Models of care developed by nurses discussed at a briefing on health care reform

Sep 17 2009

Two innovative and highly successful models of care developed by nurses were the centerpiece of a briefing today on health care reform. The event, which brought together women's health leaders and health care experts, focused on the ways in which innovative health care models can help to improve efficiency, reduce costs and ensure quality care for patients and their families.

The briefing, On the Edge of Reform: Innovative Health Care Models, was sponsored by the American Academy of Nursing (AAN), which directs the Raise the Voice campaign. Raise the Voice showcases the ways in which nurses are leading the way in transforming the health care system and informs policy makers of these innovations and their success with an eye toward seeing those innovations replicated. The campaign is supported by a grant from the Robert Wood Johnson Foundation.

"Nurses are on the front lines of health care delivery in our nation," said AAN CEO Patricia Ford-Roegner. "Through Raise the Voice, we are proud to advance and promote the work of visionary nurses among policy makers, who are making it possible for models like these to be adopted more widely. And we are grateful to the Robert Wood Johnson Foundation for supporting the Raise the Voice campaign."

The two models showcased at the briefing have received widespread acclaim and attention and have been recognized at the federal level as important to improving health care. One focuses on improving transitional care for frail elderly and the other on improving pregnancy outcomes for low-income women and quality care for their young children.

The first model was developed by Mary Naylor, PhD, RN, FAAN, a professor of gerontology at the University of Pennsylvania School of Nursing. Through this program, Advanced Practice Nurses work closely with older patients and their families to develop a discharge plan for those patients (in concert with the patients' physicians) which are then implemented in the patients' homes to ensure access to ongoing quality care. The program has resulted in fewer hospitalizations for older patients, shorter stays and greater patient satisfaction. The program has also reduced hospitalization costs and has been proposed in Congress as a benefit to be covered under Medicare.

The second model was developed by a team led by David Olds, PhD, including Harriet Kitzman, PhD, RN, FAAN, a professor of nursing at the University of Rochester. It has been adopted in several states and is included in President Obama's proposed FY2010 budget. It provides first-time low-income new mothers with home care from a registered nurse, beginning at pregnancy through the first two years of the child's life. The nurses make 14 visits to the home during the pregnancy, 28 during infancy and 22 during the toddler stage. The program has resulted in fewer health problems during pregnancy, fewer higher risk pregnancies and reductions in injuries among children and emergency department visits during the second year of life.

U.S. Congresswoman Allyson Schwartz, who sits on the U.S. House Ways and Means and Budget Committees, spoke at the briefing, as did a representative from U.S. Senator Blanche Lincoln's office. Senator Lincoln sits on the Senate Finance Committee and the Senate Special Committee on Aging. They offered praise for these and other nurse-led models that have shown promise both in improving health outcomes and reducing costs.

"Health care in the United States is inaccessible to many, expensive for most and fragmented for all," said Ford-Roegner. "The current efforts to reform our health care system speak volumes about the problems created by a system that doesn't focus on preventive care and prompt, effective and comprehensive health care delivery. Nurses know how to develop and implement programs that will achieve these goals. That is one of the many reasons that they are so important to any health care reform discussions."