Health care delivery is a complex process and system that includes multiple delivery sites such as hospitals, ambulatory-care centers, private-provider offices, community-health facilities, home-care agencies, and extended-care facilities. Managed care is a method of reimbursing or compensating for health-care services. It is responsible for more than just payment; it is also in charge of delivery services. Health care reform has been undertaken for a number of reasons, not the least of which are issues of access and health disparities. Nursing within an organization is an important component of health care delivery and an important factor in patient outcomes.

Consider the following questions:

Consider the following questions and discuss them with a fellow learner, a work associate, an interested friend, or a member of your professional community to deepen your understanding.

For the following questions, you may wish to review the Brown, Bornstein, and Wilcox article “Partnership and Empowerment Program: A Model for Patient-Centered, Comprehensive, and Cost-Effective Care,” listed in the Unit Resources.

Who holds you accountable for delegation in your organization, as well as at the state and national levels?
Is there any way you could use delegation to start a more collaborative relationship with the health care team?
What is the purpose of the delegation decision-making tree established by the National Council of State Boards of Nursing?
What are the long-term implications for health-care costs if the patient or patient population continues to have poor cost-cutting outcomes?
As a nursing leader, how can you address cost within your organization, and how does this relate to patient outcomes?