You can call it by other names, but care coordination has been an essential part of nursing practice for decades. It’s part of our past, our present, and our future. However, it will be part of our future only if we continue to advocate for nurses to be recognized and compensated for the central role we play in ensuring that patients’ needs are met longitudinally, through all transitions in care and across settings.
Person-centered care coordination is one of our strong suits. It’s a core professional standard and competency for registered nurses (RNs), who take the lead in addressing patient and family needs and preferences in collaboration with multidisciplinary team members. So it’s time that we put a stake firmly in the ground and claim that leadership role as ours, especially with the steady drumbeat for more effective and efficient care. Furthermore, newer initiatives for population health and the announcement that the Centers for Medicare & Medicaid Services will expedite a dramatic shift from fee-for-service to alternative pay for quality models present both challenges and opportunities for nurses to lead care coordination in less traditional care settings.
The American Nurses Association has been engaged in numerous activities to move health care in the right direction by ensuring key roles for nurses. We’ve developed important resources to help nurses, policymakers, and other stakeholders better understand our pivotal role in care coordination, as well as to assist RNs in making a strong, value-based case for nursing to lead these efforts—at the patient’s side, wherever that may be.
In one recent initiative, ANA partnered with the American Academy of Nursing to convene a joint Care Coordination Task Force, which ultimately recommended policy priorities and strategies to advance nursing’s contributions to care coordination. The full scope of this work is outlined in the report “Policy Agenda for Nurse-Led Care Coordination,” published in the July-August 2015 issue of the Academy’s Nursing Outlook journal. One priority focuses on promoting measures that allow baccalaureate-prepared RNs and advanced practice RNs (APRNs) to be reimbursed for consistent, high-quality care coordination activities they provide. The second priority centers on accelerating the design, endorsement, and use of care-coordination measures, including those that capture nursing care.
In 2014, ANA advanced its Framework for Measuring Nurses’ Contributions to Care Coordination, which has informed national panels working to develop more robust care-coordination quality measures, including electronic clinical quality measures. Another key resource, edited by Arizona Nurses Association member Gerri Lamb and published by ANA, is the book Care Coordination: The Game Changer; How Nursing is Revolutionizing Quality Care, in which the authors share insights, evidence-based practices, and innovative care models to advance nursing’s role in care coordination and healthcare transformation.
In other efforts, ANA and nurse members continue to serve on and provide input to national quality committees where care coordination comes into play, as well as meet with policymakers to address RNs’ and APRNs’ strengths in this arena. One recent example is Maryland Nurses Association member Patricia Sengstack, who spoke before a U.S. Senate Committee’s Health Information Technology working group to share nursing’s perspective and recommendations for utilizing health information technology and the electronic health record to improve care coordination.
Right now, many healthcare professionals are willing to take the lead as care coordinators. But nurses are already there. Our practice is rooted in holistic thinking and a nursing process that focuses on identifying both patient needs and gaps in care, and creating interventions to address them. With proficient matching of care and services to a person’s needs and preferences, nurses are reducing hospital readmissions, effectively managing patients’ chronic conditions, and ensuring smooth transitions in care. Nurses don’t let patients slip through the cracks of our fragmented healthcare system. And whether it’s just a part of our job or our entire job, our ability to coordinate care is a way nurses can make a fundamental difference—now and in the future.
Pamela F. Cipriano, PhD, RN, NEA-BC, FAAN
President, American Nurses Association