Chapter 5 Summary
Designing a Nurse-Managed Healthcare Delivery System
Julie Cowan Novak - University of Texas Health Science Center at San Antonio
This chapter was unfortunately rather underwhelming. Particularly given how important the topic was. From my perspective, the chapter did not address its title. Instead it focused on funding models for nursing educational systems, and spoke in broad vague terms about things nursing schools and nursing faculty can do for healthcare.
One of the recurring themes, similar to the last chapter, was about how economically difficult it is to make outpatient clinics profitable; let alone even cost neutral without grant support.
1. Nursing Managed Models
Three models identified include:
A. Direct Practice: this model of nurses providing care may be integrated into any type of practice environment. It spans all types of financial reimbursement models.
One interesting example, was how specific nursing agencies and industry providers may state list what specific services they require nursing assistance for. Nursing Schools review these proposals and negotiate with the nursing agencies and industry players to place their nursing students in these companies for parts of the training.
B. Indirect Practice: nursing faculty members are contracted to assist in the development of public health programs. Such as immunization, or chronic disease managment.
C. Consultation: nursing faculty may be contracted to consult on specific areas of expertise, such as operating room design or cost containment.
Doctor of Nursing Practice (DNP): There has been expansion in the interest in higher level nursing education with 130 DNP doctor of nursing practice programs opening, and another 200 in developmental stage. These provide a wide variety of advanced training in both clinical practice as well as healthcare leadership.