How DNPs Can Influence Healthcare Quality and Cost

Introduction

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 and improve clinical outcomes in a number of ways. This paper reviews the relevant literature to discuss the various ways in which nursing leaders can influence healthcare cost, policy, and delivery of care. In addition, it addresses the responsibility of DNP-prepared leaders to educate patient care team members on the financial implications of patient care decisions, along with salient examples of effective teaching methods for a clinical setting. Finally, a summary of key findings concerning the ways DNPs can influence the quality of healthcare is presented in the 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 — and DNPs may not always 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 competencies and standards developed by the American Association of Colleges of Nursing. Regardless of their area of specialization, DNPs can influence healthcare cost, 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 unnecessary medications or treatments (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 used by DNPs can help identify opportunities for improvement in areas that directly enhance the quality of healthcare services while also reducing associated costs (Sherrod, 2016). Most DNPs receive training in optimal methods for collecting, analyzing, and interpreting healthcare-related data, including clinical outcomes and associated costs (Sherrod, 2016). The findings that emerge from these analyses can generate new insights into constraints to quality patient care that might not be discoverable otherwise. In addition, DNPs can analyze healthcare processes to identify inefficient or even counterproductive practices in the delivery of care (Rumsey, 2019).

Analytical Tools and Process Improvement Strategies

While every healthcare organization's circumstances are unique, DNPs can use their analytical skills to identify constraints and develop strategies to improve clinical outcomes (Rumsey, 2019). Many of the same analytical tools 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 of strategies for reducing costs while simultaneously 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 could benefit from the growing body of scholarship concerning their application in other settings.

The value of these analytical methods lies in 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 found that the use of Lean Six Sigma methodology can help tertiary healthcare facilities reduce waste in current processes while developing sustainable improvements in the delivery of patient care.

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 only a few examples of what has proven effective in the past. These approaches should not limit DNPs but should instead serve as a springboard for developing their own innovative, organization- or situation-specific strategies based on unique needs and circumstances.

Conclusion

Taken together, it is clear that DNPs can have a profound influence on reducing healthcare costs and developing timely, 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 help ensure that healthcare services remain patient-centered and evidence-based. As noted above, while these types of activities may not be reflected in DNPs' job descriptions, the competencies and standards for the profession developed by the American Association of Colleges of Nursing require graduates to assume leadership roles in healthcare settings.

References

Androus, A. B. (2023). What are some ways nurses can influence healthcare organization costs? Registered Nursing.org. Retrieved from https://www.registerednursing.org/articles/what-nurses-can-influence-healthcare-organization-costs/

Borck, J. C., Meyer, D. D. C. A., Gettrust, L. D. A.-B., & Novalija, J. C. (2022). Escape the OR: A novel teaching strategy to promote interprofessional learning and teamwork. Nursing Management, 53(2), 28–35.

Breslin, S. E., Hamilton, K. M., & Paynter, J. (2014). Deployment of lean six sigma in care coordination: An improved discharge process. Professional Case Management, 19(2), 77–83.

Echeverry, L. M., Lamb, K. V., & Miller, J. (2015). Impact of APN home visits in reducing healthcare costs and improving function in homebound heart failure. Home Healthcare Now, 33(10), 532–537.

O'Toole, E. (2019). Healthcare in the 21st century. Nurse Practitioner, 34(7), 46–50.

Rumsey, C. M. (2019). Short-stay palliative pain management for Southwestern VA: Process improvement plan. Journal of Hospice and Palliative Nursing, 21(6), 489–495.

Sherrod, B. (2016). Higher learning: DNP-prepared leaders guide healthcare system change. Nursing Management, 47(9), 13–16.

Tovar, E. G., & Warshawsky, N. (2015). Use of a problem-based learning exercise to teach the lean 8-step problem-solving method. Nurse Educator, 40(2), 101–104.