The need to deliver quality and affordable care implores stakeholders to continually enact legislations to reform and restructure the health care delivery system with the aim of attaining better outcomes. Nurses are critical players in these reforms and restructuring since they are patient advocates. The new delivery models emerge to offer quality care at the greatest value for patients and stakeholders like nurses (Gott, 2018). The purpose of this paper is to examine changes aimed at reforming or restructuring health care delivery system through a current law or federal regulations. The paper also discusses effect of quality measures and pay for performance in patient outcomes and nursing practice. The essay also discusses professional nursing leadership and management roles in response to emerging trends and in patient safety and quality care promotion.
Current or Emerging Health Care Law or Federal Regulation
The need to improve nursing education and practice is critical to care provision in the U.S. health care system. Imperatively, the Nursing Workforce Reauthorization Act 0f 2019 is essential as it would update, reauthorize and enhance critical programs to help grow and support the nursing workforce as one of the largest labor force in the country. The Nursing Workforce Reauthorization Act of 2019 focuses on enhancing nursing education, practice and programs to retain nurses to meet the growing national demand due to an aging population and subsequent retirement of baby boomers’ nursing generation (Merkley, 2019). The law offers many programs to nurse practitioners to enhance nursing care, services and improve the overall wellbeing of these practitioners. The focus of this act is to provide more accountability to the nurse and improve scope of practice to allow increased satisfaction in the profession and lead to better retention rates.
The act will assist in aligning the nursing field within its profession as nurse get opportunity to advance their education and serve in both rural and urban areas, especially among underserved populations and communities. The act ensures that nurses will have increased skills to practice based on their level of education, training, and specialty. The act implores nurses to be more accountable in their role as primary care providers, especially in rural and underserved communities (Congress.GOV., 2019). The act ensures that the American nursing workforce is well positioned to meet care need now and in the future and can address access to care challenges in the populations where they serve.
Quality Measures/ Pay for Performance
Economic changes are essential for health care delivery in the country to remain sustainable while offering quality patient care. The Centers for Medicare and Medicaid Services (CMS) develops measures to lower the cost of care and increase access. Pay for Performance is a component of quality measures aimed at rewarding healthcare entities and providers that focus on quality care and enhancing patient outcomes. Pay for performance stresses the important of quality of care and not quantity which increases the possibility of using best clinical practices and supports promotion of good health. Pay for performance increases transparency while encouraging providers to remain accountable and enhance their overall reputation.
Using data on quality measures established in collaboration with the Agency for Healthcare Research and Quality (AHRQ), organizations and providers get financial rewards for enhancing patient care and reducing costs. Through the intervention, CMS can hold organizations and providers accountable for their shortcomings. The pay for performance is a value-based model and uses patient satisfaction and proven best practices as quality measures. Hospitals and providers report quality metrics to the public using the Hospital Consumers Assessment of Health Plan Survey (HCAHPS), and quality measures associated with falls, infections, morbidity, and mortality in different patient settings (Lee & Nathan, 2018). Providers and organizations use the Healthcare Effectiveness Data and information Set (HEDIS) for reporting these measures in outpatient settings.
Nurses, including advanced practice registered nurses (APRNs), leaders and administrators have direct influence on quality programs and patient outcomes. Nurses should know and understand the current concepts on quality that include a selection of quality measure, data collection and measurement, data reporting and effective evaluation (Gott, 2018). Nurses need to be aware of and understand as well as promoted their roles and the impact they have on high quality patient care and outcomes. They need to advocate for resources, foster a safety culture, participate in policy and decision making concerning best practices and lead in the implementation of quality
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