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Health Care Is Changing as We Speak. Why Are We Considering Mandates Based on Yesterday’s Model of Care?

August 25, 2015 | By: Paula Bussard

Health Care Is Changing as We Speak. Why Are We Considering Mandates Based on Yesterday’s Model of Care?

Evidence abounds that health care is moving away from a hospital-based model focused only on treating people with grave illnesses and injuries. Instead, we are working to keep people healthy (and out of the hospital) as well as taking care of them when they are sick.

According to a Kaufman Hall analysis, hospital and health system mergers and acquisitions increased 50 percent from 2010 to 2013. Hospitals are consolidating to access the capital needed to invest in new ways to improve the health, as well as the health care, of their communities. Hospitals are joining with partners to build continuums that include primary, outpatient, and at-home care.

Meanwhile, reliance on hospital care is decreasing. In Pennsylvania, hospital admissions are dropping steadily—down about 7 percent from 2010 to 2013.

With innovations in telehealth, patients can get medical help for common illnesses via their laptops or smart phones, without setting foot in any kind of health care setting. Lancaster General Health provides virtual doctors’ visits for ten common health problems. In a recent national survey, three out of four large employers said they plan to offer their employees telehealth options next year.

With Pennsylvania’s health care landscape evolving so quickly, are we making the best use of our time and resources by legislating hospital mandates that apply to old models of care?

Case in point: Nurse ratios that would put into law the minimum number of nurses that hospitals must have on duty to care for patients.

Do we really want a law requiring “one-size-fits-all” nurse staffing based on yesterday’s health care system?

Nurses are more important than ever to our health and health care. Always crucial, the role of nurses is changing and expanding.

A recent survey conducted by The Hospital & Healthsystem Association of Pennsylvania (HAP) shows that consumers trust nurses—ahead of doctors, hospitals, insurers, and lawmakers—to stand up for patients’ well-being. This trust makes nurses the ideal professionals for leading some of the biggest changes and improvements we need.

Nurses are often the voices of patients being cared for by a broad team of physicians, pharmacists, dieticians, physical therapists, and others. Nurses connect the dots, making sure these different experts understand patients, and vice versa.

Nurses are being recruited as health coaches and patient educators for a wide variety of health care needs—in all types of health care settings, and by insurers and employers as well as hospitals and health systems. The goal? To help consumers and patients adopt healthy habits, better manage health conditions, understand and follow their care plans—and stay out of the hospital.

Nurses are improving the efficiency as well as the effectiveness of health care. In the new team-based approach, nurses collaborate with doctors, social workers, and others. Each functions at the “top of their practice,” freeing colleagues to focus on their areas of expertise.

Old models of care that create silos, isolating health care professionals and environments, no longer work. These models hamper coordination, patient engagement, and critical thinking.

As suggested by national expert Lucien Leape, MD, in his call for transforming health care, they take away “the joy and meaning of work.”

For too many patients, health care can feel complex, confusing, and impersonal—“caught up in red tape” according to consumers in that HAP survey.

Let’s give doctors, nurses, social workers, hospitals, and others the flexibility, encouragement, and support to re-invent health care. Their job is hard enough by far without the burden of rigid mandates that may be outdated soon after they are enacted.

Paula Bussard
Written by Paula Bussard

Paula Bussard is HAP’s chief strategy officer. Paula has more than 25 years of experience in health care policy and administration. Paula assists with creating organizational direction, and executing, communicating, and sustaining high-priority and strategic initiatives for HAP and its member hospitals and health systems.




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