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NUR 514 Topic 1 DQ 1 Discuss The Shift To Value-Based Health Care And Its Impact On The Roles And Responsibilities Of Advanced Registered Nurses

NUR 514 Topic 1 DQ 1 Discuss The Shift To Value-Based Health Care And Its Impact On The Roles And Responsibilities Of Advanced Registered Nurses

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Discuss The Shift To Value-Based Health Care And Its Impact On The Roles And Responsibilities Of Advanced Registered Nurses. What major evolving trends in the health care delivery system will affect your practice in the next 3-5 years, and how do you think advanced registered nurses will continue to influence the direction of health care?

 

CAMILLE

Re: Topic 1 DQ 1

Value-based health care implies that payment for medical care is dependent on positive patient outcomes. The goal is to contain the cost of medical care while reducing complications for patients (Huffman, 2021). The total joint replacement bundles are an example of value-based health care (Schardt et al., 2020). The orthopedic surgeon provides surgical intervention for an elective joint replacement that follows surgical pathways for optimal outcomes. The advanced practice nurse may then follow up with the patient in an acute setting or office setting to monitor and provide early intervention to achieve optimal recovery. This reduces cost and leads to better patient outcomes and payment. The joint center advanced registered nurse leader participates in a collaborative team that develops protocols based on evidence to produce positive outcomes. The leader ensures protocols are followed by staff for beneficial patient outcomes. The advanced practice nurse educator is responsible for teaching direct care nurses the clinical pathways necessary for optimal outcomes. The acute care center of current employment has a Joint Center that performs in this manner to maintain cost-effective, efficient, quality care with the patient in mind. Huffman (2021) describes these elements in detail in her article. The suggestion is that nurse leaders assume a collaborative, innovative role to establish and maintain value-based care in their areas of practice.

In the next 3-5 years, many more patients will go home after surgeries. In the past, many spinal cases stayed overnight in the hospital. In the current environment, postop cervical spinal fusions and discectomies who meet the criteria for discharge go home the day of surgery with follow-up from a nurse practitioner. Total joints that are relatively low risk go home the day of surgery after meeting all discharge criteria. The health care system is moving towards home care with continued follow-up in the office with advanced practice registered nurses. Advanced practice registered nurses in various roles within the acute and community setting deliver cost-effective, quality care. This will continue into the foreseeable future to contain costs while providing safe, reliable, quality care to patients. The hope is that advanced practice nurses can continue to grow and expand their skills to provide care that encompasses the full extent of their education and skills.

 

 

References

 

Huffman, M. (2021). Value-based care: An executive briefing. Nurse Leader19(1), 82–86. https://doi.org/10.1016/j.mnl.2020.07.014

Schardt, K., Hutzler, L., Bosco, J., Humbyrd, C., & DeCamp, M. (2020). Increase in Healthcare Disparities: The Unintended Consequences of Value-Based Medicine, Lessons from the Total Joint Bundled Payments for Care Improvement. Bulletin of the Hospital for Joint Diseases78(2), 93–94.

RESPOND HERE (250 WORDS, 2 REFERENCES)

 

 

KRISTEN

Re: Topic 1 DQ 1

Value based healthcare is defined as the hospital or physician being paid based on the outcome of the patient care (NEJM Catalyst, 2017). This bases the “value” that a doctor or hospital is paid by the insurance company or Medicare on outcome-based practice. There are many positive things that can come from value-based healthcare. One example is the fact that the patient pays less money for better care (NEJM Catalyst, 2017). This allows the patient to have less out of pocket expenses related to healthcare for better care. If the provider must show outcomes of patient care, it also forces the providers to provide better care to the patient. This will eventually lead to better patient outcomes and better health promotion (NEJM Catalyst, 2017). The advanced practice registered nurse will provide care to the patient if they are working in a nurse practitioner role that requires billing to take place. This will affect the care that they give in the same way it affects other providers because it will be outcome based. This will allow for better care for the patient with the responsibility for care being on the practitioner. Initiatives have been created for the advanced practice registered nurse to provide better care for patient, therefore increasing positive outcomes for patients and reducing the amount of money that is required to be paid by the insurance company or the patient directly (Nilsson, Bååthe, Andersson, & Sandoff, 2017). Advanced practice registered nurses influence the way healthcare is going in a positive direction. Nurse practitioners are said to be more compassionate than some doctors because they have worked directly with patients over a series of steps of becoming an advanced practice registered nurse. This allows the practitioner to allow experience with direct patient care to guide their services that they are providing to patients in a practitioner role. With healthcare moving towards value-based healthcare, the advanced practice registered nurse will need to move with it and allow for better patient outcomes to drive their care.

References

NEJM Catalyst. (2017). What Is Value-Based Healthcare? Innovations in Care Delivery, https://catalyst.nejm.org/doi/full/10.1056/CAT.17.0558.

Nilsson, K., Bååthe, F., Andersson, A. E., & Sandoff, M. (2017). Value-based healthcare as a trigger for improvement initiatives. Leadership in Health Services, https://www.emerald.com/insight/content/doi/10.1108/LHS-09-2016-0045/full/html.

 

RESPOND HERE (250 WORDS, 2 REFERENCES)

 

 

La Shioma

Re: Topic 1 DQ 1

Today’s healthcare is in a state of complex constant change. With the passing of the Affordable Care Act in 2010, changes in healthcare have occurred that directly impact a patient’s ability to receive healthcare and preventative care. New healthcare delivery models have emerged in the hopes of providing quality care at the greats value to the patient (McNiff, 2018).

Economic changes are necessary for health care in the United States to be sustainable while providing quality patient care. With health care costs skyrocketing, methods were developed by the Centers for Medicare and Medicaid Services (CMS) to help reign in these costs. Pay for performance was developed to reward healthcare organizations and providers that are able to provide quality care and improve patient outcomes. Through data collection of quality measures established in collaboration with the Agency for Healthcare Research and Quality (AHRQ), providers and organizations are rewarded for improving patient care and lowering costs and holding organizations and providers who do not accountable for these shortcomings (McNiff, 2018). This value-based system is based on patient satisfaction and proven best practices. Quality metrics are reported to the public through the Hospital Consumer Assessment of Health Plan Survey (HCAHPS), care quality and delivery, and quality measures related to falls, infections, morbidity, and mortality, in the inpatient setting, and the Healthcare Effectiveness Data and Information Set (HEDIS), for outpatient settings (McNiff, 2018). All nurses, including Advanced Practice Registered Nurses (APRN’s) and administrators have a direct impact on quality initiatives and patient outcomes. With this, APRNs must be aware of current concepts on quality including selection of quality measures, data collection, data measurement and data reporting, and evaluation. Nurses will need to understand and promote their role and the impact they have on high quality patient care through advocating for the necessary resources, fostering a culture of safety, participation in decision-making regarding best practices, and leading and implementing quality initiatives.

The nursing profession is in a key position to transition health care reform and patient care models. The advent of these new care models that focus on preventative measures and health promotion across the continuum has brought about the emergence of new roles for nurses (Salmond & Echevarria, 2017). These new positions include, care coordinators, patient navigator, health coaches, virtual care nurses, bundled care coordinators, and nurse-managed care centers. All these roles are necessary as patient care becomes more complex and extends beyond the acute care hospital. Nurse managed health centers are run by nurse practitioners, nurse midwives, and public health nurses. Within these centers, nurses coordinating the care of patients along their health continuum, as patient care is transitioning away from acute hospital settings and into the communities, the patient is better assured of receiving the best evidence-based care resulting in optimal patient outcomes.

Future trends see a decrease in primary and specialty care physicians. To allow for patient coverage in this gap, healthcare delivery will shift to APRN’s and RNs to maintain public health coverage and access to care. Another trend occurring across the country is the development of Patient centered Medical Homes (PCMH). Many hospital systems are building these patient medical homes in rural areas to allow patients better access to care and many of these will be staffed and run by APRN’s and RN’s.

NUR 514 Topic 1 DQ 1 Discuss The Shift To Value-Based Health Care And Its Impact On The Roles And Responsibilities Of Advanced Registered Nurses

NUR 514 Topic 1 DQ 1 Discuss The Shift To Value-Based Health Care And Its Impact On The Roles And Responsibilities Of Advanced Registered Nurses

References

McNiff, P. (2018). Current trends in nursing practice. In Grand Canyon University (Ed.), Trends in health care: A Nursing perspective (1 ed). Retrieved from https://lc.gcumedia.com/nrs440vn/trends-in-health-care-a-nursing-perspective/v1.1/#/chapter/2

Salmond, S.W., &Echevarria, M. (2017, January). Healthcare transformation and changing roles for nursing. Orthopedic nursing, 36(1), 12-25. https://doi.org/10.1097/NOR.0000000000000308

Turner, C. (2018, April 3). How new nursing roles are shaping the future of healthcare [Blog post]. Retrieved from https://blog.meditech.com/how-the-newest-roles-in-nursing-are-shaping-the-the-future-of-healthcare

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Grading Rubric Guidelines

Performance Category 10 9 8 4 0
Scholarliness

Demonstrates achievement of scholarly inquiry for professional and academic decisions.

  • Provides relevant evidence of scholarly inquiry clearly stating how the evidence informed or changed professional or academic decisions
  • Evaluates literature resources to develop a comprehensive analysis or synthesis.
  • Uses valid, relevant, and reliable outside sources to contribute to the threaded discussion
  • Provides relevant evidence of scholarly inquiry but does not clearly state how the evidence informed or changed professional or academic decisions.
  • Evaluates information from source(s) to develop a coherent analysis or synthesis.
  • Uses some valid, relevant, reliable outside sources to contribute to the threaded discussion.
  • Discusses using scholarly inquiry but does not state how scholarly inquiry informed or changed professional or academic decisions.
  • Information is taken from source(s) with some interpretation/evaluation, but not enough to develop a coherent analysis or synthesis.
  • Little valid, relevant, or reliable outside sources are used to contribute to the threaded discussion.
  • Demonstrates little or no understanding of the topic.
  • Discusses using scholarly inquiry but does not state how scholarly inquiry informed or changed professional or academic decisions.
  • Information is taken from source(s) without any interpretation/evaluation.
  • The posting uses information that is not valid, relevant, or reliable
  • No evidence of the use of scholarly inquiry to inform or change professional or academic decisions.
  • Information is not valid, relevant, or reliable
Performance Category  10 9 8 4 0
Application of Course Knowledge –

Demonstrate the ability to analyze, synthesize, and/or apply principles and concepts learned in the course lesson and outside readings and relate them to real-life professional situations

  • Posts make direct reference to concepts discussed in the lesson or drawn from relevant outside sources;
  • Applies concepts to personal experience in the professional setting and or relevant application to real life.
  • Posts make direct reference to concepts discussed in the lesson or drawn from relevant outside sources.
  • Applies concepts to personal experience in their professional setting and or relevant application to real life
  • Interactions with classmates are relevant to the discussion topic but do not make direct reference to lesson content
  • Posts are generally on topic but do not build knowledge by incorporating concepts and principles from the lesson.
  • Does not attempt to apply lesson concepts to personal experience in their professional setting and or relevant application to real life
  • Does not demonstrate a solid understanding of the principles and concepts presented in the lesson
  • Posts do not adequately address the question posed either by the discussion prompt or the instructor’s launch post.
  • Posts are superficial and do not reflect an understanding of the lesson content
  • Does not attempt to apply lesson concepts to personal experience in their professional setting and or relevant application to real life
  • Posts are not related to the topics provided by the discussion prompt or by the instructor; attempts by the instructor to redirect the student are ignored
  • No discussion of lesson concepts to personal experience in the professional setting and or relevant application to real life
Performance Category  5 4 3 2 0
Interactive Dialogue

Replies to each graded thread topic posted by the course instructor, by Wednesday, 11:59 p.m. MT, of each week, and posts a minimum of two times in each graded thread, on separate days.

(5 points possible per graded thread)

  • Exceeds minimum post requirements
  • Replies to each graded thread topic posted by the course instructor, by Wednesday, 11:59 p.m. MT, of each week, and posts three or more times in each graded thread, over three separate days.
  • Replies to a post posed by faculty and to a peer
  • Summarizes what was learned from the lesson, readings, and other student posts for the week.
  • Replies to each graded thread topic posted by the course instructor, by Wednesday, 11:59 p.m. MT, of each week, and posts a minimum of two times in each graded thread, on separate days
  • Replies to a question posed by a peer

Summarizes what was learned from the lesson, readings, and other student posts for the week.

  • Meets expectations of 2 posts on 2 different days.
  • The main post is not made by the Wednesday deadline
  • Does not reply to a question posed by a peer or faculty
  • Has only one post for the week
  • Discussion posts contain few, if any, new ideas or applications; often are a rehashing or summary of other students’ comments
  • Does not post to the thread
  • No connections are made to the topic
  Minus 1 Point Minus 2 Point Minus 3 Point Minus 4 Point Minus 5 Point
Grammar, Syntax, APA

Note: if there are only a few errors in these criteria, please note this for the student in as an area for improvement. If the student does not make the needed corrections in upcoming weeks, then points should be deducted.

Points deducted for improper grammar, syntax and APA style of writing.

The source of information is the APA Manual 6th Edition

  • 2-3 errors in APA format.
  • Written responses have 2-3 grammatical, spelling, and punctuation errors.
  • Writing style is generally clear, focused, and facilitates communication.
  • 4-5 errors in APA format.
  • Writing responses have 4-5 grammatical, spelling and punctuation errors.
  • Writing style is somewhat focused.
  • 6-7 errors in APA format.
  • Writing responses have 6-7 grammatical, spelling and punctuation errors.
  • Writing style is slightly focused making discussion difficult to understand.
  • 8-10 errors in APA format.
  • Writing responses have 8-10 grammatical, spelling and punctuation errors.
  • Writing style is not focused, making discussion difficult to understand.
  • Post contains greater than 10 errors in APA format.
  • Written responses have more than 10 grammatical, spelling and punctuation errors.
  • Writing style does not facilitate communication.
  • The student continues to make repeated mistakes in any of the above areas after written correction by the instructor
0 points lost       -5 points lost
Total Participation Requirements

per discussion thread

The student answers the threaded discussion question or topic on one day and posts a second response on another day. The student does not meet the minimum requirement of two postings on two different days
Early Participation Requirement

per discussion thread

The student must provide a substantive answer to the graded discussion question(s) or topic(s), posted by the course instructor (not a response to a peer), by Wednesday, 11:59 p.m. MT of each week. The student does not meet the requirement of a substantive response to the stated question or topic by Wednesday at 11:59 pm MT.

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