 Evolving Practice Of Nursing And Patient Care Delivery Models

In conclusion, health centers managed by nurses, accountable care organizations, as well as medical homes constitute the new ACA health care delivery model meant to address issues related to access of quality health care and medical homes. The models are primarily competent, patient-centered, cost effective, and accessible. Their development has significantly changed the nursing role and created new standards for nurses. Nurses no longer have to serve as front-line healthcare workers only; they work as efficiency experts and care coordinators. Their role is critical in the success of the above healthcare models (McClelland, 2017). They work as care integrators and contribute significantly to continuum care in community health and acute care settings. Similarly, besides health reforms and major advancements in health technology, nurses play an increased role in preventive care, which is accentuated more than curative care. Thus, the nursing role is gaining increasing demand, which necessitates more professional, skilled, and educated nurses to ensure that changes in the health care system are implemented successfully.

NRS-440V Week 2 Evolving Practice Of Nursing And Patient Care Delivery Models