With the passing of the Affordable Care Act (ACA), there was a need for the healthcare industry to restructure itself to meet such a challenging objective. The expansion of health care coverage represented a huge task for the many stakeholders in this industry and this reason; there was a need for each to take up a calculative response (Fairman, Rowe, Hassmiller, & Shalala, 2011). Examining the approach that the Nursing sector has decided to take up requires the review of the collaborative work by Robert Wood Johnson Foundation Committee Initiative (RWJFCI) and the Institute of Medicine research (IOM), which was appropriately presented in the "Future of Nursing: Leading Change, Advancing Health" report. This paper has a state-based approach to this analysis and uses California as a reference point to better understand/present the implementation of the report recommendations at the state level.
To correctly understand the response of the Nursing sector to the challenging requirements placed upon them by the ACA, it is important to go ahead and review the IOM report as it contains key essentials facts about this topic. As mentioned in the IOM report was a cumulative effort of both the (RWJFCI) and the (IOM) with the former approaching the later in the year 2008 to discuss the best strategy to be taken up by the Nursing sector (IOM, 2011). From the report, it is easy to go ahead and identify the essential objectives that both stakeholders formulated or saw as the best approach to aid in creating the Nursing sector into a contributive element in the betterment of national health care. It is imperative to mention that this response is tailored not only to improve the health care sector but also the Nursing sector in a quasi-related approach. The Nursing sector constitutes an important element to overall healthcare thus; its betterment should also elicit a similar response in the overall industry.
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Scrutiny of the IOM report identifies its scope or in other words, the key issues that it was meant to address concerning Nursing as a whole. Four major factors were to be looked into with recommendations being generated to eventually provide a direction regarding the Nursing sector’s response. The first one involved the “reconceptualization of Nursing in its larger context of the healthcare workforce” (IOM, 2011). The convened committee simply identified that there were various drawbacks currently present that prevented nurses from fully contributing to the healthcare sector. These involved factors such as nurse shortages, the role of technology, as well as other existing factors slowing done nurses in their workplace setting. This reconceptualization, as well as revision, was also meant to expand into nursing education (IOM, 2011). With the last two being an improvement of workplace conditions as well as service delivery for and from nurses. From these four critical issues, the report was charged with formulating key recommendations that would properly address and give rise to working strategies and solutions for the Nursing sector.
After identifying the key objectives as well as issue of the IOM report, a proper step to proceed to is looking at the key recommendations that were made and eventually their implications on the Nursing sector. In response to the task before the committee through the report, four major recommendations were made, that sought to improve the Nursing sector and eventually its contribution to the Healthcare Industry. These touched on important factors such as nursing education, practice, their contribution to the healthcare sector and how to improve general the sector generally through the reliance of information and technology (IOM, 2011). From this, one can see that the report recommendations had a more specific approach, which would ensure that the different nursing aspects such as education, workplace restrictions among other affected factors would be greatly improved on the implementation of the commendations.
Other sources have gone ahead to provide more specific examples that help understand the impact of the report’s recommendations. For example, (Melnyk, Fineout-Overholt, Gallagher-Ford, & Kaplan, 2012) discusses one major restriction that was largely affecting nurses, namely the locking out or prevention of Evidenced Based Practice (EBP) by nurses. This can be seen as one of the examples of how a key grievance by nurses concerning the issue of not being able to practice EBP fully was a major restraint concerning their input to the healthcare sector, and its elimination would aid both parties to improve their output.
Hence, from such an example, one can see how the IOM report simply covered as well as provided key recommendations that would improve nursing in general. The example was largely work-based and dealt with the issue of Nurses and their grievance for workplace discrimination as compared to their other health care counterparts. This also correlates with the objective of ensuring that nurses are allowed to fully practice their trade, hence requiring the removal of restrictions that adversely affect them. (Armstrong, & Laschinger, 2006), go ahead and identify the need for nursing empowerment to improve healthcare. Hence, from an overall perspective, the improvement or revision of nursing education, workplace conditions, capabilities contributions among other key factors are key objectives as well as outcomes of the IOM report.
Looking at how the discussed factors above have been implemented at the state-level may also try to give a clear as well as practical understanding of the discussed subject matter. Using the context of California one can see that at the state level strong efforts have been placed to aid in the achievement of these set objectives. From the information posted on the Campaign for Action, which covers on the critical initiatives that are being made at the state level by nursing stakeholders it is evident that measures are being set to achieve the set objectives of the IOM. The first example that demonstrates this is that of how reliance on information technology is being employed to help improve the quality of service delivery in the country. The service known as Telehealth, which is simply a digital platform for health care delivery and its implementation in Los Angeles shows how the state of California is dedicated to improving nursing and hence the overall health care delivery (Campaign for Action, 2016). This approach is in line with the key recommendation of the IOM report concerning “data collection and information structure” IOM, (2011).
In conclusion, service delivery has also been another crucial aspect that was addressed by the committee with the main recommendations made to the nursing sector to try to improve this factor. This is reflected in the California state with the recent call for improved approaches such as “community engaged research” (Campaign for Action, 2016). These are simply examples of how the Nursing stakeholders in the state of California have looked to try and implement the report recommendations and in so doing improve their effectiveness and contribution to the healthcare sector. Despite existing barriers such as the workplace, restrictions that require doctor supervision during practice existing in California and other states efforts are still being made to tackle such issues. Nurses can simply contribute to this by focusing on implementing the recommendations made by the report. The key advantage is that all stakeholders benefit from this, thereby improving the nation as a whole.
References
Armstrong, K. J., & Laschinger, H. (2006). Structural empowerment, Magnet hospital characteristics, and patient safety culture: making the link. Journal of Nursing Care Quality , 21 (2), 124-132.
Campaign for Action (2016, August 15). “It’s Telling My Story”: Community-Engaged Research. Campaign for Action . Retrieved September 18, 2017, from https://campaignforaction.org/telling-story-community-engaged-research/
Campaign for Action (2016, October 19). Telehealth Expands Care for Those in Vulnerable Communities. Campaign for Action . Retrieved September 18, 2017, from https://campaignforaction.org/telehealth-expands-care-for-those-in-vulnerable-communities/
Fairman, J. A., Rowe, J. W., Hassmiller, S., & Shalala, D. E. (2011). Broadening the scope of nursing practice. New England Journal of Medicine , 364 (3), 193-196.
Institute of Medicine (US). Committee on the Robert Wood Johnson Foundation Initiative on the Future of Nursing. (2011). The future of nursing: Leading change, advancing health . Washington, DC: National Academies Press.
Melnyk, B. M., Fineout-Overholt, E., Gallagher-Ford, L., & Kaplan, L. (2012). The state of evidence-based practice in US nurses: critical implications for nurse leaders and educators. Journal of Nursing Administration , 42 (9), 410-417.
