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Leveraging Nurses for Healthcare Reform

May 8, 2013
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Around the country, National Nurses Week (May 6-12) is a time when all of us non-nurses can salute the hard work and effort that nurses in our healthcare system put forth.

With more than three million members, the nursing profession is the largest segment of the nation’s healthcare workforce.  Nurses play several roles in healthcare, ranging from patient advocate to record keeper to leader at the bedside to caretaker to educator. As time passes, nurses’ responsibilities seem to increase and their presence becomes even more necessary. Nurses nearly always have the closest relationship with patients; they are the front-line providers who observe and meet patient needs. Their growing role over the years is certainly something to respect and be grateful for, and frankly, they deserve a lot more than a week of appreciation for it.

And while it is important to look back on the many accomplishments of nurses over time, it is just as imperative to think about nurses’ current and future roles in healthcare. Surveys and studies continue to find that nurses are one of the most trusted groups of healthcare workers in the country. In 2010, the Robert Wood Johnson Foundation partnered with Gallup to conduct an opinion leader survey. It found that, across-the-board, opinion leaders say that our country is not taking advantage of all that nurses have to offer in terms of leadership, innovation and reform. We aren’t fully utilizing the skills and talents that nurses offer—and that’s a waste of a valuable resource.

In the survey, opinion leaders ranked nurses behind six other stakeholders when it comes to who they expect will influence health reform over the next five to 10 years. But that’s not what they want to see, according to the survey. Large majorities of opinion leaders said they would like to see nurses have more influence in a number of key areas, including reducing medical errors and improving patient safety (90 percent); improving quality of care (89 percent); promoting wellness and expanding preventive care (86 percent); improving healthcare efficiency and reducing costs (84 percent); coordinating care through the healthcare system (83 percent); helping the healthcare system adapt to an aging population (83 percent); and increasing access to healthcare (74 percent). 

“Nurses are highly trusted sources of healthcare information, but as we look to reform our health system, our nation is not taking advantage of all that nurses have to offer,” Risa Lavizzo-Mourey, M.D., president and CEO of the Robert Wood Johnson Foundation, said at the time of the survey. “This survey shows that opinion leaders recognize that we are squandering opportunities to learn from nurses and implement their ideas. We must build on the widespread trust of nurses’ expertise as an essential component in leading and implementing reform.”

The Affordable Care Act has given nurses new opportunities to deliver care and play an integral role in leading change. While many nurses have already stepped into these roles, even more will soon need to as the movement to the new healthcare progresses. The Office of the National Coordinator for Health IT (ONC) shared a data brief this week highlighting the success of ONC’s national network of regional extension centers’ partnership with nurse practitioners (NPs) to enable better care and better health through electronic health record (EHR) adoption and meaningful use (MU). Highlights of the brief include:

  • Of the 41,000-plus primary care NPs nationwide, more than 20,800 nurse practitioners (50 percent) are partnered with RECs to enable better care and better health through EHR adoption and MU.
  • Four out of five regional extension center NPs are live on an EHR. Almost one-quarter of all regional extension center NPs are already meaningful EHR users.
  •  More than half of all primary care NPs (58 percent) in rural areas work with a regional extension center.
  • Regional extension center NPs are 59 percent more likely to be paid for CMS MU incentives than non-enrolled NPs.
  • Regional extension centers are also providing assistance to NPs who are not eligible for the incentive payments, and more than 1,000 of these providers have already demonstrated MU.

So for now, evidence suggests it would be wise to continue to leverage nurses’ skills and involvement with patients as we proceed toward a more connected, IT-enabled healthcare system. After all, nurses are the foundation of that system, and if we recognize that their perspective is needed to enhance care and quality, our appreciation can last for more than just one week of the year.