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(HealthNewsDigest.com) – SILVER SPRING, MD – The federal government, health care insurers, and other health care financing systems should acknowledge the central role of registered nurses (RNs) in providing effective care coordination services, which should be fully funded to continue improving health care quality and patient outcomes and reducing costs through more efficient use of resources, the American Nurses Association (ANA) recommends.
Nurses’ contributions to care coordination, a long-held core professional standard and competency for RNs, is integral to patient care quality, satisfaction, and the effective and efficient use of health care resources. In a new position statement, “Care Coordination and Registered Nurses’ Essential Role,” ANA contends care coordination must be defined, measured, and documented by health care financing systems to create direct financial and systemic incentives for this function. Currently, care coordination, which fills many gaps in patients’ care plans, is neither well-documented nor reimbursed as a distinct component of patient care.
ANA leaders recently met with Centers for Medicare and Medicaid Services Administrator Marilyn Tavenner to discuss how to measure and pay for care coordination and how it can achieve savings for individuals eligible for both federal health programs.
“Care coordination has always been a part of nursing care. It’s long overdue that this nursing service is highlighted, accounted, and paid for, just like other essential health care services that a patient receives,” said ANA President Karen A. Daley, PhD, MPH, RN, FAAN. “Patients know that nurses are coordinating their care. They want to better understand their plan of care and be assured of continuity.”
Complementing the statement adopted June 11, ANA released a report, “The Value of Nursing Care Coordination,” highlighting numerous studies showing the positive impact of nurse-led and nurse-managed care coordination: improving patient outcomes, increasing health system efficiency, and lowering health care costs. For example, studies show that patient-centered care coordination reduces emergency department visits and hospital readmissions, lowers total annual Medicare costs, improves patient satisfaction and confidence to self-manage care, and increases safety for older adults during transitions between settings.
It is widely recognized that RNs have been leaders and innovators in designing and implementing successful team-based care coordination programs that improve patient care and reduce costs. Generally, care coordination involves ensuring that a patient’s needs and preferences for health services and information are communicated and delivered effectively among health care providers, functions, and settings over time. The main aspects of care coordination involve:
· Development of a care plan and assistance in identifying care options, guided by the preferences and needs of patients and their families;
· Management of care to maximize independence and quality of life;
· Communication with the patient, family and support network, and providers, especially during transitions between care settings; and
· Advocacy of dignified care.
“The nurse’s role is to ensure that essential services for the patient don’t fall through the cracks, which can easily happen in our current fragmented system of care where good communication between health care providers or settings is often lacking,” Daley added.
Nurses can perform care coordination as part of a multi-disciplinary health care team or independently within their scope of nursing practice.
The position statement also advocates expanding research to examine RNs’ evolving role and contributions to care coordination and more fully incorporating care coordination practices and theories into pre-licensure nursing education and continuing education.
For comprehensive information on nurses’ role in care coordination and the value provided to patients and the health care system, visit: www.nursingworld.org/care-coordination.
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The ANA is the only full-service professional organization representing the interests of the nation’s 3.1 million registered nurses through its constituent and state nurses associations and its organizational affiliates. The ANA advances the nursing profession by fostering high standards of nursing practice, promoting the rights of nurses in the workplace, projecting a positive and realistic view of nursing, and by lobbying the Congress and regulatory agencies on health care issues affecting nurses and the public.
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