Findings from a large study demonstrate that nurses are spending a majority of time away from direct patient care. The time of nurses often is diverted away from patient care due to hospital design and organizational inefficiencies.

To address these issues, more than 200 health care executives and frontline staff convened in January 2007 for the Nurse Work Environment Innovation Summit (NWEIS). This summit allowed participants to discuss the issues, review recent study questions and test potential solutions. Additionally, the Proclamation for Change emerged, which several health systems and professional consumer organizations have since adopted. This process draws from the experience of the Robert Wood Johnson Foundation and the Gordon and Betty Moore Foundation initiatives—Time & Motion Study, the Technology Drill Down (TD2), and Transforming Care at the Bedside (TCAB). The Proclamation for Change endorses the following four areas: (1) patient-centered design; (2) systemwide, integrated technology; (3) seamless workplace environments; and (4) vendor partnerships. This article captures the creation and impact of the Proclamation of Change, highlighting how three programs came together synergistically to change care in hospitals and outpatient setting.

NWEIS participants believe that the Proclamation’s four principles will result in:

• Increasing nurse time with patients;
• Turning documentation into a by-product of care;
• Administrating of medications as part of a seamless system;
• Creating a communications systems that links different health care providers; and
• Improving availability of both supplies and medical equipment on demand.