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Defining the Role of Nursing Amid Health Care Reform

by Rodney Tanaka

February 25, 2013

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Health care reform will dramatically change the way health care is delivered and financed in California. The California Institute for Nursing & Health Care (CINHC) has received a grant to take the lead in developing and defining the roles of nurses in this changing health care landscape, as it aligns exactly with CINHC’s mission to transform the capacity of nurses to meet the evolving health needs of Californians. The work includes convening leaders statewide to define the role of Registered Nurses (RNs) in the era of health care reform, as well as to develop a Transition to Practice Program (TPP) for RNs in the emerging role of care coordinator.

An estimated four million additional California residents are scheduled to have access to health care insurance in January 2014 as a result of the Affordable Care Act. To date, much of the discussion has focused on financing and how funds will be shared between providers.

Insufficient conversations have taken place about how to actually accommodate that increased volume and provide care in more effective ways, said CINHC Executive Director Judith G. Berg, RN, MS, FACHE.

“We don’t have a lot of time if we want to be effective in our support of communities and in our work as nurses,” she said. “We must exercise leadership and determine which roles will most help to build and maintain healthy communities.”

Nurses are well positioned to move diverse populations from a medical/illness driven model to one of wellness, prevention and care management. Health care reform should be a vehicle to provide medically underserved communities, and those who are uninsured or under insured, with improved access to health care and improved health outcomes.

“If we wait for others to define these roles, we will not be serving our communities well,” Berg said. “We wouldn’t be making the best use of nursing resources in California.”

The grant will allow CINHC to convene Thought Leaders, consisting of government, insurance companies, hospitals and health systems, community clinics, educational institutions, health care associations and consumers, to identify opportunities and build consensus around roles present for RNs in health care reform.

A White Paper will describe the processes and conclusions reached by the Thought Leader group. The White Paper will be widely discussed in regional forums, then finalized and widely disseminated to health care and consumer groups.

The third part of the grant is to provide training in care coordination to nurses. CINHC is partnering with Western University of Health Sciences (WesternU) to offer a Care Coordinator Program beginning March 4, 2013.

The Care Coordination Program prepares nurses to deliver and manage care, especially for vulnerable populations in both hospital and community settings across the care continuum. This program provides interactive seminars and preceptor-guided experiences over a 14-week period. Following the program, participants are intended to leverage these skills within their current or future positions.

“Care coordinators are going to be part of the health care solution,” said WesternU College of Graduate Nursing Dean Karen Hanford, EdD, MSN, FNP. “Everyone knows there are incredible gaps in health care. This grant project prepares nurses to address those gaps. They will have a much broader understanding of the community and resources available, as well as how to advocate for patients.”

“Care coordination can ensure that all parts of the health care system are working together effectively and efficiently with the best outcome and best interest of the individual or communities being served,” Berg said.

The project is funded by a grant from The California Wellness Foundation (TCWF). Created in 1992 as a private independent foundation, TCWF’s mission is to improve the health of the people of California by making grants for health promotion, wellness education and disease prevention. 

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About the California Institute for Nursing & Health Care (CINHC)

CINHC is a nonprofit 501(c)(3) organization, founded in 2001, dedicated to transforming the capacity of nurses to meet the evolving health needs of Californians. CINHC partners with California nursing leaders, educators, foundations, state agencies and healthcare organizations to develop practical and sustainable solutions to nursing workforce issues.

About Western University of Health Sciences

Western University of Health Sciences (www.westernu.edu), located in Pomona, Calif. and Lebanon, Ore., is an independent nonprofit health professions university, conferring degrees in biomedical sciences, dental medicine, health sciences, medical sciences, nursing, optometry, osteopathic medicine, pharmacy, physical therapy, physician assistant studies, podiatric medicine and veterinary medicine. The Chronicle of Higher Education named WesternU a 2012 Great College to Work For.

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