The healthcare system in the United States experiences a high level of fragmentation. As a result, the country faces considerable barriers to accessible, affordable, and quality care. Although various efforts are evident in the country to address the challenges, the Future of Nursing 2010 Report Brief and the webinar Assessing Progress on the Implementation of the Recommendations of the Future of Nursing have effectively identified policy issues and recommendations to improve health care in the country.

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Some of the policy issues identified in the report include the need to address the fragmentation in the system, communication challenges between various health care providers, and population shifts that create a shortage of primary care health professionals (National Academies of Sciences, Engineering, and Medicine, 2016). The country has made some progress in the achievement of the IOM report. As many as 44 states have made considerable efforts towards removing the scope-of-practice barriers, whereas some states have amended their legislation to offer NPs full practice and prescriptive authority (Ulrich, 2015). Generally, progress has been made in improving the role of nurses in enhancing health care outcomes.

However, some barriers still hinder the advancement of the IOM recommendations. Such challenges include federal policies, state laws, outdated insurance models, and organizational practices that fail to support the law of nurses. Besides, the fragmentation affects interactions between providers and patients, as well as other stakeholders in the health care organizations and system. Nurse leaders can implement effective strategies to advance the IOM recommendations (Ulrich, 2015). They should train nurses and other professionals to improve communication and collaboration and create a culture that enhances the role of nurses. Overall, leaders should develop effective policies and procedures to support the implementation of recommendations

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