System Evaluation and Healthcare Policy - Paper Example

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University of Richmond
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The global healthcare sector is continually changing and nurses, as part of this industry, need to keep up with these changes. The input of nurses in matters relating to healthcare reform is essential because they comprise the most significant healthcare workforce. Unlike physicians and other healthcare professionals, the contribution of nurses is critical because their work involves working closely with patients and their families in different settings. Consequently, as people who interact with patients the most, the contribution of nurses is essential to enhancing the quality of healthcare delivery and designing of healthcare systems. Additionally, any policy changes in the healthcare sector impact the professional practice of nurses and their work environment. Consequently, the engagement of nurses in policy formulation is a professional and policy obligation.

Despite the vital role that nurses play in healthcare delivery, they have had little involvement in policy-making in the health sector. To the contrary, nurses throughout the world are mainly seen as policy implementers. In other words, it means that they only implement healthcare delivery policies developed by different people including politicians who rarely interact with patients. As a way of responding to changes in the healthcare sector, nurses can play the role of policy advocate, leader, and educator (Woods, 2006). This paper will use the transformational leadership theory as it applies to the functions of-of a nurse leader. Additionally, this article will refer its final findings to the ongoing efforts by the President Donald Trump to scrap the Affordable Care Act.

The Role of Nurses in System Evaluation

The introduction of information technology in the health sector has revolutionized the delivery of healthcare. More specifically, the use of information technology has changed how health information is captured, documented, stored, analyzed, shared, retrieved, consumed, and managed. Some of the conventional techniques used in hospitals and other healthcare institutions are personal health records, electronic health records (EHRs), individual health tools (like mobile applications), and automated medication prescribing among others. Additionally, recent legislations have also impacted the realm of health information technology. For example, the Health Information Technology for Economic and Clinical Health (HITECH) act of 2009 was passed as part of efforts to improve healthcare delivery in the country (Sullivan & Decker, 2001). The adoption and use of electronic health records and other related health IT is pushing the interaction between technology and clinician at the forefront of nursing practice.

The adoption and implementation of EHRs and other healthcare systems have a significant impact on the delivery of nursing care. Currently, nurses constitute the largest healthcare providers in all healthcare delivery institutions. Consequently, nurses are the most significant users of EHRs and other related healthcare delivery systems. This can be attributed to the nurses full geographic presence, cost to hire compared to physicians, and nimble skill set. Implementation and adoption of IT systems in healthcare has a lot of impact on the delivery of nursing care (Moore & Hutchison, 2007). Considering the vital role played by nurses in the delivery of healthcare services, nurses should no longer be seen as outsiders whose only function is to implement policies developed somewhere else. To the contrary, nurses should be treated as equal partners, with other professionals when it comes to designing and implementing healthcare systems. Because they constitute the most significant end users of the methods and are likely to be the most affected, any technological changes in the sector must be nurse-driven.

As the end users, nurses are the most affected by the design of systems and should, therefore, be involved in their evaluation from a users point of view. In many instances, hospital administrators are responsible for purchasing systems and mainly consider revenue functions and not clinical implications. During system review, nurses should be part of the decision-making body, providing valuable user input before purchase and adoption. It is imperative that nurses focus on patient care instead of being distracted by inefficient technology (Mastal, Joshi & Schulke, 2007). Any system adopted in healthcare must be the user friendly and relevant to the nursing practice. Although not all nurses possess the requisite skills and knowledge to conduct an extensive evaluation of healthcare systems, the input of every nurse is essential.

The Role of Nurses in Healthcare Policy Formulation

Global health systems are changing rapidly, and the nursing profession must change as well. There are two reasons why nurses should play a central role in the formulation of health policies. First, nurses comprise the most significant healthcare workforce that works closely with patients and their families (Mund, 2011). This means that nurses experiences and input may play an important role in formulating policy aimed at improving healthcare provision and delivery. Secondly, nurses should play an important role in the formulation healthcare policy because such policies have a direct impact on nurses work environment and the nursing profession. Therefore, the inclusion of nurses in policies formulation in the health sector can ensure conducive work environment for clinical work is taken into consideration when plans are formulated (Sullivan & Decker, 2001). Despite the vital role played by nurses in the provision of healthcare, they are not adequately involved in the development of policies related to health service delivery. Historically, nursing is viewed as a female profession that includes looking after the sick, while men are seen as policymakers.

Considering the vital role played by nurses in healthcare provision, they need to play a part in the formulation of health policies and stop being just implementers. In other words, nurses need to play a central role in developing strategies that control their profession. The primary purpose of nurses in healthcare policy formulation is to use their professional values and ethics, experiences, and advocacy skills to make policy recommendations. To influence policies, nurses at all levels must identify all pertinent issues in the delivery of healthcare and work with decision-makers in shaping health care policies. Nurses can influence policymaking either directly or indirectly (Kilpatrick et al., 2012). Indirectly, nurses can play a part in policy formulation through advocacy and by lobbying with policymakers either individually or through their professional organizations. The other way through which nurses can influence policymaking in the healthcare sector is the direct assumption of leadership position in the industry.

Traditionally, nurses have been under-engaged in policy formulation because of poor leadership and policy formulation skills. Consequently, nurses need to acquire leadership skills to play a more critical role in policy formulation (Woods, 2006). Unfortunately, nurses have been poorly equipped to perform their part in policy formulation in the healthcare sector. To influence the decision-making process, nurses need to gather and present evidence in front of policymakers. Therefore, there is a need to equip nurse with the skills required to collect, analyze, and generate scientific evidence that is useful in policy formulation.

Theoretical Framework

The healthcare sector is complex and characterized by organizational dilemmas, sudden changes, and chaos. Healthcare institutions are continually restructuring and revising their delivery models to keep up with emerging challenges in the sector. In many countries, health care is unaffordable to many people, especially the uninsured. Health care institutions in America and other countries are forced to bear the enormous financial burden by uninsured people who suffer from chronic diseases. Additionally, many people in poor neighborhoods do not have access to adequate health care due to the shortage of healthcare personnel and downsizing of hospitals. Consequently, nursing leaders must ensure that their subordinates are always motivated and inspired to continue working in this chaotic environment. This calls for transformational leadership.

Transformational leadership is an approach to leadership in which a leader works closely with the subordinates to bring about positive organizational changes. The leader starts by identifying the required change and creates a vision to guide the journey towards the attainment of the shift (Pearson et al., 2007). Transformational leadership style augments the morale of employees through mechanisms like acting as a role model to subordinates and linking the subordinates sense of identity to the project to be undertaken. According to Hackman & Johnson (2009), transformational leaders have unique qualities like challenging the status quo and inspiring subordinates to share in the pursuance of vision. Although the nucleus of leadership is power, transformational leaders do not use it to repress and control constituents but rather to motivate them (Sullivan & Decker, 2001). According to the transformational leadership theory, leadership is not about the exercise of power but rather the empowerment of the subordinates. This should not be mistaken to mean that leaders should relinquish control, but instead, it is about reciprocity between the leader and the constituents. The underlying principle of this leadership theory is that the goals of the leaders and the constituents should be entangled to create a shared purpose.

Application to Professional Practice

The Affordable Care Act, commonly referred to as Obamacare is a piece of legislation that aims to extend health care to most Americans. Since the act came into force, many Americans who could not afford to pay insurance premiums can access quality healthcare. Nonetheless, the Republicans are planning to use their numbers in the senate and congress to repeal it. In fact, President Trump made repealing Obamacare as one of his main campaign items. I am of the opinion that President Trump should not repeal Affordable Care Act but instead should revise it to make it more applicable. As noted earlier, the role of a nurse in response to changes in the health sector is to act as a policy advocate, leader, and educator (Pearson et al., 2007). As a nurse, I plan to influence the policy regarding the Affordable Care Act directly and indirectly. Indirectly, I plan to gather all the relevant data regarding the positive impact of ACA since it came into effect. Armed with facts, I will then mobilize my fellow nurses through our professional body and contact our local representatives and congressman and lobby them. As a leader, I will also engage my local community and fellow nurses in conducting door to door visits and educating people on the consequences of repealing the act. Although not an immediate goal, I plan to vie for a seat on the state health board. This will make me a member of the policy-making body and will influence things from the inside.


Compared to other health professionals, nurses are the best source of information because their work involves being in direct contact with patients. Therefore, their input in all matters related to healthcare delivery is essential. For this to succeed, nurses at all levels must acquire the necessary leadership skills and competencies. Additionally, they must work in collaboration with other stakeholders in the health sector.


Alexander G. & Staggers, N. (2009). A systematic review of the designs of clinical tech...

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