Landing the Flight: Bringing the 30,000 Ft View to the Bedside

Teresa L. AndersonEdD, MSN, RNC-OB, NE-BCPresident, Nebraska Nurses Association Landing the Flight: Bringing the 30,000 Foot View to the Bedside

1DisclaimerPresident of the Nebraska Nurses AssociationANCC Magnet Program Consultant, the American Nurses Association, Silver Spring, MarylandChief Nursing Officer of Voalte, Inc., Sarasota, FloridaThe speaker acknowledges the following affiliations but has no financial conflicts of interest related to the contents of this program:

2ObjectivesIdentify the trends affecting patient care in the United States today.

Discuss the potential impact of these programs on nursing policy and practice.

Describe the nursing skill set of the future.

3Trends and Manifestations Affordable Care ActGuaranteed issue and community rating (premiums/pre-existing)Individual mandate (federal subsidies sliding scale)Minimum health insurance policy standardsHealth insurance exchangesMedicaid expansion optionEmployer shared responsibility Elimination of the cos(co-pay, co-insurance, deductibles)Fee-4-Service to bundles andACOs

President Obama signing the bill4Trends and Manifestations Pay 4 Performance (aka P4P or Value-Based Purchasing)Rewards for meeting pre-established targets for care delivery (quality and patient satisfaction (HCAHPS scores)Disincentives - removal of payments for adverse never events

Foreign object unintentionally retained after surgerySurgical site infection after bariatric, orthopedic, and bypass surgeryVascular-catheter associated infectionCatheter-associated urinary tract infectionAdministration of incompatible bloodPressure ulcer stages III and IV Falls with injuryAir embolismReadmission within 30 days http://www.ahrq.gov/professionals/quality-patient-safety/quality-resources/pay4per.html

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Meaningful Use

Stage 1 Objective domains: Improve Quality, Safety, Efficiency Engage Patients & Families Improve Care Coordination Improve Public and Population Health Ensure Privacy and Security for Personal Health Information

Stage 2 ObjectivesIncrease health information exchange between providers and promote patient engagement by giving patients secure online access to their health informationTrends and Manifestations6Meaningful Use

7Meaningful Use

8Trends and ManifestationsNurses should practice to the full extent of their education and training. Nurses should achieve higher levels of education and training through an improved education system that promotes seamless academic progression Nurses should be full partners, with physicians and other health professionals, in redesigning health care in the United States Effective workforce planning and policy making require better data collection and an improved information infrastructure

http://www.neactioncoalition.orgIOM, Future of Nursing 9Trends and ManifestationsMagnet Recognition ProgramGlobal Issues in Nursing and Healthcare10

FinancialProvider Consumer

Potential Impact11Potential ImpactTechnicalCosts in financial and human capitalExtension of the healthcare continuum

Chasing innovation

12Potential ImpactSocial CommunicationConfidentiality (includes social media)Portability

13Potential ImpactProfessional (includes advocacy)Policy and Practice

www.nursingworld.org 14Professional Nursing Skill SetBSN, MSN, and BeyondSpecialty certificationsCross-training to a minimum of three areasMultiple home-unit mind set

15Professional Nursing Skill SetQuality, EBP, and Research Performance improvement methodologiesQuality toolkitGlobal access to information

16Professional Nursing Skill SetCommunication and CollaborationInterprofessional collaborative education and trainingStrong professional communication

17Professional Nursing Skill SetProfessional involvement and advocacyProfessional organization membership and leadershipPartnerships and affiliations to support healthy communitiesUnderstanding public policy from multiple viewpointsLegislative advocacy

18Professional Nursing Skill SetStrategic and Tactical Management

Networking?

Social media?

Project management?

19Excellence begins AND ends

with YOU!

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Teresa (Terry) Anderson, EdD, MSN, RNC-OB, NE-BCnnapresident@nebraskanurses.org402-556-4274 (home)402-679-1551 (cell)21