Nursing MSN NP

Please critique this topic  1 reference 1 page

DUE: 2/6/2022 6 PM

Read the article Will Disruptive Innovations Cure Health Care?. While the article was published in 2000, it was so poignant (and also ignored until more recently) that Dr. Christensen remains on the forefront in healthcare economics today.

 In learning about your primary NP role as a clinician, how do you view yourself as fitting into the current healthcare delivery model?

I think the role of an NP is still quite limited despite having the autonomy to practice. I plan to take the Cardiac NP role and from what I have seen at my institution, NPs (Nurse Practitioner) still do not have the full authority to practice independently. For example, an NP can order diagnostic and therapeutic tests, but a physician must approve the order and interpret results before the NP can act on it. Due to this, we have had delays in patient care. Therefore, I agree with Christensen et al., (2000) that we need diagnostic and therapeutic advances that allow nurse practitioners to treat disease that used to require a physicians care (p.4).

With the role of NPs expanding to meet the demands of health care, and as Christensen et al., suggested, I have seen NPs within my community working as primary care clinicians or working in primary care roles. Additionally, within my community I have seen NPs utilized in express care clinics to autonomously assess, diagnose, and order tests for conditions like strep throat or urinary tract infections. However, I recognize that not every state or community allows NPs to work independently in these ways or has utilized NPs for these purposes. Working on an outpatient basis, I believe, would allow me to fit in to the current healthcare delivery model as outlined by Christensen et al., however, my role would be limited in the hospital as I would be working under a team of physicians. While this dynamic has worked out well before where the NP is utilized fully, there are unfortunately other instances where the NP is not fully utilized. For instance, sometimes NPs function more as medical scribes or assistants, or require approval for orders and tests by a physician. Depending on the community and state I pursue my career in, as well as the potential for NP underutilization and limited practice autonomy, I agree with Christensen et al., that the idea of Disruptive Innovation could transform healthcare for the better (2000, p. 4).   

 How might this view be different in a rural setting? Urban underserved setting?

Christensen et al identifies that most patients need uncomplicated care to include preventative care and treatment plans for singular uncomplicated issues such as simple infections or uncomplicated diseases and forced to churn patients at alarming rates (p. 108). Physicians are spending time providing care for those that could be cared for by less expensive professions, in less expensive environments saving specialists and physicians for complicated cases (Christensen, et al., 2000). In underserved areas, such as urban or small rural settings where health care professionals and services may be limited, activating innovative disruptive principles would benefit these populations by providing cost effective, quality care.

With a shifted emphasis on primary care or uncomplicated medical issues to the treatment of complex disease states, incurable infections, and high monetary medical research endeavors, the demand for Disruptive Innovation has become increasingly essential (Christensen et al., 2000). Specifically, NPs functioning in a primary clinician role. Christensen et al. discusses how NPs working in primary care not only aids health care in meeting the demand for providers, but also for helping to expand the roles of everyone at all levels ie. Patient, NP, Physician, Specialist (2000). Expansion of the NP role allows for increased primary care availability in rural settings or urban underserved areas, while simultaneously encouraging higher rates of specialty referrals and medical collaborations with specialty physicians. Additionally, it promotes more cost-effective treatments and services for those communities. While I think the Disruptive Innovation model would fit in well with the rural and underserved communities as there is a high demand for affordable medical care, I do not think the model would fit in as well in a more populated urban and richer community. With more options for physicians, medical care options, and the bias/stigma surrounding the role of the NP, Christensen et al. idea of Disruptive Innovation would not go over as smoothly.  

Do you see your clinician role or Disruptive Innovation continuing the same trajectory in the future?

I do see the Disruptive Innovation continue moving in the same path, as Christensen et al., (2000) states its in the physicians interest to embrace this change. Rather than fight the nurse practitioners who are invading their turf (p.7). The article continues to state, nurse practitioners typically devote more time to patients during consultations than physicians do and emphasize prevention and health maintenance to a greater degree (P.5) The Disruptive Innovation might help in the push for total autonomy for NPs in their practice.

Disruptive innovation may be accelerated as an increasing number of people seek healthcare creating a demand, and a limited number of available physicians leading to lack of supply. I imagine the pure inconvenience and delay in health care will hopefully push states to be innovative with providing the reimbursement, scope of practice, and necessary tools for APRNs (Advanced Practice Registered Nurses) to provide the safe and effective care as they have been trained to do. The APRN and physician bring unique attributes to the health care profession and although there are differences within the profession, both professions hold one thing in common and that is provide care in the best interest of the patient. Disruption is what will build a higher quality, more convenient and lower cost healthcare system (Christensen, et al., 2000 p. 112).

How do the sub-roles of collaborator and interdisciplinary team member fit (or dont they?) into the idea of a Disruptive Innovation?

Throughout history disruptive innovation has been geared towards improving quality and convenience for less cost. According to Tracey & OGrady, (2019) transdisciplinary teams provide better primary care access for underserved populations, improved outcomes and contained costs (p. 297).

Collaborators and interdisciplinary team members are integral in the idea of Disruptive Innovation. As the healthcare scene evolves and changes, so do the expectations and roles of its members. Kaplan (2020) notes that a changing workforce, changing patient demographics, pressures to contain costs, and new technologies are influencing the various types of healthcare providers to improve their performance. This has implications for collaborators and interdisciplinary team members as their role expectations may be influenced by changes.

Discuss why or why not and provide examples from the literature.

            There are numerous examples of how collaborators and interdisciplinary team members, including the patient themselves, fit into the idea of Disruptive Innovation. Christensen, et al., (2000) noted that previously, diabetic patients would need to be seen by an MD which involved expensive testing, just to obtain accurate blood glucose readings. Currently, diabetics can obtain an accurate reading within moments by use of small, portable glucometers. Expansion and advances in technology allows more accurate, less expensive, more convenient diagnosis and treatment by less expensive practitioners, and in some cases, clients. This allows for upmarketing of disciplines as APRNs can diagnosis and treat, which encourages Medical Doctors to do the same and upmarket their set off skills and education for more intensive cases. Regardless of a healthcare workers title, all should feel empowered to collaborate on the shared goal of improvement of the healthcare system and an interdisciplinary approach is necessary to discover solutions (Kaplan, 2020).

References

Christensen, C. M., Bohmer, R., & Kenagy, J. (2000). Will disruptive innovations cure health care?. Harvard business review, 78(5), 102-112.

Kaplan, G. S. (2020). Defining a new leadership model to stay relevant in healthcare. Frontiers of Health Services Management, 36(3), 1220. https://doi.org/10.1097/hap.0000000000000077

Tracey, M. F., OGrady, E. T. (2019). Hamric and Hansons Advanced Practice Nursing an Integrative Approach. Elsevier.