America is a leading economy globally, but healthcare is far from satisfactory within its boundaries. To deal with the challenges facing healthcare in America, the core competencies of healthcare were developed from the Quality Chasm ( Clark, Raffray, Hendricks & Gagnon, 2016) . The core competencies were designed as a framework for clinicians on what is expected of them for the building of a better health system. The Quality Chasm report required medical practitioners to behave differently to meet the expected health needs of patients. The core competencies are provision of patient-centered care, ability to work in interdisciplinary teams, evidence-based practice, utilize informatics and apply quality improvement (Rubenfeld & Scheffer, 2015). Besides providing medication, all medical practitioners, especially nurses, are be a workforce that is ready for implementation of the five core competencies by providing wholesome care.
Provision of Patient-Based Care
Taking care of a patient is more than asking about their signs and symptoms. Nurses should seek to create a personal relationship with their patients before and while administering medication. Making the patient the center of attention builds trust, which makes the process more transparent. In cases where patients do not feel free with the practitioner, they might choose to withhold information. Patient autonomy is advocated for by the ethics that govern nursing, but a survey in health centers reveled that patients expect the professionals to have greater input in their medical decisions ( Lasater & Nielsen, 2009) . While the patient would choose some options over others, in most cases, the patient relies on the practitioner for professional advice, and tends to make their decisions based on the information practitioners give. The finding makes preventive medicine among nurses essential. When advising patients on medical decisions, nurses must form a rapport, and besides giving the medication for the current illness, also give information on its prevention, to counsel, listen, apply community interventions and meet patient-specific needs.
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Working in Interdisciplinary Teams
To guarantee excellence in clinical practice, good communication between teams by applying expertise and relevant knowledge builds bridges that give the patient better care. A breakdown in communication across professions results in passing inaccurate or inadequate information. Communication breakdown could be due to a language barrier, differing beliefs, politics or unhealthy professional competition ( Clark, Raffray, Hendricks & Gagnon, 2016) . In my nursing practice, hierarchy is a major slow down to processes, with patients having to wait for long before they are cleared to move to the next department. For instance, patients take long to be admitted due to long processes. Nurses are the main staff in charge of admission, so are a vital arm in dealing with the admission and discharge snare up. In my workplace, the admission and discharge processes have been automated to reduce the time that patient take in the queue. The transmissions between a department and another have been connected through a patient system that identifies patients with codes in all departments of the facility. The interaction of schedules and creating a niche for all professionals have created harmony, which has been achieved through the facility’s training. The facility has invested in making interdisciplinary communication paperless and training staff on use of computers and software that lessens human effort.
Evidence-Based Practice
The knowledge medical practitioners gain during training is immense, but it needs to be integrated into medical practice. Emerging trends such as bioterrorism and emerging diseases are also new content that medics are supposed to learn. Besides the theoretical content taught in class, nurses need to find a niche where the information is relevant, and how to apply it ( Lasater & Nielsen, 2009) . Hospitals also need to update their machines to be in synchrony with the practitioners’ knowledge and patient needs, competence emphasizes on patient-centered care. Adopting an evidence-based curriculum would prepare students to deal with real life issues once out of school in preparation for interpretation of clinical data. Facilities need to provide nurses young in the profession with platforms, such as community outreaches, with the help of the experienced, where they can prepare to apply theory in clinical practice.
Quality Improvement
Besides providing medical attention, healthcare facilities also need coordination and management. These roles could best be played by medical practitioners, who also double as health advocates and administrators (Rubenfeld & Scheffer, 2015) . Having a manager who understand both patient and practitioner needs. My workplace is far from integrating management and service provision. Most of the managers are non- medics thus do not relate to the challenges that nurses go through in their daily operations. For instance, the management may insist on increasing profits by admitting more patients. If the manager was a nurse or doctor, they would understand why quality healthcare is better than many patients. Many patients without proper care will mean the same patients keep coming back. Besides the hospital ensuring managers are competent, there is also need for personal evaluation to determine whether the nurse is contributing to better health care
Utilization of Informatics
Even with the presence of the latest machines, inability to utilize informatics makes medical practice hard. The ability to communicate effectively using available clinical information ensures treatment remains patient-centered ( Robert & Peterson, 2013). Nurses are in charge of the most processes in a hospital set up. Nursing students must therefore be prepared to interpret data in the right way and use it to make independent decisions without seeking the help or interpretation of others. Health facilities need to consider holding trainings on utilization of informatics since clinical data changes fast over a few years. With rapid digitization, nurses must also ensure they stay up to date with emerging diseases, cures, trends and expectations of the public. Proper utilization of informatics also makes interdisciplinary communication effective
Conclusion
The five core competencies in healthcare were established to ensure citizens received the best healthcare. Medical practitioners are expected to understand, embrace and implement the competencies as they aim at making healthcare wholesome. The competencies are also a guide to patients on what they should expect in healthcare facilities. Although the requirements have not been fully met yet, is an avenue towards improved healthcare in America.
References
Clark, M., Raffray, M., Hendricks, K., & Gagnon, A. J. (2016). Global and public health core competencies for nursing education: a systematic review of essential competencies. Nurse education today , 40 , 173-180.
Lasater, K., & Nielsen, A. (2009). Reflective journaling for clinical judgment development and evaluation. Journal of Nursing Education , 48 (1), 40-44.
Robert, T., & Peterson, S. (2013). Critical thinking at the bedside: Providing safe passage to patients. MedSurg Nursing, (22), 2, 85-91.
Rubenfeld, M. G., & Scheffer, B.K. (2015). Critical thinking TACTICS for nurses: Achieving the IOM competencies (3rd Ed.). Sudbury, MA: Jones and Bartlett.
