NUR 514 Topic 1 DQ 1 AND 2 GLADYS Essay

NUR 514 Topic 1 DQ 1 AND 2 GLADYS Essay

NUR 514 Topic 1 DQ 1

The evolution of the health care system in the United States continues to create new care delivery models aimed at affordability, value-proposition, and improving the quality of care. Traditionally, the system was disease-focused and based on fee-for-service where providers were paid for each service offered. However, the model led to overuse of services and a rise in healthcare costs without necessarily improving quality and patient outcomes (DeNisco, 2021). As such, providers were compensated based on quantity and not quality.


In recent times, the evolution has focused on value-based healthcare where the aim is to offer quality care to patients based on outcomes and not volume. Under this model, providers get incentivized to improve patient health, reduce the impacts and incidences of chronic diseases, and promote healthier living in an evidence-based manner. The enactment of the Affordable Care Act (ACA) in 2010 heralded the start of innovative care models like the value-based healthcare as a core component of accountable care. According to the Centers for Medicare and Medicaid Services (CMS), value-based care has three primary goals that include better health for individuals, public health in populations, and lowering costs of healthcare for all (Teisberg et al., 2019). The implication is that there is a rise in demand for healthcare services across populations.

The shift to value-based care has had impact on delivery by increasing access and lowering costs thus increasing the role and responsibilities of advanced registered nurses who are at the pivotal point in care provision. As primary care providers and patient advocates, advanced practice registered nurses (APRNs) work alongside physicians to meet the diverse healthcare needs of different populations, especially those with chronic and lifestyle conditions (Agba et al., 2022). To deliver care, APRNs must work collaboratively with other providers through integrated approaches with roles in health promotion, disease prevention and management of chronic conditions. The APRNs also have roles in advocacy, leadership and policymaking and implementation.

Different evolving trends in health care delivery system will impact nursing practice. These include the increased focus on primary care or disease prevention, the rise in healthcare technologies’ use, and nurses being recognized as primary healthcare providers through full practice authority in many states. The rise in primary care demand and need for population health management will imply that APRNs should focus on specialization and deliver care based on innovative models like value-based approach (DeNisco, 2021). The APRNs will influence this direction through being leaders, through advocacy, and policymaking at different levels of government.

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Agba, C. O., Snowden-Bahr, J. D., Kadakia, K., Chaker, S. A., Young, J. B., Forystek A. G.,

(2022). Global horizons for value-based care: Lessons learned from the Cleveland clinic. NEJM Catalyst, 3 (5)

DeNisco, S. M. (Ed.). (2021). Advanced practice nursing: Essential knowledge for the profession

            (4th ed.). Jones & Bartlett Learning. ISBN-13: 9781284176124

Teisberg, E., Wallace, S., & O’Hara, S. (2019). Defining and implementing value-based health

care. Academic Medicine, 95(5), 682–685.

Topic 1 DQ 2

At the core of systems thinking is a holistic approach or model that considers organizations as complex, interconnected bodies as opposed to being a collection of individual components. Through this perspective, leaders understand the relationship and interactions among different components of the system to enable them make informed decisions and develop stronger inter-professional and organizational interactions (Bodine, 2023). The systems thinking model espouses that a holistic approach to solving problems begins with collaboration among the different people in the system. System thinking helps nurse leaders in making better decisions that confer benefits to the entire organization, and leads to increased efficiency as nurses identify inefficiencies or bottlenecks within their operational environment (DeNisco, 2021). Again, systems thinking leads to enhanced understanding by allowing leaders to consider the bigger picture and understand how changes in on part impact other areas of the entire system. The understanding enhances communication and collaboration among different professionals.

Nurse leaders can deploy different systems thinking tools to enhance inter-professional collaboration and improve patient outcomes and organizational initiatives. These include causal loop diagrams that help visualize the interactions among the different aspects of the system and how they impact each other, and systems maps. These maps offer a visual representation of the system, demonstrating the connection between different parts (Henry, 2023). The leaders can also use simulation modeling tool that allows leaders to test various scenarios and decipher their possible impact on the system.

The incorporation of inter-professional education collaborative (IPEC) model is essential as it allows nurses leaders to use the competencies that it advances. These competencies include values and ethics, roles and responsibilities, inter-professional communication, teams and teamwork. Nurse leaders can incorporate these competencies into their practice to improve knowledge about their roles and responsibilities, enhance values and ethics and communication as well as effective teamwork for quality care delivery (Wakefield et al., 2021). For instance, value and ethics considerations ensures that nurses and nurse leaders make decisions in the best interest of patients and the organization.


Bodine, J. (2023). The Future of Nursing 2020–2030: Charting a Path to Achieve Health Equity:

Implications for Preceptor Development. Journal for Nurses in Professional Development, 39(2), 115-116. DOI: 10.1097/NND.0000000000000975.

DeNisco, S. M. (Ed.). (2021). Advanced practice nursing: Essential knowledge for the profession

            (4th ed.). Jones & Bartlett Learning.

Henry, T. A. (2023 May 1). Why you need to be a systems thinker in health care.

Wakefield, M., Williams, D. R., & Le Menestrel, S. (2021). The future of nursing 2020-2030:

            Charting a path to achieve health equity. National Academy of Sciences


Topic 1 DQ 1

Assessment Description

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.

Topic 1 DQ 2

Assessment Description

Based on your experience, explain how systems thinking helps leaders to build strong interprofessional and organizational relationships. Discuss some system thinking tools nursing leaders can apply to increase interprofessional collaboration to benefit patient outcomes or organizational initiatives. Make sure to incorporate the Interprofessional Education Collaborative (IPEC) competencies in your response.

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