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Can Nurses Drive Health Reform?

Janice Simmons, for HealthLeaders Media, February 8, 2010

Upon release last month of a Gallup Survey of opinion leaders about nursing leadership, Risa Lavizzo Mourey, MD, president and CEO of the Robert Wood Johnson Foundation (RWJF), said the organization commissioned the survey because of the importance related to "expanding the leadership of nurses and tapping into all the wisdom and expertise that nurses have [which] is critical to healthcare reform and the healthcare system."

In the survey of 1,500 opinion leaders, nurses were viewed as one of the most trusted sources of health information, but they were often seen as having less impact on healthcare reform than government, insurance and pharmaceutical executives, and others.

Many nursing leaders, though, think the tide may be turning in that area and that the roles of nurses—and the work that they do—will be steadily influencing the movement toward healthcare reform and emerging health policy and research issues. Overall, they need to take advantage of opportunities that are opening up to them now.

Some of those opinions were expressed at the conference releasing the survey itself. "We do have considerable evidence about nurses' contributions" in areas such as patient safety, overall quality, care coordination, aging, and prevention, said Mary Naylor, PhD, RN, a professor at the University of Pennsylvania, School of Nursing, and program director of the RWJF Interdisciplinary Nursing Quality Research Initiative.

"We know nurses are making a major contribution in terms of improving value, quality, alignment with patients' experiences, and with family caregivers' experiences relative to investment in costs,” Naylor said. "Equally important, we are making major contributions—and we have major evidence to support this—in areas where opinion leaders have identified that we have little influence around access, around cost and efficiency."

"So the tremendous opportunity here is to get that message out as quickly as we can—to share the knowledge, to capitalize on every opportunity, to communicate what we know so that we continue to have others build on our ideas," she said. "We have a treasured gift here: The public trusts us. So we have to build on that foundation. We have to accelerate our ability to influence what it is that we know they need because [the public] is actually counting on us."

With healthcare reform being on the mind of many, "This is really an opportunity for all of us to begin to change our paradigm—the way that we think of healthcare being delivered," said Rich Hader, senior vice president and chief nursing officer at Meridian Health, an integrated healthcare system in New Jersey.

"When you think about it, nursing is at every avenue of the healthcare experience—whether or not it's in prevention and wellness, or diagnostic and treatment, or rehab or end-of-life care. It is the nurse who is the consistent, focused caregiver who is able to move us through that system," he said at the RWJF conference.

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