The Institute of Medicine (IOM) released a groundbreaking report last Tuesday that called for a radical transformation of the nursing profession to meet increasing demands for health care at a time of significant demographic and health system changes.
Nurses’ roles, responsibilities and education should change significantly to meet the increased demand for care that will be created by health care reform and to advance improvements in America’s increasingly complex health system, the report says.
“The report aims at empowering nurses to be even more effective and making long-lasting improvement to quality, access and the value of health care for all Americans,” IOM president Harvey Fineberg, M.D., M.P.P., Ph.D., told a standing-room-only crowd at a news conference unveiling the report at the National Press Building in Washington, D.C. Established in 1970, the Institute of Medicine provides independent, objective, evidence-based advice to policy-makers, health professionals, the private sector, and the public.
The Future of Nursing: Leading Change, Advancing Health is the product of a two-year study convened under the auspices of the Robert Wood Johnson Foundation (RWJF) Initiative on the Future of Nursing, at the Institute of Medicine. An expert committee reviewed scientific literature on the nursing profession and held a series of public forums to gather insights and evidence from a range of experts.
“The report’s recommendations provide a strong foundation for the development of a nursing workforce whose members are well-educated and prepared to practice to the fullest extent of their training, meet the current and future needs of patients, and act as full partners in leading advances in the nation’s health care system,” said committee chair Donna E. Shalala, Ph.D., F.A.A.N., president of the University of Miami in Florida. Shalala headed the U.S. Health and Human Services Department under President Clinton.
“Transforming the nursing profession is a crucial element to achieving the nation’s vision of an effective, affordable health care system that is accessible and responsive to all,” added committee vice chair Linda Burnes Bolton, Dr.P.H., M.P.H., M.S.N., vice president for nursing, chief nursing officer, and director of nursing research at Cedars-Sinai Medical Center in Los Angeles.
Report Comes at Critical Time as Nation Overhauls Health Care System
The report comes as the nation faces a looming shortage of primary care providers, including nurses. People are living longer, but they are also living sicker, and having to manage multiple chronic health conditions for indefinite periods of time. At the same time, millions more patients are entering the health care system thanks to the Affordable Care Act of 2010, the new law reforming America’s health care system.
As the demand for nursing and other health care services rises, the supply of nurses is shrinking. Nurses and nurse educators are aging along with the rest of the population, and there are not enough new nurses in the pipeline to meet projected demands for their services.
To address these and other health care challenges, the IOM report recommends changes in the following areas: removing barriers that prevent nurses from practicing to the full extent of their training and abilities; fostering interprofessional collaboration so that nurses are full partners with physicians and other health professionals in redesigning health care in the United States; improving nurse education so that nurses are able to meet changing health care needs; creating an infrastructure for interprofessional health care workforce data collection; and preparing and enabling nurses to lead change.
Specific recommendations include the implementation of residency training for nurses, increasing the percentage of nurses who attain a bachelor’s degree to 80 percent by 2020, and doubling the number who pursue doctorates.
At more than 3 million in number, nurses make up the single largest segment of the health care workforce. They also spend the greatest amount of time in delivering patient care as a profession. Nurses therefore have valuable insights and unique abilities to contribute as partners with other health care professionals in improving the quality and safety of care as envisioned by the Affordable Care Act, the committee said.
The Initiative on the Future of Nursing will hold a national conference Nov. 30 through Dec. 1 to discuss ways to implement the report’s recommendations.
“Some of the conclusions are likely to be controversial but that is because they are consequential,” said Risa Lavizzo-Mourey, M.D., M.B.A., RWJF president and chief executive officer. “But I want you to draw an important conclusion from this: We can do it. But it’s going to take more cooperation and collaboration across private sectors than we’ve ever seen before.”