The DNP is How Nurses Can Lead the Charge for Efficient, Patient-Focused Health Care Reform

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Kimberly Cleveland, JD, MSN, RN, C-MBC

Much of the conversation around the Patient Protection and Affordable Care Act (ACA) centers on its provisions to increase health care access. However, it is no secret to healthcare professionals that the scope and the impact of the ACA was far greater; it fundamentally changed the practice of patient care at both the macro and micro levels of organizations.

When leaders of health systems seek clinical experts to help develop initiatives and programs that address the rapidly changing health care environment, they need not look any further than Doctors of Nursing Practice (DNPs). DNPs are uniquely prepared to participate in leading, shaping and implementing changes in health policy, health reform, and the business of health care.

Through my administrative and legal experiences with health policy teams, health finance reform, and educating students who are pursuing their DNP degree, I see first-hand how this practice doctorate prepares students to lead sustainable health finance and policy initiatives. The focus on creating sustainable value in the healthcare system has met well with the competencies obtained during a DNP education.

DNPs Use Best Practices to Guide Sustainable Economic Change

DNPs are champions of timely best practice implementation. Often when programs are being incepted, health systems need one individual with clinical experience and passion for patient care who can translate research into practice. This unique skill set advances conversations about affordable systems solutions that are economical at the decision-making table. Input of this nature drives change for vulnerable patient populations that were not previously conceived of, or considered in, previous health care delivery models.

Because DNPs remain close to the patient through their clinical practice, they are able to identify threats to the stability of business plans that arise due to factors related to access to care or insufficient patient education or resources. The ability to identify these threats early, construct business models that integrate the latest research and financial information timely, and communicate the benefits to both the health system and patients make DNPs indispensable because they are able to guide the team away from costly errors in implementation and planning.

There is no better environment to illustrate the potential impact of DNP contributions than the value-based care provisions of the ACA or the inception of Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) and Merit Based Incentive Payments System (MIPS) quality reporting requirements. The ability of the DNP to translate research to provide for quality initiatives is indispensable. Understanding where patient care, quality, systems, and finance intersect is the key to timely implementation of best practices that reduce costs and create sustainable, high-quality patient outcomes.

At Kent State, our DNP students get the opportunity to take their DNP project to the next level by creating and presenting a business plan for implementation. Students innovate a business plan to introduce a change in the health system of their choice. I am amazed at the multifaceted unique solutions our students create using the knowledge they acquired throughout their experience in the program. It is clear that our students are not reinventing the wheel. They are prepared to answer cost-risk analysis questions and defend why their solutions make sense in our current economic environment. More importantly, they are thoughtful in predicting whether their programs make sense now and what could change in the future to make their implemented program obsolete.

Health Policy Decision Makers Need a DNP at Their Side

With policy changes impacting regulations and laws that affect the everyday business of health care, policy makers need a trusted resource who can efficiently and practicably apply proposed policies across patient populations and health delivery systems. DNPs learn to communicate the impact of these policy proposals in a manner that meets the policy maker’s needs and represents the interests of the population at hand. DNPs are prepared to meet the challenge of providing for input and evidence regarding the impact of policy change amid the cacophony of rhetoric that derails and isolates patients and caregivers alike. The presence of a DNP brings reason and hope to discussions that have been historically confrontational.

DNPs bring the ability to focus policy making on health outcomes through excellent communication skills. Verbal and written communication skills are quintessential in the health policy cycle in order to engage stakeholders and bring opponents and proponents to agreement. The DNPs ability to integrate clinical decision making, critical health systems analysis, and financial impact creates a natural trust at the decision-making table. This trust opens the door for DNPs to advocate on behalf of patients and caregivers from the organizational to the international level.

At Kent State, our students experience the opportunity to explore, apply, and critically analyze the impact of their project in the current health policy environment. Students consider obstacles to implementing and expanding their projects amid the current realities of changing policies, regulations, and laws. The discussions that students engage in are enlightened, energized, and expansive. These conversations change the way we look at healthcare as a class. Because we change the way we look at things, the things we are looking at continue to change.  There is no better preparation for policy making and revision than learning that process.

The ACA has challenged health care providers to provide care to more patients. It further challenges health care providers to improve the value in the health care system by providing higher quality with contained costs. DNPs are positioned to meet the challenges the ACA creates for leadership in the financial and policy arenas. Their unique preparation enables them to hit the ground running with solid skills that advance health care operations while preserving economic integrity. DNPs will be providing a future in health care leadership that is unprecedented.


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About Kimberly Cleveland

Kimberly Cleveland, JD, MSN, RN, C-MBC, is a nurse-attorney and the health policy coordinator at Kent State University College of Nursing. Professor Cleveland is admitted to the bar of the United States Supreme Court and the Supreme Court of Ohio. She is member of the Nurses on Boards Coalition Members Board and a Board Member for The American Association of Nurse Attorneys where she chairs the education and policy committee. Cleveland is also a consultant for issues in health care administration, finance, quality, and risk.

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