Advanced Practice Nursing Strategies and Interventions for Improving Patient Care

How Doctors of Nursing Practice Can Influence the Quality of Healthcare

Today, doctors of nursing practice (DNPs) serve as nurse educators, researchers, and administrators as well as serving in vital healthcare leadership roles in their local communities, states and even nationwide. Consequently, DNPs are well situated to influence the quality of healthcare that improve clinical outcomes in a number of ways. The purpose of this paper is to review the relevant literature to provide a discussion concerning the various ways in which nursing leaders can influence healthcare cost, policy, and delivery of care. In addition, a discussion concerning the responsibility of DNP-prepared leaders to educate patient care team members on the financial implications of patient care decisions together with salient examples of effective teaching methods for a clinical setting. Finally, a summary of the research and key findings concerning the ways DNPs can influence the quality of healthcare are presented in the paper’s conclusion.

How Nursing Leaders Can Influence Healthcare Cost, Policy and Delivery of Care

Even though it may not be specifically reflected in their job descriptions or DNPs may not conceptualize their role in these terms, DNPs have a fundamental responsibility to contribute to improvements in the healthcare system in leadership roles pursuant to the set of competencies and standards developed by the American Association of Colleges of Nursing. Indeed, regardless of their area of specialization, DNPs can influence healthcare, policy and the delivery of care in a number of ways. For instance, DNPs can help reduce healthcare costs by promoting patient-centered, evidence-based strategies and interventions that focus on prevention as well as the elimination of medications or treatments that are unnecessary (Androus, 2023). Likewise, DNPs can influence the cost of healthcare by promoting interventions that reduce costly medical and medication errors (O’Toole, 2019).

With respect to healthcare policies, the analytical methods that are used by DNPs can help identify opportunities for improvement in areas that directly improve the quality of healthcare services as well as reducing its corresponding costs (Sherrod, 2016). For example, most DNPs typically receive training concerning optimal methods for collecting, analyzing and interpreting healthcare-related data including clinical outcomes and associated costs (Sherrod, 2016). The findings that emerge from these types of analyses can generate new insights into constraints to quality patient care that might not be possible otherwise. In addition, DNPs can analyze healthcare processes to identify inefficient or even counterproductive practices in the delivery of care (Rumsey, 2019).

While every healthcare organization’s circumstances are unique in some fashion, DNPs can use their analytical skills to identify constraints and develop strategies to improve clinical outcomes (Rumsey, 2019). In fact, many of the same analytical tools that are used in the business world have significant value in healthcare settings. For instance, lean methodologies and process improvement strategies such as Lean Six Sigma and total quality management can facilitate the implementation and administration of strategies for reducing costs while concomitantly improving patient care (Tovar & Warshawsky, 2015). Although the use of these business management strategies in healthcare settings is not new, they remain largely underutilized by DNPs who can benefit from the growing body of scholarship concerning their application in other settings.

The value of these types of analytical methods is their ability to single out those constraints to patient care that are most amenable to cost-effective interventions. For example, a study by Breslin et al. (2014) determined that total quality improvement played a key role in “preventing costly readmissions and improving outcomes for patients through better transitions of care from the hospital to the community” (p. 83). Similarly, the Breslin et al. (2014) study also found that the use of Lean Six Sigma methodology can help tertiary healthcare facility reduce waste in their current processes while developing sustainable improvements in the delivery of patient care.

Further, DNPs can also reduce the costs of healthcare services while also improving the quality of patient care through the use of home visits that might not be practicable for other practitioners. For instance, a study by Echeverry et al. (2015) concluded that, “By providing quality primary care in the home setting, [DNPs] can treat homebound patients effectively and decrease the number of hospitalizations, 30-day readmissions, and emergency department visits” (p. 533). Moreover, the Escheverry et al. (2015) study also identified significant improvements in physical functionality and quality of life as well as a reduction in the frequency of the symptoms reported by participants over the course of 3 months.

In sum, DNPs can draw on a wide array of analytical tools and methodologies to influence healthcare costs, policies and the delivery of patient care. It is important to note, however, that the foregoing strategies and interventions are just a few examples of what has proven effective in the past. These approaches should not limit DNPs but should rather serve as a springboard to developing their own innovative strategies that are organization- or situation-specific based on their unique needs and circumstances such as those described below.

Examples of Effective DNP Teaching Methods for a Clinical Setting

Although it ravaged and overwhelmed the nation’s healthcare system, a positive result from the Covid-19 pandemic was the enhanced expertise it provided practitioners in using remote learning and collaborative technologies. This outcome means that DNPs can use online applications to supplement traditional teaching methods in clinical settings. This approach can include recorded training sessions organized by topic or theme as well as various online modules, videos, and other digital resources to provide timely instruction in a wide range of clinical skills.

In addition, DNPs can leverage their experience, training and expertise in their specialty area to help others learn about the most recent advances in delivering evidence-based, patient-centered care. For this purpose, DNPs can use hypothetical scenarios that involve commonly encountered clinical challenges or other situations that require efficacious nursing interventions. In fact, these types of teaching strategies are currently being applied using the popular “escape room” format that requires participants to determine the problem and formulate appropriate treatment strategies. This approach has demonstrated effectiveness in helping participants collaborate in interdisciplinary settings (Borck et al., 2022).

Conclusion

Taken together, it is clear that DNPs can have a profound influence on reducing healthcare costs and developing timely and informed policies that improve the delivery of care. The research was consistent in showing that through collaboration with other healthcare practitioners, DNPs can help educate patient care team members concerning the financial implications of their patient care decisions. In addition, DNPs can also help ensure that healthcare services remain patient-centered and evidence-based. As noted above, though, while these types of activities may not be reflected in DNPs’ job descriptions, the set of competencies and standards for the profession developed by the American Association of Colleges of Nursing requires graduates to assume leadership roles in healthcare settings.