Initiative on the Future of Nursing in America

Sponsored by the Robert Wood Johnson Foundation and conducted by the Institute of Medicine, IFN will identify nurse-based solutions to the country's health care challenges, find new approaches to meet the changing needs of our aging population, and consider strategies to give nursing leaders a greater voice in health care discussions and decisions.

    • July 30, 2009

A groundbreaking new initiative will consider how the nation’s health care system can take fuller advantage of nurses’ knowledge and expertise—steps experts say can help increase access to health care, improve quality, and lower costs. On July 14, 2009, the Robert Wood Johnson Foundation (RWJF) and the Institute of Medicine (IOM) launched the “Initiative on the Future of Nursing.” It is designed to uncover existing nurse-based solutions to the country’s health care challenges, and to find new approaches that will meet the changing needs of our aging population.

“To successfully transform the way health care is structured and delivered in our country, it is absolutely essential to actively engage nurses for their leadership and unique expertise”, said Donna E. Shalala, Ph.D., secretary of Health and Human Services under President Clinton and chair of the Initiative’s 16-member study committee. “Nurses and their concerns must be part of our national discussion about health reform, and viewed as a key to the solution.”

As part of the Initiative, an expert committee will consider strategies that would give nursing leaders a greater voice in health care discussions and decisions, and spread the word about the many types of health care services nurses deliver.

“For health reform to succeed, and for patients to receive better care at a cost we can afford, we must change the way health care is delivered,” said Risa Lavizzo-Mourey, M.D., M.B.A., president and CEO of the Robert Wood Johnson Foundation (RWJF). “And nursing is at the heart of patient care.”

In conjunction with physicians and other health providers, nurses can improve care by playing larger roles in primary care delivery, Lavizzo-Mourey said. They are also uniquely trained to help patients manage chronic diseases and lead prevention and wellness efforts—both of which can improve the quality and reduce the costs of health care.

Higher nurse-patient ratios in health care settings have also been shown to reduce medical errors and hospital-acquired infections, shorten hospital stays and lower patient mortality, she added.

Committee to Confront Future Challenges to Nursing

The committee will also consider solutions to challenges to the nursing industry that threaten to undermine patient care, one of which is a serious nurse shortage predicted for the near future.

Americans are living longer—and sicker, placing greater demands than ever on the nation’s health care system. The nursing workforce, meanwhile, is also aging, and there are not enough younger nurses entering the field to meet projected demands. These twin phenomena suggest that demand for nurses will far outstrip supply in coming years, and could lead to a shortage of a half-million nurses by 2025.

Exacerbating the problem is a shortage of another kind: a lack of enough educators to train the next generation of nurses. Cash-strapped colleges, universities and community colleges cannot afford to hire enough faculty to expand nursing-school enrollment and, as a result, nursing programs are turning away thousands of qualified applicants—even as experts predict their skills will be in extremely high demand in the coming years.

Chaired by Shalala, now president of the University of Miami, the Initiative’s study committee will address these and other concerns facing the nursing profession and the health care system in a series of meetings over the course of the next year. Its first meeting was on July 14.

Also serving on the committee is vice chair Linda Burnes Bolton, Dr.P.H., R.N., F.A.A.N., vice president for nursing, chief nursing officer and director of nursing research at Cedars-Sinai Medical Center in Los Angeles, as well as 14 prestigious health leaders from academia, industry and non-profit organizations.

The committee will gather data at three forums and will present findings in a report to be released in the fall of 2010 that will include recommendations for public and institutional policy changes at the federal, state and local levels.

The Initiative is sponsored by RWJF and conducted by the IOM, which provides independent, objective, evidence-based advice to policy-makers, health professionals, the private sector, and the public. Susan Hassmiller, Ph.D., R.N., F.A.A.N., is serving as Initiative director.

To learn more about the Initiative on the Future of Nursing, click here.