NUR-514 Topic 1 DQ 1: Health Care Systems, Organizational Relationships, and Interprofessional Health Care Environments
Consider the evolution of the U.S. health care system. Discuss how the shift to value-based health care has impacted delivery of care and the role and responsibilities of the advanced registered nurse. Project what major evolving trends in the health care delivery system will affect nursing practice and how advanced registered nurses will influence the direction of health care.
Contemporary Health Care Structure
Discuss the relationship among structure, profession, practice, and the individual in ways that reflect contemporary health care structure.
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How does this look different for nurses, educated at the level of an advanced practice registered nurse (APRN) – (Certified Nurse Midwife, Clinical Nurse Specialist, Certified Registered Nurse Anesthetist, or Nurse Practitioner) compared to nurses, educated at the level of an advanced registered nurse (APN) – (Educator, Public Health, Informatics, Leadership, or Administration)?
LGBTQ+ Care: Training and Resources for Nurses
The modern healthcare framework places a strong emphasis on patient-centered care, career development, and progression for all healthcare practitioners. According to Bradley et al. (2018), contemporary healthcare also acknowledges the coexistence of disease and wellness. It regards health as a dynamic state in which the mind, body, and spirit function harmoniously. The profession and all stakeholders strive to enhance the multifaceted roles of patients.
As highlighted by Souliotis (2016), the current healthcare definition places great importance on recognizing patients’ active efforts and contributions to their own well-being. By actively participating in decision-making, patients exercise their autonomous rights and demand high-quality and satisfactory services. Advanced practice registered nurses (APRNs) play a pivotal role in delivering patient-centered direct services aimed at improving patient wellness. They provide specialized and direct healthcare services while ensuring culturally-competent care for patients.
In the realm of healthcare, educators, public health professionals, informaticists, leaders, and administrators are all dedicated to providing support for patients and their fellow nurses. Educators ensure that all stakeholders possess essential knowledge of treatment procedures. In the face of current technological advancements and policy reforms, Dumit (2017) emphasizes the critical need for continuing education among practitioners. Informaticists play a crucial role in ensuring competence with the technology used to support patient care. Meanwhile, leaders and administrators are responsible for establishing and implementing policies that guide nurse practitioners in delivering top-notch care while fostering fulfilling careers.
However, regardless of the variations in practice structures within these different categories, the patient always remains at the heart of healthcare practice. The overarching theme is to promote fullness in life and overall wellness. Health-related issues are observed from an individual perspective, even in cases of chronic illnesses, where individuals can still experience health, and nurses find satisfaction in their roles and contributions to societal well-being. In the contemporary healthcare system, all stakeholders are open to learning and gaining new experiences.
Organizational Relationships:
The healthcare delivery structure is significantly influenced by various factors, including the political climate, economic development, technology, social and cultural values, environment, demographics, and global influences. These factors contribute to the shifting focus within the US healthcare delivery system, transitioning from illness to wellness, acute to primary care, individual to community well-being, fragmented to managed care, independent to integrated systems, and from duplication to a continuum of services.
These trends are driven by the goal of promoting health while reducing the cost of healthcare. Consequently, midlevel health professionals and health coaches collaborate with medical professionals to enhance the effectiveness and efficiency of care.
Physicians, advanced practice nurses, therapists, and other healthcare professionals may possess a deep understanding of their clinical roles but might not fully comprehend the external forces that can significantly impact current and future clinical practices. This underscores the importance of promoting interprofessional education and collaboration (DeNisco, 2021).
Advanced practice registered nurses, including nurse practitioners, clinical nurse specialists, nurse midwives, and nurse anesthetists, are striving to expand their scope of practice to become independent practitioners, meeting regulatory requirements without the need for direct supervision. Other advanced nurse practitioners, such as clinical nurse leaders and educators, seek to better evaluate the implications of healthcare policies and understand how they relate to healthcare delivery services.
NUR-514 Topic 1 DQ 1: Health Care Systems, Organizational Relationships, and Interprofessional Health Care Environments References:
DeNisco, S. (Ed). (2021). Advanced practice nursing: Essential knowledge for the profession (4th Ed.). Jones and Bartlett Learning
REPLY
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Again, Welcome!
Over the past two years, the healthcare system in the United States, as well as healthcare systems worldwide, has undergone rapid and substantial transformations in response to the COVID-19 pandemic. This crisis has brought to light the vulnerabilities of our healthcare system, despite the considerable technological advancements and medical progress in patient care, disease prevention, and treatment.
The pandemic has not only exposed the shortcomings of our healthcare system but has also underscored the public health challenges many Americans face. It has revealed issues related to poor patient care outcomes and the prevalence of chronic illnesses among Americans, which strain hospital costs and healthcare resources, resulting in extended wait times in emergency rooms. The pandemic has unveiled the fragility and weaknesses of our healthcare system.
Addressing these issues requires a thorough overhaul of how we approach patient treatment and the enhancement of health outcomes. A significant proportion of Americans suffer from chronic health conditions, driving up healthcare costs and putting pressure on our healthcare resources. In light of these challenges, there has been a shift towards improving patient health outcomes through holistic approaches and treating patients as a whole. Furthermore, the Affordable Care Act has pushed for the implementation of value-based healthcare initiatives, where healthcare providers are compensated based on patient health outcomes.
The value-based healthcare model aims to achieve better outcomes, efficient and effective patient care, cost control in the hands of patients, reduced recidivism rates, and an overall improvement in societal health. Advanced nurses are poised to play a pivotal role in this transformation, working closely with communities and patients to improve their health outcomes. They will reinforce health education, guide individuals to healthcare resources, reach out to vulnerable communities lacking healthcare access, assist people in finding resources for disease prevention and treatment, and establish strong relationships and visibility within underserved communities, especially those grappling with poverty and healthcare disparities.
I wholeheartedly agree that our healthcare system is in dire need of revamping, particularly in addressing the significant issue of health inequality. In my role at a major healthcare system in North Phoenix, we provide services to nearby Native American Tribes, such as the Navajo tribe. The Navajo Nation faces numerous health disparities due to isolation, lack of transportation infrastructure, limited government healthcare funding, inadequate infrastructure (including clean water, plumbing, and electricity), and limited educational opportunities.
Patients from the Navajo Nation who require specialized care are often transported to hospitals far from their reservation, leading to isolation from their families and limited communication. As a leader in the acute care setting, we can explore opportunities to provide resources to the Navajo Nation. For example, we can organize multidisciplinary teams, comprising nurse practitioners, RNs, providers, dietitians, pharmacists, and respiratory therapists, to establish temporary clinics focused on health education, prevention, and the management of chronic diseases like diabetes and heart disease.
When caring for Native American patients in the hospital, it is crucial to equip the medical care team with the tools to communicate effectively and to have an understanding of their culture in order to provide information and support for making informed decisions. The Office of Minority Health (OHM) has set standards to adapt care to accommodate language and culture, recognizing the importance of providing culturally competent care.
The Navajo Nation is a glaring example of where the U.S. healthcare system has failed, contributing to health inequality by not addressing poverty and failing to provide safe living environments, infrastructure, and access to healthcare. Looking at global perspectives and diversity issues in healthcare, we can gain a deeper understanding of health equity, particularly in impoverished regions like the Navajo Nation. The top 25 wealthiest nations, excluding the U.S., offer some form of universal healthcare coverage, considering access to healthcare as a basic human right.
Studies, such as one by the RWJF, demonstrate that eliminating health disparities would substantially reduce healthcare costs, underscoring the importance of equal healthcare access for all communities in the United States. This highlights the pressing need for equitable healthcare access for all.
NUR-514 Topic 1 DQ 1: Health Care Systems, Organizational Relationships, and Interprofessional Health Care Environments References
Braveman, P., Gottlieb, L., Francis, D., Arkin, E., & Arcker, J. (2019, November 12). What can the health care sector do to advance health equity? Robert Wood Johnson Foundation. Retrieved September 24, 2022, from https://www.rwjf.org/en/library/research/2019/11/what-can-the-health-care-sector-do-to-advance-health-equity.html
DeNisco, S. M. (Ed.). (2021). Advanced practice nursing: Essential knowledge for the profession (4th ed.). Jones & Bartlett Learning. ISBN-13: 9781284176124
Nez, J. (2020, July 17). The Navajo Nation – United States Commission on civil rights. U.S Commission of Civil Rights. Retrieved September 25, 2022, from https://www.usccr.gov/files/2020/2020-07-17-Jonathan-Nez-Testimony.pdf
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