Evolving Practice of Nursing and Patient Care Delivery Models

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The health care industry is experiencing several changes in contemporary times. For instance, the nursing practice is evolving and nurses go beyond the expected scope of work to enhance caring. With these evolving new care practices, the health care sector should concentrate on the continuum of care by focusing on exceptional nontraditional caring practices. This study will elaborate on the nontraditional caring practices of nurses in a bid to inform caregivers on how the nursing practice is expected to shape in this era where their exceptional services are in high demand. This objective will be achieved by analyzing the aspects of contemporary care such as the continuity of Accountable Care Organizations (ACO), nurse-managed health clinics, and medical homes.

Continuum of care

In the United States, the widely spread acute care hospitals depend on a huge number of the state’s registered nurses (Buerhaus, 2008). Due to the short-lived interactions of nurses and patients, the health care system has generated shortcomings like errors that undermine patient care outcomes. Due to the changing demands and structure of the healthcare industry in the US, it is predicted that the nursing sector will initiate new models that involve practicing with dignity, being present to take responsibility, and enhancing the wellbeing of patients. The emerging complexities arising in the health care sector require advanced medical education in a bid to ensure that nurses acquire critical thinking skills, technology integration, and nurse-patient engagement skills.

Accountable care organizations (ACO)

ACO is a partnership of caregivers, health centers, and other health experts with renewed attention on the patients’ needs, quality care, and affordable costs to patients. ACO is governed by defined statutory, which registered nurses have to adhere to, hence defining the commitment by ACO to ensure quality service delivery. ACO seeks to meet the best quality by advocating accountability, investing in technology, and engaging in capacity-building programs. ACO emphasizes patient-centered models, which ensures that caregivers take time to engage with patients. The ACO model gives nurse practitioners the opportunity to exercise key organizational leadership skills such as deciding on how to manage chronic diseases (Buerhaus, 2008).

Nurse-managed Health clinics (NMHCs)

The patient Protection and Affordable Care Act of 2010 (PPACA) has designed a new initiative to fund nurse-oriented health care centers targeting the provision of quality primary care and healing services, particularly for the less privileged or vulnerable people. This new program brings service to communities, thus creating nursing opportunities to learn new skills about primary care delivery, control of emerging diseases, nurse-patient relationship education, and the integration of technology. These new measures bring a highly effective and cost-friendly health care system that embraces positive patient responses. NMHCs provides nurses with the opportunity to exploit the full potential of their expertise, thus resulting in effective outcomes and value-oriented practice (Harrington & Estes, 2008).

Health homes

Medical homes are community-based programs aimed at providing patients with centralized primary care services by government-designated caregivers across different settings. These medical homes require nurses to encourage preventive care management. In addition, nurses help society in capacity building to ease the reliance on experts and emergency services. Health care homes involve a dedicated health team that should provide patient assessment and education coupled with maintaining a clear understanding of the patients’ current needs (Esperat, Feng, Owen & Green, 2005). In these homes, the focus is to achieve interpersonal interactions amongst caregivers, patients, and their families in a bid to ensure patient safety and quality care. Medical homes are intended to unlock the potential to change the way through which care is administered by establishing nursing models that suit certain environments coupled with factoring out new additions that should be targeted to ensure that care providers are involved in all endeavors geared towards effective care.

Summary of the feedback

After sharing the aforementioned expected changes in the health care delivery system, three nurse colleagues had numerous shared beliefs as well as divergent views on the matter. They expressed their consistent and compassionate nature to respond to patients even when they have to put their own priorities at stake for the well-being of their patients. The first respondent questioned the role of law and practice ethics, which are limited in scope in most cases. For instance, she referred to the case of disaster and emergency response in community settings. She questioned whether registered nurses have an ethical obligation to respond to disasters. Regardless of the situation, she claimed that nurses are driven by feelings of exceptional compassion together with care to respond willingly. The first respondent claimed that it is difficult for her to respond at times because the policy does not provide adequate security. She argued that the reforms advocating the continuum of care lacks sufficient professional ethical and legal security procedures for the nursing practice in times of crises. In addition, she claimed that some health organizations, for instance, require nurses to demonstrate accountability, but they do not consider the emotional and legal protection involved.

The second respondent acknowledged that the said reforms were positive and they cover a wide scope of engagement. However, he criticized the legal system by arguing that it has affected the nurses’ decisions to respond to certain cases. He claimed that the ACO’s requirements, which demand nurses to adhere to certain standards, affect the nurses negatively. He claimed that this approach creates insecurity especially when alternative assurance systems for nursing practice are lacking. In addition, he claimed that nurses should feel comfortable and respected. In response, they are motivated to demonstrate dignity and equality, which eliminates health care differences within a given society. He argued that the flexibility and versatility of the anticipated programs like the medical homes increase passionate commitment to the populations that are served.

The last respondent argued that the anticipated reforms would bring the necessary addition to cover the gaps that have been persistent in the health care delivery system. He claimed that the medical homes’ approach provides services to communities, which ends the shortage of acute care services in different areas. According to him, the nurse-managed clinics are a huge milestone towards empowering the nursing professionals. Giving nurses the opportunity to plan and strategize on how to initiate preventive care and manage chronic diseases creates a room for creativity and accountability (Harrington & Estes, 2008).Self-organization enables teams to establish how to administer care in the best way possible based on the patients’ requirements and team capacity. He implied that the time to implement such changes has come because nurses have an array of opportunities to steer the desired changes in the evolving health care system. This assertion implies that collaboration by ACO is crucial as it brings together nursing professionals, policymakers, service providers, and the community to bridge the gaps in the health care industry.


In general, the feedbacks given by the three nursing colleagues are complimenting the reform models discussed earlier in this paper. Although the first and second respondents express their concerns about the deficiency of the existent legal system, these views are just but additional segments, which are either not sufficiently incorporated or are been overlooked. They share common belief about responding to patient needs within a model that embraces creativity, technology, and service that extends the scope of the current hospital setting. They all agree that the stated reforms have these elements as well as the medical homes will enable continued link of patients to care teams even through websites. This scenario will help patients to manage their own care as well as make informed choices on the kind of care they need, thus easing the work of the nurses especially during emergency cases (Bent, Moscatel, Baize, & McCabe, 2007).


The contemporary nursing practices are shaping the future’s health care delivery by designing models that are quality centered, affordable, and accessible for people in dire need of health care services. Giving nurses the responsibility to address community needs by bridging the gap between preventive and basic care services gives nurses firsthand information in understanding the health concerns of different populations in different set ups. However, in a bid to ensure that the health sector implements the desired reforms, the policymakers must recognize the impact made by nurses. Consequently, policymakers should incorporate such ideas in the decision-making process for cases that involve nurses during the implementation process.


Bent, K., Moscatel, S., Baize, T., & McCabe, J. (2007). Theory of Human Caring in 2050. Nursing Science Quarterly, 20(4), 331-335.

Buerhaus, P. (2008). Current and Future State of the US Nursing Workforce. Journal of the American Medical Association, 300(20), 2422-2424.

Esperat, C., Feng, D., Owen, D., & Green, A. (2005). Transformation for Health: A framework for health disparities research. Nursing Outlook, 53, 113-120.

Harrington, C., & Estes, L. (2008). Health policy: Crisis and reform in the U.S. health care delivery system. Sudbury, MA: Jones and Bartlett.

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NursingBird. 2022. "Evolving Practice of Nursing and Patient Care Delivery Models." April 8, 2022. https://nursingbird.com/evolving-practice-of-nursing-and-patient-care-delivery-models/.

1. NursingBird. "Evolving Practice of Nursing and Patient Care Delivery Models." April 8, 2022. https://nursingbird.com/evolving-practice-of-nursing-and-patient-care-delivery-models/.


NursingBird. "Evolving Practice of Nursing and Patient Care Delivery Models." April 8, 2022. https://nursingbird.com/evolving-practice-of-nursing-and-patient-care-delivery-models/.