The challenges facing incoming President Barack Obama and Congress are tremendous, but Americans are making it clear they want healthcare to be a high priority on the national agenda.
In a national survey released Jan. 15 by Kaiser Family Foundation and the Harvard School of Public Health, 43% of respondents said they view reforming healthcare as a top concern, ranking it third behind improving the economy at 73% and fighting terrorism at 48%. We asked nurse leaders from the Texas and Louisiana how they would advise the new president to improve the U.S. healthcare system.
What healthcare issue do you think the Obama administration should address first in 2009?Sam Ruffing, RN, BSN
“One of the first big issues would be the shortage of nurses. Across the country, we are facing a nursing shortage and the state of Texas is no different. There is a shift, however, in the reason for the shortage. In the 90s, the nursing shortage was caused by a lack of nursing students. A decade later, there are six potential nursing students for every available seat in nursing school, but we find ourselves with a shortage of nursing instructors because their salaries are not competitive and commensurate with their years of experience.
“Methodist has addressed this shortage through a creative partnership with El Centro Community College of Nursing which offers a two-year nursing program on the Methodist Dallas campus. Methodists Department of Education instructors oversee the clinical and skills labs, while lectures are shown via teleconference from El Centro. Creative programs such as this help to maximize the use of instructors, but will not eliminate the need to increase nursing instructor salaries to make it a more attractive career option.
The need to address the shortage of nursing instructors is greatly intensified because many of them will soon be retiring, creating an even larger pool of positions that need to be filled.
– Sam Ruffing, RN, BSN
CNO, Methodist Dallas Medical Center
Based on our experience as a public, county facility, Id like to see a focus on wellness and prevention. If theyre delayed because of the economy, people get sicker and the cost of care will go up. In the long run, it saves money if the patient population is healthier.
– Barbara Reece, RN, MS, NEA-BC
Associate Administrator/Chief Nursing Officer
Lyndon B. Johnson General Hospital, Houston
“Providing health insurance needs to be made easier for employers. The Obama administration is going to need to get creative and look at things such as tax incentives to encourage employers to sponsor health insurance plans or provide certain health-related fringe benefits that are excluded from federal taxation, such as medical savings accounts or flexible spending arrangements.”
– Bonnie Clipper, RN, MA, MBA
CNO, St. Davids Medical Center
“The Obama administration should focus on the availability and affordability of healthcare for all Americans. … By promoting health and wellness and practicing a proactive approach through disease management … we will be able to decrease the burden felt by many healthcare providers and hospitals.”
– Karen Robeano, RNC, MS, NEA-BC
Vice President of Patient Care Services, CNO
Harris Methodist Fort Worth Hospital
“The Obama administration speaks strongly for affordable and accessible healthcare for all. A vital component to achieving this vision is the issue of healthcare reimbursement. Reimbursement for Medicare, Medicaid, and underinsured patients does not keep pace with a hospitals rising cost of doing business. From the price of supplies to the cost of labor, the cost of caring for a patient often far exceeds the amount that is reimbursed. In order for hospitals to continue providing quality healthcare for their communities they must also be fairly compensated.”
– Theresa Williams, RN, MSN, MBA
Vice President of Patient Care Services, CNO
Touro Infirmary, New Orleans
“Its great to focus on new models to cover the underserved, but first we should focus on determining the value added by delivering any healthcare service, and the benefit to the patient. That benefit has to be defined by the patient, who would probably say survival first, followed by quality of life, good functionality, ability to resume a normal life, and, if they can get beyond illness, how to stay healthy.”
– Barbara L. Summers, RN, PhD, NEA-BC
VP and CNO,
University of Texas M. D. Anderson Cancer Center, Houston
From a nursing vantage point, [we need] to push everyone to electronic medical records. The rationale is that reducing the time spent handwriting documentation at the nurses station increases efficiency and the amount of time at the bedside. That increases patient safety, confidence, and satisfaction, which differentiate an organization in the marketplace. It also drives quality and evidence-based practice because when you have all the protocols online, you dont have to rewrite them every time you need them.
The question is how a 300- to 500-bed hospital can pay $40 million to $80 million for software, hardware, and training, but anything that drives up efficiency and quality of care drives down cost. Making an environment practice-friendly, convenient, and comfortable will reduce employee turnover. That retention will save around $88,000 per nurse and offset the shortage.
– Chuck Stokes, RN, BSN, MHA, FACHE
Chief Operating Officer
Memorial Hermann Health Care System, Houston
“Christus Healths No. 1 priority is creating access for all to healthcare. We are promoting a national system where all have health insurance. Our campaign is called Healthcare Within Reach. Of course we are looking at other extremely important issues such as quality, transparency, health IT, and work force.”
– T. Jane W. Kamstra, RN, MSN, CNOR , CNO,
Christus Santa Rosa Hospital, San Antonio
“With the growth of the United States population over the last several years and the aging of the baby boomers, the demand for healthcare will clearly exceed our ability to supply adequate care within our current delivery system. President Obama must create incentives to proactively manage patients with chronic illnesses in outpatient settings so the burden of this care is not primarily placed on emergency departments and acute care settings.”
– Rosemary Luquire, RN, PhD, FAAN, CNAA
Senior Vice President and CNO
Baylor Health Care System, Dallas