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NUR-514 Topic 1 DQ 1

Discuss the shift to value-based health care and its impact on the roles and responsibilities of advanced registered nurses.

Re: Topic 1 DQ 1

Value-based health care implies that payment for medical care is dependent on positive patient outcomes. The goal is to contain the cost of medical care while reducing complications for patients (Huffman, 2021). The total joint replacement bundles are an example of value-based health care (Schardt et al., 2020). The orthopedic surgeon provides surgical intervention for an elective joint replacement that follows surgical pathways for optimal outcomes. The advanced practice nurse may then follow up with the patient in an acute setting or office setting to monitor and provide early intervention to achieve optimal recovery. This reduces cost and leads to better patient outcomes and payment. The joint center advanced registered nurse leader participates in a collaborative team that develops protocols based on evidence to produce positive outcomes. The leader ensures protocols are followed by staff for beneficial patient outcomes. The advanced practice nurse educator is responsible for teaching direct care nurses the clinical pathways necessary for optimal outcomes. The acute care center of current employment has a Joint Center that performs in this manner to maintain cost-effective, efficient, quality care with the patient in mind. Huffman (2021) describes these elements in detail in her article. The suggestion is that nurse leaders assume a collaborative, innovative role to establish and maintain value-based care in their areas of practice..

In the next 3-5 years, many more patients will go home after surgeries. In the past, many spinal cases stayed overnight in the hospital. In the current environment, postop cervical spinal fusions and discectomies who meet the criteria for discharge go home the day of surgery with follow-up from a nurse practitioner. Total joints that are relatively low risk go home the day of surgery after meeting all discharge criteria. The health care system is moving towards home care with continued follow-up in the office with advanced practice registered nurses. Advanced practice registered nurses in various roles within the acute and community setting deliver cost-effective, quality care. This will continue into the foreseeable future to contain costs while providing safe, reliable, quality care to patients. The hope is that advanced practice nurses can continue to grow and expand their skills to provide care that encompasses the full extent of their education and skills.



Huffman, M. (2021). Value-based care: An executive briefing. Nurse Leader19(1), 82–86. https://doi.org/10.1016/j.mnl.2020.07.014

Schardt, K., Hutzler, L., Bosco, J., Humbyrd, C., & DeCamp, M. (2020). Increase in Healthcare Disparities: The Unintended Consequences of Value-Based Medicine, Lessons from the Total Joint Bundled Payments for Care Improvement. Bulletin of the Hospital for Joint Diseases78(2), 93–94.


Hello Camille,

I agree with you that in the value-based care, the money is paid for medical care is dependent on patient’s positive outcome. In this care there is need for quality services that will promotes better recovery of the patient consequently enhancing patient satisfaction (Hirpa et al., 2020). It is the responsibility of the advanced practice nurse to ensure that they proper follow up mechanisms, which in the end will facilitate quicker recovery of the patient and reduce the chances of readmission. The nurses have to identify what the patients consider as the priority in their recovery process so that they are able to collaborate with the patient to achieve complete recovery and continue living a quality life.

I do agree with you that in the coming three to five years, patients who have undergone surgical operations may be discharge to get home within the same day as long as the patient is in a stable condition and there is a nurse assigned to regularly check on the patient’s progress (Cairo et al., 2017). The advanced nurse practitioners have the responsibility of continuous education to ensure that they improve on their knowledge and expertise. This was the major emphasis in the Institute of Medicine report on the Future of Nursing, Advancing Healthcare report. The nurses with higher qualification have better chances of ensuring that they incorporate the research skills in their care practices and influence crucial decision-making points using their experience and empirical experimental evidence from their EBP project research work..


Hirpa, M., Woreta, T., Addis, H., & Kebede, S. (2020). What matters to patients? A timely question for value-based care. PLOS ONE, 15(7), e0227845. https://doi.org/10.1371/journal.pone.0227845

Cairo, S. B., Raval, M. V., Browne, M., Meyers, H., & Rothstein, D. H. (2017). Association of Same-Day Discharge With Hospital Readmission After Appendectomy in Pediatric Patients. JAMA Surgery, 152(12), 1106. https://doi.org/10.1001/jamasurg.2017.2221


Discuss the shift to value-based health care and its impact on the roles and responsibilities of advanced registered nurses. What major evolving trends in the health care delivery system will affect your practice in the next 3-5 years, and how do you think advanced registered nurses will continue to influence the direction of health care?

Topic 1: Health Care Systems, Organizational Relationships, and Interprofessional Health Care Environments



  1. Discuss the evolution of the U.S. health care system to a value-based system and its impact on advanced registered nursing and the delivery of care.
  2. Explain how interprofessional relationships increase collaboration among the advanced registered nurse roles and improve patient outcomes in an increasingly complex health care system.
  3. Examine how leaders benefit from applying systems thinking to lead within a dynamic organizational environment.


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