The contribution of nursing to high-value inpatient care.
Reports of suboptimal health care quality and rising expenditures have led payers to institute policies intended to improve outcomes and lower costs. Referred to as value--driven health care, these policies have multiplied in recent years. Despite their appeal, nursing--the nation's single largest provider of health care-has largely been excluded from these policy directions. This article describes the nature of the evidence substantiating nursing's contribution to quality and cost and explores the reasons--scientific, economic, societal, and political--that these contributions have been largely ignored in the formulation of federal policy. Recommendations are made to strengthen the nurse-value case and convince health care stakeholders, including policy makers, that the relationship is established, enduring, and sufficient for national action.
Kurtzman
Ellen T
ET
The George Washington University, Washington, DC 20037, USA. hspetk@gwumc.edu
D057179:Advanced Practice Nursing; D003363:Cost Control; D017598:Efficiency, Organizational; D018166:Health Care Reform; D006801:Humans; D017146:Models, Organizational; D024802:Nurse's Role; D010346:Patient Care Management / Q000191:economics / Q000458:organization & administration*; D011050:Policy Making; D011787:Quality of Health Care / Q000191:economics / Q000458:organization & administration*; D014481:United States