Nurse leaders are in sync with their colleagues in blaming the government for industry woes (37%), followed by health plans (23%), physicians (8%), hospitals (5%), vendors (3%), patients (1%), technology (1%), and nurses (0%).
"I think when they start pointing fingers at who is to blame, why nurses aren't pointed out is because they aren't reimbursed by third-party payers," says Kadlick. "They aren't seen as the ones delaying discharges in acute care settings or ordering unnecessary diagnostic tests in the outpatient facilities."
In an area of disconnect between nurses and doctors, about 77% of nurse leaders said in the survey that the quality of their organization would be positively affected by increasing the scope of care for nurses, while only 10% thought it would worsen. When physician leaders were asked that question, 48% said it would improve, while 26% said it would worsen.
As nurses become more involved in coordinated care and multidisciplinary approaches, Kadlick says the impact of nurses on quality will be more fully appreciated. "The nurses can do more—add value to the interaction with physicians and for patients' care," Kadlick says.
According to the survey, patient experience and satisfaction is the top priority among nurse leaders; 72% rank it among their top three priorities. Next is clinical quality and safety at 55% and cost reduction and process improvements at 45%.