To Improve Health Care, Broaden the Role of Nurses
October 07, 2010
In a rapidly changing health care environment, the nation's 3 million-plus nurses can and should play a much greater role in delivering care, according to a new Institute of Medicine report. David C. Goodman, MD, MS, of The Dartmouth Institute for Health Policy and Clinical Practice, a researcher known for his expertise on issues involving the health care workforce, is a member of the Committee that authored the report.
"Nurses already are central to high quality care. Of any member of the health care team, they have the most enduring relationship with patients and are the most trusted professionals in health care." said Dr. Goodman, who is also a Professor of Pediatrics and of Community and Family Medicine at Dartmouth Medical School and a practicing physician at the Children's Hospital at Dartmouth-Hitchcock Medical Center.
The report, The Future of Nursing: Leading Change, Advancing Health, was authored by the 18 member Committee on the Robert Wood Johnson Foundation Initiative on the Future of Nursing, at the Institute of Medicine. Over two years of analysis and deliberation, including five meetings, workshops, three public forums, and numerous site visits, the Committee considered its charge to "examine the capacity of the nursing workforce to meet the demands of a reformed health care and public health system."
Among its recommendations, the Committee concluded that to fully take advantage of the skills and commitment of nurses, they must have expanded educational opportunities, and be freed from "scope of practice" regulations that limit the care they can provide. Further, it recommends that nurses be given a greater role in health care redesign and improvement efforts.
"...We believe the search for an expanded workforce to serve the millions who will now have access to health insurance for the first time will require changes in nursing scopes of practice, advances in the education of nurses across all levels, improvements in the practice of nursing across the continuum of care, transformation in the utilization of nurses across settings, and leadership at all levels so nurses can be deployed effectively and appropriately as partners in the health care team," write the authors.
The nursing population represents the largest portion of the U.S. health care workforce. Yet, it faces many challenges to being integrated as fully as it could be in the provision of care, according to the report. Among these are a lack of diversity in race, ethnicity, gender and age; insufficient education and preparation to adopt new roles; restrictions on scope of practice, limitations by insurance companies, and in some cases "professional tensions" that make it difficult or impossible to practice to their full potential.
"Producing a health care system that delivers the right care -- quality care that is patient-centered, accessible, evidence based, and sustainable -- at the right time will require transforming the work environment, scope of practice, education, and numbers of America's nurses," the report states.
"This report will advance the nursing profession to the center of leading change and improvement in health care systems as the nation seeks higher value in patient care," said Dr. Goodman.
About the Institute of Medicine
The Institute of Medicine was established in 1970 by the National Academy of Sciences to secure the services of eminent members of appropriate professions in the examination of policy matters pertaining to the health of the public. The Institute acts under the responsibility given to the National Academy of Sciences by its congressional charter to be an adviser to the federal government and, upon its own initiative, to identify issues of medical care, research, and education.
About the Robert Wood Johnson Foundation
The Robert Wood Johnson Foundation is a non-profit philanthropic institution, founded in 1936, whose mission is to improve the health and health care of all Americans.
For more information contact Deborah Kimbell at (603) 650-4676.