Healthcare leaders shared their perspectives about nursing in the age of healthcare reform during Floridas first statewide nursing summit, Nursing in Florida: Celebrating the Past and Advancing the Future, Nov 13-15, hosted by the Florida Blue Foundation and the Florida Action Coalition.
To deliver quality healthcare, we will need teams, and everybody has to work up to their training, said Donna Shalala, PhD, president of the University of Miami, who delivered the keynote address: Health Care Reform and the Future of Nursing. This is a golden opportunity for nurses. For the first time, there is real movement on scope of practice. We need nurses more than ever, and they are better trained than any generation.
The opportunities and challenges of todays healthcare paradigm were discussed by other speakers at the event. Denise H. Harris, RN, MSN, MBA, NEA-BC, CNO and vice president of nursing administration at West Kendall Baptist Hospital and past president of the Florida Organization of Nurse Executives, moderated a panel discussion about claiming leadership. Peter I. Buerhaus, RN, PhD, FAAN, spoke at the session, Increasing the Value of Nurses in an Era of Health Care Reform. This is a complicated time, because of the interplay of so many different forces, said Buerhaus, the Valere Potter professor of nursing and director of the Center for Interdisciplinary Health Workforce Studies at Vanderbilt University Medical Center in Nashville, Tenn.Peter Buerhaus, RN
Buerhaus said factors changing healthcare include the recession, demographic changes, healthcare reform implementation and budget sequestration, which has reduced Medicare payments to providers, including hospitals and other employers of nurses, by 2%. The healthcare system is changing in a profound way.
Buerhaus predicted the transformation in healthcare delivery associated with the Affordable Care Act will be bigger than the implementation of Medicare or managed care. He encouraged nurses to stay informed about healthcare reform. Know what’s going on and how to position your career to take advantage of [the opportunities healthcare reform offers], Buerhaus said.
In addition, Buerhaus talked about the slow jobs recovery, caused in part by the effects and uncertainty of healthcare reform. Meanwhile, nursing educators have ramped up significantly the number of students they can accept into nursing programs. Thats good, but we are adding supply at a time when the market is holding back some in this era of healthcare reform, he said.
Buerhaus said employers and payors are both interested in value in this case, the relationship between the quality and cost of healthcare, and more specifically, nursing care. Because healthcare organizations will be paid based on value, he said, nurses will need to understand how they contribute. For some hospitals, nursings value could be raised by nurses improving the quality of care. In other organizations, the cost of producing quality care may be too high, which can affect a hospitals bottom line. Nurses can increase their value by maintaining the high quality of care but decreasing the cost of providing that care. Nurses have to be in touch with the changing economics with fee-for-service dying out, Buerhaus said. They need to meet with management and ask What can I do that adds value to what we are trying to do as an organization?Susan Towler
The type of care and setting will define what value means. For instance, he said, the ability to reduce readmissions will mean more to hospitals than other healthcare employers that arent penalized on that metric. Once nurses know what the employer values, Buerhaus said they should take action and use data to illustrate the increase in value brought about by their efforts.
Once you have determined the area to improve value (either quality or cost), then go to the literature and see if others have tested ideas that could work in your organization, Buerhaus said. Ask nurses for their ideas. Get connected to the quality improvement department. Talk with physicians. Organize a group of nurses dedicated to improving value and ask management how best to work with them. Assess, plan, implement, evaluate.
The summit was held at the University of South Florida. It was simulcast at the University of Miami, the University of North Florida in Jacksonville, Pensacola State College and Florida State University in Tallahassee to allow greater numbers of nurses to participate.