Interprofessional Organizational and Systems Leadership

Discussion

The passage of the Affordable Care Act (ACA) created health reforms in America and affected nursing practice in many ways. The ACA, also known as Obamacare, is a law that was approved in 2010 and it aimed to ensure that more people in the United States had health insurance coverage, improve the quality of health care, regulate health insurance, and reduce health care spending in the country (Galan, 2018). Nine years after the passing of the law, it remains at the forefront of healthcare issues. With more people having health insurance, this health reform created a significant impact on the nursing workforce. Currently, the rate of uninsured in the country is steady at the rate of 8.8% (Coombs, 2018). The ACA placed a high demand for nurses and nurse practitioners with more people having the means to seek for healthcare needs.

Now that more people have increased access to health care, many organizations are making modifications in their healthcare system’s delivery of care. Pittman and Scully-Russ (2016) stated that in response to the ACA, healthcare organizations are adopting concepts of moving staff to ambulatory and home care settings, generating new jobs that involve care coordination, and developing new modes of healthcare delivery to address consumerism. Some of the said changes are evident in the organization where I currently work. Northside Hospital, in response to the increasing demand for nurses, created a nursing residency program.

As a staff nurse on the med surg unit within the Northside Hospital system, one of my roles is to facilitate the training of the resident nurses. The residency program sponsors the training of new graduates with their choice of nursing specialty. Resident nurses are given didactic and clinical training within 12 weeks and provided basic salary during the program. The program helped encourage new nurses to work within the organization, allowing them to work in specialty areas even without prior experience. This promoted retention due to the contract of two years that they must fulfill after graduating from the program. Many of the new nurses were employed in urgent care settings.

With regards to adopting of new healthcare settings, Northside Hospital, within the last five years, opened several urgent care facilities, and primary care centers. Current staff nurses of the organization were prioritized to transfer to the new urgent and primary care settings. ACA also resulted to generating new jobs that involved care coordination (Pittman & Scully-Russ, 2016). At Northside Hospital, new nursing positions like case management and transfer center nursing coordinators were opened to serve as care coordinators to the new healthcare settings. Moreover, to support the new urgent and primary care settings, the organization granted scholarships and tuition reimbursement programs for current employees interested in furthering their education.

Graduates of the program are then hired in any facility within the organization to work as nurse practitioners, also encouraging retention of nurses within the organization. In addition, with staffing shortages resulting from the ACA, it is not easy for just one professional in primary care to manage the needs of patients effectively (Norful, de Jacq, Carlino, & Poghosyan, 2018). A new care delivery of two primary care professionals such as a physician and a nurse practitioner co-managing a patient helps to satisfy health care demands. With all the change initiatives within the organization due to the ACA, the importance of the leaders effectively communicating to the staff the major changes in the delivery of care of the organization play a significant role.

Communication and knowledge are crucial for the team to embrace the major innovations. Many employees were initially resistant to change. The directors, managers, and supervisors in the Northside Hospital System went to leadership and sensitivity training to help the staff cope with the rapid changes. According to Marshall and Boone (2017), for innovations to happen, leaders should empower their employees to be involved and contribute to the change. By keeping the staff informed and making them a part of the change, leaders can obtain their support to welcome the changes. The ACA has affected healthcare in many ways. Healthcare organizations were affected and are continuously changing to adapt to the effects of the ACA. Leaders have a crucial role to help with the changes be made acceptable to the staff.

References

Coombs, B. (2018). Rates of uninsured in US hold steady at historic low 8.8 percent. Retrieved from https://www.cnbc.com/2018/09/12/rates-of-uninsured-in-us-hold-steady-at-historic-low-8point8-percent.html

Galan, N. (2018). The affordable care act: An update. Medical News Today. Retrieved from https://www.medicalnewstoday.com/articles/247287.php

Marshall, E., & Broome, M. (2017). Understanding contexts for transformational leadership: Complexity, change, and strategic planning. In Transformational leadership in nursing: From expert clinician to influential leader (2nd ed., pp. 37-62). New York, NY: Springer.

Norful, A. A., de Jacq, K., Carlino, R., & Poghosyan, L. (2018). Nurse practitioner-physician co-management: A theoretical model to alleviate primary care strain. Annals of Family Medicine, 16(3), 250-256. doi:10.1370/afm.2230

Pittman, P., & Scully-Russ, E. (2016). Workforce planning and development in times of delivery system transformation. Human Resources for Health, 14(56), 1-15. doi: 10.1186/s12960-016-0154-3