Fragmentation, access issues, unaffordable costs, subpar results, and inequities influence the healthcare revolution. The most significant impetus for change was driven by changing social and disease-type demographics, price and quality issues, and cost concerns. Taking care of and paying for medical care for persons with chronic health concerns are important considerations. The Centers for Medicare & Medicaid Services are now in charge of several programs under the Affordable Care Act that attempt to increase quality and reduce costs. An increase in care coordination will result in better outcomes, higher quality care, and lower costs, especially when it comes to avoidable expenses like avoidable emergency room visits, hospital stays, diagnostic testing, repeat medical histories, multiple prescriptions, and avoidable drug interactions. As a nation, we have made small strides toward higher quality and lower costs for decades. By participating fully in the interprofessional team as we transition from episodic, provider-based, fee-for-service care to team-based, patient-centered care across the continuum that provides seamless, affordable, and high-quality care, nurses are positioned to contribute to and lead the transformative changes that are occurring in healthcare. These changes call for a new focus on patient-centered care, care coordination, data analytics, quality improvement, and a new or improved set of wellness and population care knowledge, skills, and attitudes.
Nursing is in a position to contribute to and lead revolutionary changes in healthcare because of their role, their education, and the respect they have gained. Nurses who want to play a significant role in influencing these changes must be aware of the forces driving the change, the requirements for practice change, and the competencies (knowledge, skills, and attitudes) necessary for individual and system success. To transition from episodic, provider-based, fee-for-service care to team-based, patient-centered care across the continuum that provides seamless, affordable, and high-quality care, this article discusses the driving factors causing healthcare transformation as well as the role of the registered nurse (RN) in leading and being a fully contributing member of the interprofessional team. To achieve the triple goals of enhanced patient care (including quality and satisfaction), improved population outcomes, and decreased healthcare per capita costs, the nurse must fully participate in the unrelenting efforts to accomplish this new health paradigm.