As lawmakers and lobbyists in Washington publicly plot the future of the healthcare delivery system in the U.S., a number of private-sector initiatives already have set the industry on a course toward self-improvement. This issue of Modern Healthcare takes an in-depth look at two of those initiatives, which reinforce what we’ve said in this space many times. True healthcare reform happens from the bottom up—from the healthcare executives and caregivers on the front lines.
From the front lines
While Washington talks reform, private sector makes its move
Last week, the Institute of Medicine and the Robert Wood Johnson Foundation launched a yearlong project aimed at expanding access, improving quality and controlling costs by redesigning the practice of nursing. As reporter Joe Carlson describes in this issue’s cover story (p. 6), a 16-member study committee chaired by former HHS Secretary Donna Shalala intends to produce a comprehensive report by the fall of 2010 that will make recommendations on everything from nurses’ role in the overall healthcare workforce to nursing education to nursing practice to nursing recruitment and retention.
Modern Healthcare has covered numerous major initiatives over the past two decades to address and solve the nursing shortage and/or crisis once and for all. None produced any long-lasting positive results. But we’re cautiously optimistic that the IOM and the Robert Wood Johnson Foundation will succeed where others have failed.
The reason is, the committee appropriately enough resides largely outside of the organized nursing profession itself. It will be able to see the forest through the trees and make recommendations that aren’t tainted by self-interest and immediately dismissed by other segments of the healthcare delivery system. Five of the 16 committee members are registered nurses, including the committee vice-chair, Linda Burnes Bolton, chief nursing officer at Cedars-Sinai Medical Center in Los Angeles.
Some certainly will argue that more of the committee should have been nurses, and that may be a valid position. But none of the organizations represented on the committee are national nursing organizations. And no unions representing nurses.
A July 6 news release issued by the American Nurses Association shows why not including national nursing organizations on the committee is a smart move. According to the ANA, 72% of the more than 15,000 nurses who responded to an online poll said that staffing on their unit and shift is insufficient, and 53% said that they are thinking about quitting.
Almost immediately after we reported the survey results in our Daily Dose electronic newsletter, we were flooded with e-mail responses from nurses and nurse executives saying that the ANA’s poll results were negatively skewed and didn’t reflect the views of the nursing collective. By keeping such inflammatory rhetoric out of the committee’s deliberations, its ultimate recommendations will be that much more credible and likely to be acted on for the betterment of nursing and of the industry as a whole.
The second private-sector initiative we report on in this issue is an effort by the ECRI Institute to educate healthcare executives on the types of information and medical technologies they should be procuring now to get ready for the demands of the healthcare delivery system of the future. Ultimately, the ongoing comparative-effectiveness research effort will determine whether these new technologies will become standards of care. You can read more about that in our Special Report by reporter Jean DerGurahian on p. 26.
As the two private-sector projects illustrate, while Washington fiddles, healthcare’s front lines burn with the desire to make the system better for patients.
Lawmakers would be wise to look at such projects to see how the future of healthcare is being shaped.
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