Nursing Essay Example on Patient Care Delivery Models

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In the recent past, the United States of America has been focusing on the health care delivery system restructuring in order to facilitate the provision of high-quality and affordable health care services to people. The continued restructuring of the health care delivery system has led to the creation of new jobs for nurses, and more nursing jobs are expected to be created in the future. According to Sullivan-Marx (2010), most of these nursing jobs are expected to be available in the community. On the other hand, nursing jobs in acute care hospitals are likely to decline considerably. In my view, the continued restructuring of the U.S. health care delivery system is likely to impact significantly the practice of nursing. The practice of nursing is likely to shift its focus from acute care hospitals to community-based health organizations. The reason for this is the development and implementation of new health care delivery models such as the continuum of care, Accountable Care Organizations (ACOs), medical homes and nurse-managed health clinics.

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Evolving Practice of Nursing and Patient Care Delivery Models

First and foremost, the continuum of care can be defined as a nursing concept that involves the use of an integrated system of care that directs and monitors the recovery of patients over a given period through a comprehensive collection of health services. The continuum of care involves the provision of a range of health care services to patients both within and outside health care systems. Through the continuum of care, the intensity of care increases as the health problems faced by patients become more complex. The continuum of care targets improving the quality of care services offered to patients by facilitating the coordination and communication between health care providers such as nurses and doctors. As a consequence, this helps in ensuring that medication errors are eliminated during the health care delivery. It also helps in reducing the cost of providing health care services because medical procedures such as diagnosis are not repeated or duplicated. The array of care services provided through the continuum of care includes in-home treatment services, counseling services, residential treatment and community outreach services among others. The continuum of care also helps in creating strong interpersonal relationships between health care providers and patients. As a result, this facilitates the exchange of information and provision of health care services. It also eliminates gaps in the health care delivery system which may disrupt the quality of services provided. In my view, the continued use of the continuum of care model in the health care industry implies that more nurses would be employed in order to assist in the provision of patient-centered care services.

Secondly, the creation of more Accountable Care Organizations (ACOs) is also likely to facilitate the creation of new nursing jobs in the country. An Accountable Care Organization refers to a group of health care providers who provide highly coordinated care services to patients. Accountable Care Organizations also focus on proper management of chronic illnesses such as heart disease, cancer and diabetes. The main mission of Accountable Care Organizations is to improve the quality of health care services received by patients. According to Pavarini, McGinty and Schaff (2012), Accountable Care Organizations also focus on offering affordable care services to patients hence increasing the accessibility of care services in the country. Accountable Care Organizations often use a variety of payment options such as capitation and fee-for-services to facilitate the provision of care services. In my opinion, the increasing use of Accountable Care Organizations in health care delivery systems is likely to create more nursing jobs because more nurses would be required to help in the provision of high-quality services to patients. Consequently, this would help in ensuring that the right services are offered at the right time to patients. I would also encourage nurses to join the Accountable Care Organizations voluntarily in order to aid in the provision of care services to patients.

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Thirdly, the restructuring of the U.S. health care delivery system has also been characterized by the emergence of more medical homes. A medical home refers to a health delivery model that provides comprehensive and continuous medical care to patients with the main goal of maximizing the outcomes. Medical homes are usually led by physicians, physician assistants (PAs) or nurse practitioners (NPs). Medical homes also aim at increasing the accessibility of care services. Medical homes usually deal with defined population of patients and are also referred to as patient-centered medical homes (PCMH).

In my view, the increased use of medical homes in the U.S. health care delivery system would result in the creation of more jobs for nurses. The reason is that additional nurses would be recruited in order to aid in the provision of care services. What is more, they would aid in the coordination of various resources such as health information technology needed for effective and efficient provision of care services. Moreover, additional nurses would be needed to monitor regularly the progress of patients in medical homes.

Last but not least, the emergence of nurse-managed health clinics is likely to lead to increased employment of nurses in the health care industry. Nurse-managed health clinics are of paramount importance to institutions that provide care services to patients in rural and semi-urban areas which are usually characterized by limited access to health care. Nurse-managed health clinics also provide care services to uninsured and underinsured people. Torrisi and Hansen-Turton (2008) also agree that the increase in number of nurse-managed health clinics is likely to maximize the demand for nurses who would provide primary care to patients.


In conclusion, I would advise nurses to seek further trainings in order to be able to embrace and manage more challenging tasks that would be presented by changes in nursing practice as a result of restructuring of the U.S. health delivery system.

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