How Value-Based Purchasing is Changing Nursing

Rebecca Hendren, June 14, 2011

The advent of value-based purchasing has thrown everyone into a mad scramble. You can't stand in a group of nurse executives without hearing someone ask about how others are improving their patient satisfaction or sharing notes about HCAHPS scores. 

"Value-based purchasing is a game changer," says Lillee Gelinas, MSN, RN, FAAN, vice president and chief nursing officer at VHA Inc.

On a long-term scale, it has everyone wondering how on earth they will achieve so much—from improved patient experience to sustainable quality outcomes—in such a short time. As hospitals plan how to best operate in this new world, it's worthwhile taking the time to reevaluate who should be working on what.

Gelinas recently presided over a meeting of 100 VHA CNOs and says it was one of the most successful CNO meetings VHA has ever held because rather than focusing on a specific topic, such as value-based purchasing, the group focused on innovation and how to develop strategies that will help organizations achieve transformation.

One of the meeting's "A-ha!" moments came when speaker Tim Porter-O'Grady shared a conversation he had with a CEO. The CEO was talking about his passion for patient care and how he was working on improving it. Porter-O'Grady responded that CEOs should not be concerned with things with which they have no competency.

The importance of organizations ensuring proper role delineation struck a chord with the CNOs. Gelinas says it's important that people who are competent to do so are responsible for the right things. The c-suite should be responsible for the context of care, whereas direct caregivers must be responsible for the content of care. Confusion over these two things only results in inertia and everyone trying to do everything.

Rebecca Hendren Rebecca Hendren is a senior managing editor at HCPro, Inc. in Danvers, MA. She edits and manages The Leaders' Lounge blog for nurse managers. Email her at
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