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Care Coordination and the Expansion of Nursing Scopes of Practice

Published online by Cambridge University Press:  01 January 2021

Y. Tony Yang  and
Mark R. Meiners
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Extract

Recent developments in the health care industry have precipitated a new wave of interest in expanding the scope of practice for nursing. This is because the Patient Protection and Affordable Care Act (ACA), broadly designed to increase access to health insurance, will inevitably result in increased demand for primary care providers. And with compensation for primary care physicians already lagging far behind that of specialists, the role of nurse practitioners is once again receiving increased attention as a viable means by which to ease the pressure for access to health care.

But the economics of this trade-off are controversial. On one hand, it sets primary care physicians at odds with specialists; namely, if the ultimate goal is to “bend the cost curve downward,” should specialist compensation be reduced in order to increase spending on primary care?

Type
Independent
Information
Journal of Law, Medicine & Ethics , Volume 42 , Issue 1 , Spring 2014 , pp. 93 - 103
Copyright
Copyright © American Society of Law, Medicine and Ethics 2014

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References

The NP is just one subset of a group of well-trained advanced-practice registered nurses (APRNs) that comprise only 8 percent of the overall nursing population.Google Scholar
Institute of Medicine, “The Future of Nursing: Leading Change, Advancing Health”, available at <http://www.iom.edu/Reports/2010/The-Future-of-Nursing-Leading-Change-Advancing-Health.aspx> (last visited February 4, 2014).+(last+visited+February+4,+2014).>Google Scholar
Safriet, B. J., “Closing the Gap between Can and May in HealthCare Providers Scope of Practice: A Primer for Policy Makers”, Yale Journal on Regulation 19, no. 2 (2002): 301–303.Google Scholar
Ohio Rev. Code § 4723.01 (2003).Google Scholar
Ohio Rev. Code § 4723.01 B (2003).Google Scholar
Ohio Rev. Code § 4723.43(2003).Google Scholar
National Conference of State Legislature, “Scope of Practice Legislative Database, 2011–2013”, available at <http://www.ncsl.org/issues-research/health/scope-of-practice-legislation-tracking-database.aspx> (last visited February 4, 2014).+(last+visited+February+4,+2014).>Google Scholar
Christian, S. Dower, C., and O'Neil, E., “Overview of Nurse Practitioner Scopes of Practice in the United States”, available at <http://futurehealth.ucsf.edu/Public/Publications-and-Resources/Content.aspx?topic=Overview_of_Nurse_Practitioner_Scopes_of_Practice_in_the_United_States> (last visited February 4, 2014). (last visited February 4, 2014).' href=https://scholar.google.com/scholar?q=Christian,+S.+Dower,+C.,+and+O'Neil,+E.,+“Overview+of+Nurse+Practitioner+Scopes+of+Practice+in+the+United+States”,+available+at++(last+visited+February+4,+2014).>Google Scholar
Id., at 4.Google Scholar
Fairman, J. A. Rowe, J. W. Hassmiller, S., and Shalala, D. E., “Broadening the Scope of Nursing Practice”, New England Journal of Medicine 364, no. 3 (2011): 193–196.CrossRefGoogle ScholarPubMed
Lebuhn, R. Swankin, D. A., Reforming Scopes of Practice: A White Paper, Citizen Advocacy Center (July 2010), available at <http://www.cacenter.org/files/ReformingScopesofPracticeWhitePaper.pdf> (last visited February 4, 2014).+(last+visited+February+4,+2014).>Google Scholar
Compare N.H. Rev. Stat. Ann. § 326-B:13 (nurse practitioner scope of practice statute), with N.H. Rev. Stat. Ann. § 328-G:10 (acupuncture scope of practice statute).Google Scholar
Montana Society of Anesthesiologists v. Montana Board of Nursing, 171 P.3d 704 (Mt. 2007) (Board of Nursing rule allowing certified registered nurse anesthesiologists to administer without physician supervision was authorized by the scope of practice law).Google Scholar
Keck v. Metrohealth Medical Center, 2008 WL 519320 (Ohio App. 2008) (nurse practitioners testimony was sufficient to establish diagnosis of bedsores but, because cause of death is a medical determination, testimony inadequate to establish causation).Google Scholar
See Institute of Medicine, supra note 2, at 278.Google Scholar
See Safriet, , supra note 3, at 320.Google Scholar
Id., at 320–322.Google Scholar
See, e.g., Colorado Medical Society v. Hickenlooper, 2012 WL 2928528 (Colo. App.) (physicians challenge the ability of nurse anesthetists to administer anesthesia without physician supervision).Google Scholar
Abbott, A., The System of Professions: An Essay on the Division of Expert Labor (Chicago: University of Chicago Press, 1988): at 86CrossRefGoogle Scholar
Marrelli, T. M., “Restorative Care and Home Care: New Implications for Aide and Nurse Roles?”, Geriatric Nursing 24, no. 2 (2003): 128–129.Google ScholarPubMed
Id.Google Scholar
Rheaume, A., “The Changing Division of Labor between Nurses and Nursing Assistants in New Brunswick”, Journal of Advanced Nursing 41 no. 5 (2003): 435–443.CrossRefGoogle ScholarPubMed
See Lebuhn, Swankin, , supra note 11.Google Scholar
Id.Google Scholar
American Medical Group Association, Medical Group Compensation and Financial Survey, available at <http://www.amga.org/Research/grpCompSurvey_research.asp> (last visited February 10, 2014).+(last+visited+February+10,+2014).>Google Scholar
American Academy of Nurse Practitioners, 2011 AANP National NP Compensation Survey, available at <http://www.aanp.org/research/aanp-research> (last visited February 4, 2014).+(last+visited+February+4,+2014).>Google Scholar
American Association of Colleges of Nursing, Nurse Practitioners: The Growing Solution in Health Care Delivery, available at <http://www.aacn.nche.edu//media-relations/fact-sheets/nurse-practitioners> (last visited February 10, 2014).+(last+visited+February+10,+2014).>Google Scholar
The Truth About Nursing, Do Physicians Deliver Better Care Than Advanced Practice Registered Nurses? available at <http://www.truthaboutnursing.org/faq/aprn_md.html> (last visited February 5, 2014).+(last+visited+February+5,+2014).>Google Scholar
Nurse-managed clinics focus on primary care, health promotion, and disease prevention.Google Scholar
Coddington, J. A. Sands, L. P., “Cost of Healthcare and Quality Outcomes of Patients at Nurse-Managed Clinics”, Nursing Economics 26, no. 2 (2008): 75–83.Google ScholarPubMed
Chenoweth, D. Martin, N. Pankowski, J., and Raymond, L., “Nurse Practitioner Services: Three-Year Impact on Health Care Costs”, Journal of Occupational and Environmental Medicine 50, no. 11 (2008): 1293–1298.CrossRefGoogle ScholarPubMed
National Governors Association, The Role of Nurse Practitioners in Meeting Increasing Demand for Primary Care, available at <http://www.nga.org/cms/home/nga-center-for-best-practices/center-publications/page-health-publications/col2-content/main-content-list/the-role-of-nurse-practitioners.html> (last visited February 5, 2014); Badger, T. A. McArthur, D. B., “Academic Nursing Clinic: Impact on Health and Cost Outcomes for Vulnerable Populations”, Applied Nursing Research 16, no. 1 (2003): 60–64.CrossRefGoogle ScholarPubMed
Bryant, R. Graham, M. C., “Advanced Practice Nurses: A Study of Client Satisfaction”, Journal of the American Academy of Nurse Practitioners 14, no. 2 (2012): 88–92.CrossRefGoogle Scholar
Dicenso, A., Research presented at the XV International Nursing Conference, available at <http://www.truthaboutnursing.org/faq/aprn_md.html> (last visited February 10, 2014).+(last+visited+February+10,+2014).>Google Scholar
Seale, C. Anderson, E., and Kinnersely, P., “Treatment Advice in Primary Care: A Comparative Study of Nurse Practitioners and General Practitioners”, Journal of Advanced Nursing 54, no. 5 (2006): 534–541.CrossRefGoogle ScholarPubMed
Hayes, E., “Nurse Practitioners and Managed Care: Patient Satisfaction and Intention to Adhere to Nurse Practitioner Plan of Care”, Journal of the American Academy of Nurse Practitioners 19, no. 8 (2007): 418–426.CrossRefGoogle ScholarPubMed
Gardner, A. Gardner, G., “A Trial of Nurse Practitioner Scope of Practice”, Journal of Advanced Nursing 49, no. 2 (2005): 135–145.CrossRefGoogle ScholarPubMed
Fights, S. D., “Nursing: The Key to Coordination of Care”, Medsurg Nursing 20, no. 5 (2011): 213–246.Google ScholarPubMed
Gittell, J. H., “Coordinating Mechanisms in Care Provider Groups: Relational Coordination as a Mediator and Input Uncertainty as a Moderator of Performance Effects”, Management Science 48, no. 11 (2002): 1408–1426.CrossRefGoogle Scholar
American Nurses Association, The Value of Nursing Care Coordination: A White Paper for the American Nursing Association, June 2012, available at <http://www.nursingworld.org/carecoordinationwhitepaper> (last visited February 5, 2014).+(last+visited+February+5,+2014).>Google Scholar
Id.Google Scholar
Craig, C. Eby, D., and Whittington, J., Care Coordination Model: Better Care at Lower Cost for People with Multiple Health and Social Needs, Institute for Healthcare Improvement, available at <http://www.ihi.org/knowledge/Knowledge20Center20Assets/Pages20-20CareCo-ordinationModelBetterCareatLowerCostforPeoplewithMultipleHealthandSocialNeeds_58e1bba1-9069-4099-8ae9-f17aac484695/IHICareCoordinationModelWhitePaper2011.pdf> (last visited February 5, 2014).+(last+visited+February+5,+2014).>Google Scholar
Iansiti, M. Clark, K. B., “Integration and Dynamic Capability: Evidence from Product Development in Automobiles and Mainframe Computers”, Industrial and Corporate Change 3, no. 3 (1996): 557–605.CrossRefGoogle Scholar
See Gittell, , supra note 40, at 1409.Google Scholar
Faraj, S. Xiao, Y., “Coordination in Fast-Response Organizations”, Management Science 52, no. 8 (2006): 1155–1169.CrossRefGoogle Scholar
Id., at 1157.Google Scholar
The Commonwealth Fund, Reducing Care Fragmentation, available at <http://www.improvingchroniccare.org/> (last visited February 4, 2014).+(last+visited+February+4,+2014).>Google Scholar
Cross, R. Prusak, L., The People Who Make Organizations Go – or Stop, Harvard Business Review, June 2002, available at <http://hbr.org/2002/06/the-people-who-make-organizations-go-or-stop/ar/1> (last visited February 5, 2014).CrossRef+(last+visited+February+5,+2014).>Google Scholar
Lind, M. Seigerroth, U., “Team-Based Reconstruction for Expanding Organisational Ability”, Journal of the Operational Research Society 120, no. 54 (2003): 119–129.Google Scholar
See Gittell, , supra note 40, at 1410–1411.Google Scholar
Id., at 1410.Google Scholar
Gittell, J. H. et al., “Impact of Relational Coordination on Quality of Care, Postoperative Pain and Functioning and, Length of Stay: A Nine Hospital Study of Surgical Patients”, Medical Care 38, no. 8. (2000): 807–819.CrossRefGoogle ScholarPubMed
Young, G. J. et al., “Patterns of Coordination and Clinical Outcomes: A Study of Surgical Services”, Health Services Research 33, no. 5 (1998): 1211–1236.Google ScholarPubMed
Cipriano, P., “The Imperative for Patient-, Family-, and Population-Centered Interprofessional Approaches to Care Coordination and Transitional Care: A Policy Brief by the American Academy of Nursings Care Coordination Task Force”, Nursing Outlook 60, no. 5 (2012): 330–334.CrossRefGoogle ScholarPubMed
Rittenhouse, D. R. Shortell, S. M., and Fisher, E. S., “Primary Care and Accountable Care – Two Essential Elements of Delivery-System Reform”, New England Journal of Medicine 361, no. 24 (2009): 2301–2303.Google ScholarPubMed
See Fights, supra note 39, at 213.Google Scholar
Shiu, A. Lee, D., and Chau, J., “Exploring the Scope of Expanding Advanced Nursing Practice in Nurse-Led Clinics: A Multiple-Case Study”, Journal of Advanced Nursing 68, no. 8 (2012): 1780–1792.CrossRefGoogle ScholarPubMed
Lee, T. H., Turning Doctors into Leaders: Medicine Is in for a Radical Change as the Old Guard Gives Way to Performance-Driven Teams, Harvard Business Review, April 2010, available at <http://www.bumc.bu.edu/facdev-medicine/files/2010/10/HBR-Doctors-into-Leaders-10-26-10.pdf> (last visited February 5, 2014).+(last+visited+February+5,+2014).>Google Scholar
See Cipriano, , supra note 54.Google Scholar
Marek, K. D. Popejoy, L. Petroski, G., and Rantz, M., “Nurse Care Coordination in Community-Based Long-Term Care”, Journal of Nursing Scholarship 38, no. 1 (2006): 80–86.CrossRefGoogle ScholarPubMed
Olds, D. L. et al., “Enduring Effects of Prenatal and Infancy Home Visiting by Nurses on Maternal Life Course and Government Spending: Follow-Up of a Randomized Trial among Children at Age 12 Years”, Archives of Pediatrics & Adolescent Medicine 164, no. 5 (2010): 419–424.CrossRefGoogle ScholarPubMed
See American Nurses Association, supra note 41.Google Scholar
See Badger, McArthur, , supra note 32.Google Scholar
Havens, D. S. Gittell, J., and Lin, W., “Relational Coordination among Nurses and Other Providers: Impact on the Quality of Patient Care”, Journal of Nursing Management 18, no. 8 (2010): 926–937.CrossRefGoogle ScholarPubMed
Id.Google Scholar
Ralston, J. F. Weinberger, S. E., “Nurses Scope of Practice”, New England Journal of Medicine 364, no. 3 (2011): 280–281.Google ScholarPubMed
The patient-centered medical home is a model of health care based on an ongoing, personal relationship between a patient, doctor and the patients care team. Whatever the medical needs – primary or secondary, preventive care, acute care, chronic care, or end-of-life care – the patient has a medical home; a single, trusted doctor and care team, through which continuous, comprehensive and integrated care is provided.Google Scholar
Beder, J., Hospital Social Work: The Interface of Medicine and Caring (Routlege: New York, 2006).Google Scholar
Volland, P. J. Schraeder, C. Shelton, P., and Hess, I., “The Transitional Care and Comprehensive Care Coordination Debate”, Generations 36, no. 3 (2013): 13–19.Google Scholar
Reinhard, S. C. Levine, C., and Samis, S., Home Alone: Family Caregivers Providing Complex Chronic Care, AARP Public Policy Institute, Washington, D.C., October 2012, available at <http://www.aarp.org/content/dam/aarp/research/public_policy_institute/health/home-alone-family-caregivers-providing-complex-chronic-care-rev-AARP-ppi-health.pdf> (last visited February 5, 2014).Google Scholar
Center for Applied Research, How to Foster Interprofessional Collaboration between Physicians and Nurses? Incorporating Lessons Learned in Pursuing Consensus, Robert Wood Johnson Foundation, January 2013, available at <http://www.rwjf.org/content/dam/farm/reports/program_results_reports/2013/rwjf403637> (last visited February 5, 2014).+(last+visited+February+5,+2014).>Google Scholar
American Medical Association, 2012 State Legislative and Regulatory Prospectus, available at <http://www.ama-assn.org/resources/doc/arc/state-leg-reg-prospectus-2012.pdf> (last visited February 5, 2014).+(last+visited+February+5,+2014).>Google Scholar
American Medical News, Virginia Law Promotes Team-Based Care by Doctors and Nurse Practitioners, available at <http://www.amednews.com/article/20120423/profession/304239960/4/> (last visited February 10, 2014).+(last+visited+February+10,+2014).>Google Scholar
See National Governors Association, supra note 32.Google Scholar
Safriet, B. J., Federal Options for Maximizing the Value of Advanced Practice Nurses in Providing Quality, Cost-Effective Health Care, at Appendix H, available at <http://www.iom.edu/Reports/2010/The-Future-of-Nursing-Leading-Change-Advancing-Health.aspx> (last visited February 5, 2014).+(last+visited+February+5,+2014).>Google Scholar
Lind, K. D., Recent Medicare Initiatives to Improve Care Coordination and Transitional Care for Chronic Conditions, AARP Public Policy Institute, Washington, D.C., at Fact Sheet 278, March 2013, available at <http://www.aarp.org/content/dam/aarp/research/public_policy_institute/health/2013/recent-medicare-initiatives-improve-coordination-transitional-chronic-AARP-ppi-health.pdf> (last visited February 5, 2014).Google Scholar
Shaljian, M. Gibson, A., The Primary Care Consensus: A Comparison of Health System Transformation Proposals, Patient-Centered Primary Care Collaborative, June 2013, available at <http://www.pcpcc.net/resource/primary-care-consensus-comparison-health-system-transformation-proposals#sthash.ufTj9wxH.dpuf> (last visited February 5, 2014).+(last+visited+February+5,+2014).>Google Scholar
Eglehart, J., “Expanding the Role of Advanced Nurse Practitioners – Risks and Rewards”, New England Journal of Medicine 368, no. 20 (2013): 1935–1941.CrossRefGoogle Scholar
For more information, see Program for All-Inclusive Care for the Elderly (PACE), available at <http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Long-Term-Services-and-Support/Integrating-Care/Program-of-All-Inclusive-Care-for-the-Elderly-PACE/Program-of-All-Inclusive-Care-for-the-Elderly-PACE.html> (last visited February 5, 2014).+(last+visited+February+5,+2014).>Google Scholar
Thygeson, M. Morrissey, L., and Ulstad, V., “Adaptive Leadership and the Practice of Medicine: A Complexity-Based Approach to Reframing the Doctor-Patient Relationship”, Journal of Evaluation in Clinical Practice 16, no. 5 (2010): 1009–1015.CrossRefGoogle ScholarPubMed
Wagner, E. H. Austin, B. T., and Von Korff, M., “Organizing Care for Patients with Chronic Illness”, Milbank Quarterly 74, no. 4 (1996): 511–544.CrossRefGoogle ScholarPubMed
Institute of Medicine, Crossing the Quality Chasm: A New Health System for the 21st Century (Washington, D.C.: National Academy Press, 2001), available at <http://www.iom.edu/Reports/2001/Crossing-the-Quality-Chasm-A-New-Health-System-for-the-21st-Century.aspx> (last visited February 5, 2014).+(last+visited+February+5,+2014).>Google Scholar
See supra notes 81 and 82.Google Scholar
Coleman, E. A. Smith, J. D. Frank, J. C. Min, S. Parry, C., and Kramer, A. M., “Preparing patients and caregivers to participate in care delivered across settings: The Care Transitions Intervention”, Journal of the American Geriatrics Society 52, no. 11 (2004): 1817–1825.CrossRefGoogle ScholarPubMed
Prochaska, J. O. et al., “Stages of Change and Decisional Balance for 12 Problem Behaviors”, Health Psychology 13, no. 1 (1994): 39–46.CrossRefGoogle ScholarPubMed
Hibbard, J. H. Greene, J., “What the Evidence Shows about Patient Activation: Better Health Outcomes and Care Experiences; Fewer Data on Costs”, Health Affairs 32, no. 2 (2013): 207–214.CrossRefGoogle ScholarPubMed
Block, L. et al., “In the Wake of the 2003 and 2011 Duty Hours Regulations, How Do Internal Medicine Interns Spend Their Time?”, Journal of General Internal Medicine 28, no. 8 (2013): 1042–1047.CrossRefGoogle ScholarPubMed
Irwin, G. Topdjian, J., and Kaura, A., Putting an I in Healthcare, Strategy+Business Issue 7 (Summer 2013), available at <http://www.strategy-business.com/article/00167?gko=80904> (last visited February 5, 2014).+(last+visited+February+5,+2014).>Google Scholar