NRS 440 Health Care Delivery Models and Nursing Practice

NRS 440 Health Care Delivery Models and Nursing Practice

NRS 440 Health Care Delivery Models and Nursing Practice

Healthcare delivery models influence how the healthcare services are delivered to the target population with specific healthcare needs. Different models that have been employed in healthcare systems differ in how clinical decisions are made, how resources are allocated and the works delegated, and even how and when the patients are involved in their care. Laws and regulations that are passed may affect these models or lead to the discovery of other systems such as pay for performance that aims at improving the quality and safety of healthcare for the patients. The objective of this paper is to describe the healthcare laws that affect healthcare delivery, discuss the impacts of pay for performance in nursing practice, and then highlight the roles of nursing leadership and management and how such roles respond to trends in healthcare.

Emerging Healthcare Law

            The healthcare workforce is the major stakeholders in healthcare on whom the quality of healthcare services depends. The size of this workforce should therefore always adjust to meet the healthcare needs including the increased healthcare demands. However, the enactment of the Affordable Care Act increased healthcare access for individuals of low socioeconomic status owing to the increased affordability of care (McIntyre & Song, 2019). Despite this increase, the healthcare practitioners were not increased commensurate with the increased patient population thus contributing to the shortage in the workforce. Legislations have therefore been proposed to help in addressing this shortage.

The healthcare law that has recently attempted to address the need for a healthcare workforce in the US is H.R728, the Title 8 Nursing Workforce Reauthorization Act of 2019. It was introduced in the 116th Congress by Congressman Dave Joyce and Congresswoman Tulsi Gabbard (Tracy et al., 2020). It seeks to reinforce the training of nurses through reauthorizing their loan repayment and scholarships and granting them education grants to further their education. By facilitating the education, the Bill would ensure that more nurses are trained even with specialized skills and knowledge that would be required to meet the healthcare needs in the community (Hardie & Ortelli, 2020). It also recommends recruitment and retention of the nursing workforce that would result in an expansion of the nursing workforce thus addressing the shortage (Tracy et al., 2020). With revamped nursing workforce, the quality of healthcare services delivered to the patients is anticipated to improve.

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Nurses play an advocacy role to protect the patient’s interests. Given this proposed change is in the best interests of the patients, the role and responsibility of the nurses are therefore to advocate for its passage into law. They can achieve this role through lobby groups and meetings with the other stakeholders to influence the enactment of the Bill (Hardie & Ortelli, 2020). After its passage, the nurses will then be tasked with offering career guidance talks to individuals who are interested in pursuing nursing courses on the available opportunities. The bill will therefore revolutionize the role of nurses in practice and education.

How Quality Measures and Pay for Performance affect Patient Outcomes

            Value-based system of payment has been adopted in healthcare to promote the quality of care provided. The

NRS 440 Health Care Delivery Models and Nursing Practice
NRS 440 Health Care Delivery Models and Nursing Practice

shift from volume-based to value-based systems such as payment for performance ensures that reimbursement of a practitioner for services provided considers the quality of care, patient satisfaction, and outcome of care (Kyeremanteng et al., 2019). The system is guided by the quality measures such as low mortality rates, reduced hospital stays, and decreased complications for services provided (Hardie & Ortelli, 2020). When the practitioners meet the set standards, they are incentivized to recognize the achievement and encourage better performance. Failure to meet the standards may however lead to punishment by withholding the incentives. Quality measures and payment for performance may promote better performance by the practitioners who aim to get the reward although it may lead to patient dumping which results in a poorer outcome of care (Kyeremanteng et al., 2019).

The quality measures and payment for performance have revolutionized nursing practice. It outlines the performance indices that the nurses work towards. In an attempt to meet the measures, the nurses engage in continuous education that helps them adopt evidence-based practices and collaborations in healthcare (McIntyre & Song, 2019). The quality of nursing services is therefore improved, patient safety enhanced, and outcome of care promoted.

Nursing Leadership and Management

            The adoption of technology in care and the legislation changes has affected the approach to nursing leadership and management. The nurses are expected to be equipped with nursing informatics that will enable them to operationalize the technologies and educate patients on the use of the technologized systems (Specchia et al., 2021). It may require advancement in nursing education with a focus on nursing informatics to prepare the nurses for their changing roles in the face of technology (Anders et al., 2021). Adoption of these technologies would improve service delivery and therefore minimize adverse healthcare outcomes such as medical errors.

The legislation on healthcare is those that recommend a multidisciplinary approach to care and increased involvement of the patients in their treatment process. Such legislation may require the nurses to engage and participate in healthcare teams that manage the patients and also cooperate with other stakeholders in the healthcare system to improve service delivery to the patient (Tracy et al., 2020). Given the changing roles of nurses and possible new demands on nursing leadership, the nurses may change their leadership styles to accommodate the changing roles. For instance, they may adopt transformational leadership to enhance their participation in educating the patient or transcultural leadership to enhance their understanding of cultural changes in healthcare (Specchia et al., 2021). Change in leadership would further enable them to coordinate and communicate with their subordinates, cooperate with other stakeholders and even lead the healthcare teams.

Emerging Trends

            Emerging trends in healthcare are evident in the increased adoption of technology in care. For instance, there has been the invention of the closed-loop system for diabetes management. The system automatically regulates insulin administration to the patient depending on the blood glucose levels (Yatsu & Saeki, 2022). It, therefore, prevents adverse events such as overdose or underdose and missed doses that may trigger hypoglycemia or hyperglycemic emergencies respectively. The use of telemedicine is another trend that has improved access to care for patients in remote locations (Specchia et al., 2021). These trends have improved the quality of healthcare delivered to patients.

There is a recent shift in healthcare delivery from hospital-based services to ambulatory and home-based care. In light of these changes, I project that nursing care will also have to move from hospital-based care to nurse-led clinics and nursing ambulatory services where they attend to patients from out of the hospital. This change may also lead to change in a nursing role where the nurses will be more engaged in facility leadership than in the past. Nurses should therefore be trained in the emerging trends to prepare them for their emerging roles.


            In conclusion, healthcare delivery models guide the healthcare provider on their roles to the patients. They incorporate changes in healthcare laws to revamp the workforce and even change the payment models to value-based payment systems that promote the quality of care provided. The emerging laws and trends may also change the roles of nurses in healthcare necessitating modification of nursing training to prepare them for the changes in roles. Training of nurses should therefore consider the emerging trends in technology and healthcare delivery to provide an appropriate education for the nurses.




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