Nursing Practice Growth and Patient Care Delivery Models
This paper examines the expected growth and transformation of nursing practice in the context of healthcare system reform, focusing on emerging patient care delivery models including Accountable Care Organizations (ACOs), medical homes, and nurse-managed health clinics. It explores how factors such as rising healthcare costs, nursing shortages, and increasing patient demand are driving these changes. The paper also presents the perspectives of three nurse colleagues on the implications of these shifts—particularly regarding nursing education, leadership roles, and care coordination. Collectively, these perspectives highlight both the promise and the challenges of preparing nurses to assume expanded leadership responsibilities in a rapidly evolving healthcare environment.
- Introduction: Forces Driving Change in Nursing Practice: Healthcare reform drivers reshaping nursing responsibilities
- Emerging Patient Care Delivery Models: ACOs, medical homes, and nurse-managed clinics explained
- Continuity of Care in Future Nursing Practice: Multidimensional care coordination across providers
- Nurse Colleagues' Impressions of Evolving Practice: Three nurses react to nursing's changing future
- Implications for Nursing Education and Professional Development: Calls to overhaul curricula for leadership readiness
- Conclusion: Nursing education must align with transformed practice roles
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What makes this paper effective
- Combines conceptual analysis of emerging care delivery models with primary perspectives gathered from nurse colleagues, giving the paper both theoretical and experiential grounding.
- Organizes three distinct care models (ACOs, medical homes, nurse-managed health clinics) clearly and systematically before transitioning to stakeholder reactions, creating a logical two-part structure.
- Uses the continuity-of-care concept as a unifying thread that connects all three delivery models to a shared rationale, strengthening the paper's analytical coherence.
Key academic technique demonstrated
The paper effectively integrates practitioner viewpoints as informal qualitative data. By reporting and synthesizing the impressions of three nurse colleagues, the author demonstrates how professional dialogue can supplement literature-based argument—a technique common in reflective and practice-focused nursing scholarship.
Structure breakdown
The paper opens by identifying systemic drivers of change in nursing, then introduces three patient care delivery models in turn. A bridging section on continuity of care ties the models together conceptually. The second half presents three distinct nurse perspectives on the changes, with attention to nursing education and leadership readiness. A concluding synthesis reinforces the paper's central argument that nursing education must evolve alongside practice transformation.
Introduction: Forces Driving Change in Nursing Practice
The practice of nursing is expected to continue growing and changing given the reform initiatives taking place in the healthcare system. Some of the factors contributing to these changes include the restructuring of the healthcare delivery system, increased healthcare costs, rising demand for nurses, nursing shortages, and growth in the patient population. Given these factors, nurses are expected to assume a wide range of healthcare responsibilities because of the complexities involved in patient care delivery (Tiffin, 2012). As nursing practice continues to change and grow, new models of patient care delivery will emerge. Understanding these changes and the emerging care delivery models is essential to enhancing nursing practice.
Emerging Patient Care Delivery Models
One of the patient care delivery models that will emerge as a result of expected changes in nursing practice is Accountable Care Organizations (ACOs). ACOs entail collaboration between healthcare facilities, primary care clinicians, clinical specialists, and other healthcare professionals toward improving the quality and cost of care delivered to patients. Patient care delivery in the future will be increasingly dominated by ACOs, given the expanded shared cost savings between these organizations and Medicare programs (Haney, 2010). ACOs are likely to receive financial rewards and bonuses when they achieve established quality and savings objectives. The prominence of ACOs in future care delivery will be supported by the leadership roles assumed by their stakeholders in coordinating and implementing care, especially for disadvantaged populations.
Secondly, patient care delivery in the future will be increasingly shaped by medical homes, whose role will involve coordinating healthcare services across different settings and between different providers, particularly in primary care practice. While medical homes are similar to ACOs, their emphasis will be on care and services that fall specifically within the scope of nursing practice. Through medical homes, nurses will be recognized as crucial leaders and members of the healthcare team. The basis for the emergence of medical homes will be to provide and facilitate health promotion and preventive services in the primary care setting.
Third, the future of nursing practice will be significantly shaped by nurse-managed health clinics as a patient care delivery model. These are nurse-practice arrangements led by advanced practice nurses. The focus of nurse-managed health clinics will be the provision of comprehensive primary care services and wellness services to vulnerable and disadvantaged populations throughout the country. Because these arrangements are linked to educational institutions, social service agencies, and other health-related organizations, they will enable nurses to practice to their full professional scope. The enhanced nursing practice supported by nurse-managed health clinics will in turn contribute to better patient outcomes and value-oriented care.
Continuity of Care in Future Nursing Practice
The emergence of these patient care delivery models is also grounded in the concept of continuity of care. Unlike in conventional healthcare settings, continuity of care in future nursing practice will require multidimensional approaches, because patients' healthcare needs can rarely be met by a single professional in today's complex healthcare system (Gulliford, Naithani, & Morgan, 2006). Multidimensional patient care delivery models will continue to be developed to help meet patients' healthcare needs by integrating, coordinating, and sharing information among healthcare providers.
Conclusion
This presentation and the subsequent impressions of the three nursing colleagues demonstrate that nursing practice is expected to change and grow substantially, particularly because of the emergence of new patient care delivery models. The restructuring of the healthcare system driven by health reforms will continue generating changes that affect nursing practice. As shown in this discussion and in existing literature, nurses will increasingly assume roles in care management and coordination as they shift from the conventional responsibility of performing discrete patient care tasks (Nurse Oncourse Learning, 2013). This shift will have a profound impact on the continuum of care, as nurses will have the capability to practice to their full extent. Therefore, nursing education and other aspects of the nursing profession must undergo significant changes in order to support the evolving role of nurses and enhance their effectiveness in patient care delivery.
References
Gulliford, M., Naithani, S., & Morgan, M. (2006, October). What is "continuity of care"? Journal of Health Services Research & Policy, 11(4), 248–250.
Haney, C. (2010, June 9). New care delivery models in health system reform: Opportunities for nurses & their patients. Retrieved December 3, 2016, from
Nurse Oncourse Learning. (2013, December 9). Nursing: A new paradigm. Retrieved December 3, 2016, from https://news.nurse.com/2013/12/09/nursing-a-new-paradigm/
Tiffin, C. (2012, March 28). Beyond the bedside: The changing role of today's nurses. The Huffington Post. Retrieved December 3, 2016, from http://www.huffingtonpost.com/charles-tiffin-phd/nursing-school_b_1384285.html
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