Assignment: Health Reform Act
Assignment: Health Reform Act
Assignment: Health Reform Act
Week 1 discussion The Affordable Care Act Healthcare reform is a term that is ever present in our practice settings and will not disappear any time soon. Share with the class implementation of the Affordable Care Act in your organization. (If you are not working as a nurse, think about what was happening when you were a prelicensure student). How did your fellow healthcare workers react to implementation of the ACA? How were citizens in your community impacted?
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The 2010 healthcare reform act (Patient Protection and Affordable Care Act, or PPACA) gives nurses new opportunities to deliver care and play an integral role in leading change. (See http://championnursing.org/sites/default/files/nursingandhealthreformlawtable.pdf.) Understanding these opportunities is just the first step. We need to know how we can be part of the solution to achieve better patient outcomes at a more reasonable cost. We need to do more to prevent disease; provide chronic care management to an aging, sicker, and more diverse population; and offer end-of-life care that emphasizes comfort and compassion. Across all settings—especially geriatrics—we must do more to prepare ourselves for the future.
In this article, I outline nine challenges that individual nurses and our profession must address if we are to help lead our country to a healthcare system that is more equitable and provides a higher quality of care. (For a flowchart of these challenges, see Nurse’s role in reforming healthcare by clicking on the PDF icon above.)
Use nurse-led innovations. Nurses know how to expand access to care and improve quality at lower cost. We’ve developed innovative care models to prove it, including nurse-managed health clinics, home visiting programs for low-income mothers, and the Transitional Care Model (TCM). By emphasizing the use of master’s-prepared nurses to oversee care from the hospital to within the home, this model has reduced rehospitalizations for elderly patients with multiple chronic conditions. Research shows that using the TCM helps patients achieve better long-term health outcomes and avoid repeat hospitalizations, all at a reduced cost. We need more nurses to develop innovations. (For good examples to follow, visit www.aannet.org/i4a/pages/index.cfm?pageid=3303.)
Generate evidence and engage in research. Nurses play important roles as innovators who help shape quality and safety. Successful models aren’t born, implemented, or sustained without solid effectiveness data. It’s up to all nurses to collect and track data to improve their own practice as part of broader efforts to improve care. Nursing research helps build the scientific foundation for clinical practice, prevention, and improved patient outcomes.
We must support nurse researchers through adequate funding. The Robert Wood Johnson Foundation (RWJF) is doing this by funding the Interdisciplinary Nursing Quality Research Initiative, a program that links evidenced-based nursing care to improved patient outcomes.
Redesign nursing education. All nurses need to possess basic competencies to meet the demands of an aging and diverse society, with an emphasis on clinical training in multiple settings across the lifespan. The emphasis should be on quality and safety, evidence-based practice, research, and leadership. Several RWJF programs are working to incorporate these concepts into nursing education, including Quality and Safety in Nursing Education, the New Jersey Nursing Initiative, and the Nurse Faculty Scholars program. Therefore, we need to remove barriers to attaining baccalaureate and advanced degrees, such as by strengthening partnership links between community colleges and upper-division degree-granting institutions and all academic institutions and practice organizations. The RWJF-funded Center to Champion Nursing in America is providing technical assistance to help with academic progression. A standardized residency program would give nurses on-the-job learning and would better prepare them for clinical practice. Certification and continuous learning opportunities are essential to a profession that’s responsible for others’ lives.
Expand the scope of practice. Advanced practice nurses (APNs) must be allowed to practice to the full extent of their education and licensure. Working with physicians, they can provide cost-effective care and help address the primary care shortage. However, statutory and regulatory barriers prevent them from practicing to the full extent of their licensure. With 32 million Americans about to receive health insurance under PPACA, it’s crucial that APNs be permitted to provide the primary care they’re trained to give.
Diversify our workforce. Approximately 33% of our population belongs to a racial or ethnic minority group, and by 2042 minorities will account for a majority of the U.S. population. To reduce health disparities, greater efforts must be made to ensure that the nursing workforce reflects patients’ diverse backgrounds and cultural values. Furthermore, all nurses should be educated to provide culturally competent care. Finally, we need to bring more men into the profession. The goal of RWJF’s New Careers in Nursing program is to provid
