Jun 7, 2019 in Research

Health Care

The health care sector has been undergoing significant changes over the years. However, the pace of changes has skyrocketed in the past 10 to 15 years as exhibited by numerous developments in technology and patient safety. According to Best et al (2012), the changes in the sector have been anchored in factors such as the passage of the National Healthcare Reform Act or the Patient Protection and Affordable Care Act and the recommendations suggested by the Institute of Medicine Future of Nursing report. Thesis: The Patient Protection and Affordable Care Act of 2010 and the Institute of Medicine (IOM) Future of Nursing report have caused significant changes in the healthcare sector through their recommendations on issues such as costs and technology.  

Impact of PPACA and IOM on the Forces Driving Changes in the Health Care Sector

The National Healthcare Reform Act better referred to as the Patient Protection and Affordable Care Act (PPACA) of 2010 is a comprehensive health reform meant to expand health care coverage, control health costs, and improve health care delivery to the American people. Blumenthal, Abrams, and Nuzum (2015) opine that the passage of the Patient Protection and Affordable Care Act represents one of the most significant health care reforms in the history of the U.S. health care industry. 

The Institute of Medicine (IOM) Future of Nursing report highlights a number of recommendations for the nursing profession that will make it possible for nurses, the largest segment of the health care workforce, to respond effectively to many changes taking place in the health care sector. The Institute of Medicine (2010) includes some of the recommendations such as ensuring that nurses are able to practice their nursing skills to the full extent of their education and training, improvement of nursing education by asserting the necessity of nurses to get higher education and training, and enabling nurses to assume leadership positions.  

Both the Act and report have had an impact on the five categories of change identified earlier and highlighted below.

Cost

Foster (2010) asserts that PPACA has brought health care costs under control.  For example, the provision for creation of bodies like Accountable Care Organizations prevents doctors from charging patients for everything that they do during treatment. In addition, the concept of bundle payments generates a single fee for treatment despite the number of tests conducted on a patient.  The health care law also reduces provision of minimum benefits and minimum value for plans. Another relevant way by which this health law reduces cost is the provision of the dollar limit which prevents insurers from imposing a dollar limit on essential care. Expansion of Medicaid has also been useful in decreasing health care cost by reducing the number of unpaid emergencies due to the lack of coverage. 

The primary impact of the Institute of Medicine (IOM) Future of Nursing report on cost is that it will ultimately reduce the expenses in the long run. The adherence to the recommendations of the report will bring nurses who are more efficient and thus able to provide better patient care and outcomes. Another relevant impact is that it will improve patient safety due to better trained nursing practitioners further reducing the health care cost. The prevention of the excess cost will result from endangering a patient requiring emergency treatment. Furthermore, it will also save cost that will arise due to any legal action that the family of the endangered patient may take. Another significant impact of the report causing the reduction in the cost is that it will improve care coordination among nurses due to improved training and education. 

 

Technology

According to Bardhan and Thouin (2013), PPACA has impacted technology by empowering health care Information Technology (IT) first. This has led to change in the business of health care provision across the country. It has also been useful in developing a new way of thinking for health care IT, a fact that has improved the overall quality of care provided in the health care sector. Secondly, the passing of the Patient Protection and Affordable Care Act has facilitated the provision of grants which have been approved to support implementation and adoption of health care information technology. Thirdly, various changes induced by the passage of the Affordable Care Act will cause a need for change in various information systems, further impacting on technology. Lastly, PPACA has compelled many health care providers, particularly in hospitals and clinics, to adopt better and more meaningful electronic health record technology. 

The Institute of Medicine (IOM) Future of Nursing report has encouraged the advancement in technology since it is necessary for the realization of various recommendations of the report. For example, there is a need for better data collection and infrastructure, which can be made possible by improving the forms of technology. This advancement in technology will create patient-centered care that will be less burdensome to nurses. 

Aging Population

PPACA impacts on the ageing population in a number of ways. Firstly, Blumenthal, Abrams, and Nuzum (2015) opine that seniors receive more Medicare benefits as a result of the health care law. Secondly, the Act has been instrumental in ensuring that drugs prescribed are more affordable. This is significant for the seniors whose drugs prescription list increases with age. Another impact of the Affordable Care Act on seniors is that it has increased preventive care coverage. As a consequence, seniors can have access to various preventive services and annual wellness visits without having to pay for them from their pockets. In addition, the health care law  is aimed at strengthening the emphasis on home and community-based care. This can be achieved by extending the list of states that allow for the enrollment of Medicaid. This is highly beneficial to the aging population as it ensures that they have a place where they can be cared for as they continue to age. 

The Institute of Medicine (IOM) Future of Nursing report impacts on the ageing population by improving the type of health care that they receive. According to Bardhan and Thouin (2013), this has been emphasized by the national change in health care needs. Currently, most health care needs are related to chronic conditions. The most affected are the seniors. This state of affairs requires better trained nurses since current nurses are skilled in treating mostly acute diseases and injuries. The recommendations provided by the report will facilitate the creation of an improved nursing team, enhancing the overall health care provided to the elderly. 

Diversity of Population and the Workforce

PPACA has had an obvious impact in terms of increasing the diversity of the population. To be more specific, it has critically affected the minority groupings that have been underrepresented in the health care act. Blumenthal, Abrams, and Nuzum (2015) note that there are various provisions in the health care law that deny health care access for some of the minority groups. Similarly, PPACA has equally underrepresented the minority workforce. Despite the fact that the health care act recognizes the significance of having an increase in diversity of the population and health care workforce, the impact of its programs is limited. 

The Institute of Medicine (IOM) Future of Nursing report provides improved ways of catering for the needs of the diversified population. It also promotes the diversity of the health care workforce by encouraging workers to develop skills that will enable them to meet the needs of the diversified population. 

Changing Disease Patterns and Treatment

PPACA has encouraged the development of methods for managing changing disease patterns and treatment as a result of its goal to improve the provision of health care. 

The impact of the Institute of Medicine (IOM) Future of Nursing report on disease patterns and treatment is that it has made it possible for nurses to coordinate disease patterns and treatment. This is due to its recommendation to improve nursing education and the skills level of nurses. Another influence is that it has made identification of disease patterns and treatment easier and effective among nurses. 

Impact of the Forces Driving Changes in Health Care on Nursing and Nurse Leaders

The above five forces driving changes in health care have an impact on nursing and nurse leaders as illustrated below.

Cost

The impact of cost on nursing and nurse leaders can be viewed from the perspective of both increasing and decreasing costs. For this reason, the impact can be positive or negative. Bardhan and Thouin (2013) reiterate that a decrease in cost of health care will increase the number of people able to access health care. The impact of this is that it will place a constraint on nurses and nurse leaders as the professionals strive to meet the needs of the increasing number of patients. Recent economic difficulties have led to a tremendous increase in the cost of health care for many people across the country, even after the significant health care reforms in the sector. This has made it difficult for many people to access health care. The impact of this on nursing is that it has reduced the drive for people to pursue the profession due to poor incentives. 

Technology

The impact that technology has had on nursing is that it has revolutionized the profession. According to Bardhan and Thouin (2013), technology has led to the creation of new models of care and working practices in nursing. This ultimately led to more effective methods of providing health care. For example, technological advancements have enabled quicker and more accurate methods of diagnosis. Moreover, nurses were enabled to manage patient data and information through the use of sophisticated information systems. Technological advancements and innovations have also helped improve patient safety.

Technology has eased the work of nursing leaders to a large extent. By easing a large part of operations necessary for nurses to provide health care, their jobs are being done faster, with more accuracy and productively. For this reason, nurse leaders do not have to spend a lot of time following up on the performance of their nurses and can thus focus on other important health care work. 

Aging Population

The impact of the ageing population on nursing is that it has led to improvement in the level of skills of health care professionals. Harrington and Heidkamp (2013) assert that this is due to the complexity of the ailments affecting this segment of the population, their increasing demand for health care, and the need to provide them with efficient care. For this reason, the level of training of care for the seniors has improved. It has compelled nurse leaders to adopt improved styles of leading their teams so as to guarantee that the most effective care is provided. However, it is imperative to note the constraint that the ageing population has placed on nursing. It has created a number of health challenges which have placed a higher demand on the nursing professionals and nurse leaders. Furthermore, the increase in the number of the ageing population is more likely to create shortage in the number of nursing care givers. 

Increasing Diversity of Population and the Workforce

Diversity in the population has complicated nursing. This is because the increasing diversity of the population makes it difficult to identify the most efficient methods of meeting the health needs of various segments of the population. On a positive note, it has led to development of specialization in nursing since this is the most effective way how the professionals can provide efficient health care. According to Curtis, deVries, and Sheerin (2011), specialization has led to creation of a team of nurses with expert knowledge in specific areas of health care, thus further boosting the level of care given to patients. Nurse leaders have had a struggle assembling nurse teams that can meet various needs as a result of the diversity. 

Changing Disease Patterns and Treatment

Changing disease patterns and treatment has posed challenge for nursing and nurse leaders. The changing disease patterns have affected nurses’ ability to diagnose diseases since it involves constantly finding new ways of doing so. This also applies to methods of treatment. Nurse leaders are continuously challenged with keeping their nurses up-to-date with the latest methods of diagnosis and treatment as a consequence of the change in disease patterns. 

Force Driving Change that Has the Greatest Challenge to My Work Place

Where I work, technology has proven to be the greatest challenge in ensuring optimal patient outcomes. One reason for this is its changing nature. My organization has been unable to follow the technological changes taking place in health care. Despite this, it has strived to secure the best technology possible for treatment and diagnosis of illnesses. Technology remains a challenge because of the high cost required to secure it. This has forced my organization to stick to some of the old ways of treatment. Furthermore, the high level of training for the staff as to the utilization of some technological advancements has become too expensive and time-consuming for the organization. The final technological challenge that my workplace is facing is the high cost of maintenance for some technology is expensive and requires a lot of expertise. 

Types of Nurse Leaders Needed to Shape a Preferred Future for the Profession

Given the predictions about the future of nursing, healthcare, and general future, the types of nurse leaders that the profession needs to shape a preferred future are those that can handle the anticipated changes and provide the most effective leadership possible. They must also be leaders who can handle the changes and pressure that may come with them. Nurse leaders must have the ability to inspire confidence in the team that they lead and be able to handle what the future will bring to the profession. Curtis, deVries, and Sheerin (2011) add that the changes that will be experienced in nursing require leadership that is capable of transforming not only the physical environment of work but also the beliefs and practices of those whom they lead. Furthermore, the types of nurses needed to shape a preferred future should be knowledgeable and skilled; these are the characteristics that can be acquired through improved training and education. Therefore, very strong and capable leadership is needed. 

These qualities of nurse leaders are also needed today. The reason for this is that the nursing profession is facing a number of challenges that require well-trained leaders to manage them. The above characteristics of nurse leaders can serve to propel the success of the profession not only in the future but also at present. 

Globalization will have an effect on the predictions made about the changes in the health care sector. For example, globalization can lead to development of an increasingly interconnected workforce that can span international borders and systems. This will positively impact on health care and the changes taking place since it will enable the workforce to effectively work together to manage these changes. 

Personal Reflection

I feel that these changes are inevitable and will take place despite the current situation in the health care sector or any barriers intending to stop them. I also find them necessary as they will enhance the health care sector in the end. They will have a positive influence on and improve the care provided to patients. Therefore, in my opinion, these changes will be effective. 

In order to guarantee the effectiveness of these changes in the health sector, the following recommendations can be considered. Firstly, it is necessary to collect data on how best they can be implemented. This should include the method, timing, and implementation model. My second recommendation is to identify possible barriers that will inhibit the success of these changes. This will lead to cost saving as it will prevent spending resources that will not return any investment. 

The course has shaped my current and future perception of myself as a leader. I have come to realize that a true leader is the one who is able to remain effective despite the changes taking place in their environment. 

Conclusion

Change is inevitable as it is a normal occurrence, even in health care. The forces driving changes in health care are highly diverse and unpredictable. Some of the most noticeable changes include laws aimed at reforming the sector and research reports with recommendations for implementation. Therefore, it is imperative for various stakeholders in this sector to find the best ways of managing these changes.

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