The Accountable Care Act has served as a tipping point for health care reform in the United States. However, there remains a great deal of uncertainty about how the system and subsystems will look once the details of the reform are implemented. Instead of waiting for all the processes and regulations to become fully developed, we have enough guidance and information to shape the future of our nation's health care. Nurses are the largest group of frontline providers, currently at 3 million. We can leverage our numbers and knowledge to demonstrate the patient and system-level impact.
In this issue, Dr Sean Clarke, a noted nurse scientist, describes academic-service partnerships over time and related challenges, as well as key recommendations for excellence in this domain in light of reform. Drs Linda Everett and Mary Sitterding introduce a successful, innovative model of staff nurse engagement and development that puts these direct care givers in the driver's seat to lead improvement. Dr Mary Newell provides tangible findings from a study of school nurses and conveys how, if our school nurses are not well trained and do not work closely with their local providers, the results will translate into more patients being admitted to inpatient settings where staff are unprepared to meet not only their physical needs but also their developmental needs. This is particularly true of those being transitioned from pediatric to adult care settings. Other highlights in this issue include new findings about personal care robotics, engaging patients and families in system-level improvements, insights from a quality improvement program, how to build a successful patient and family advisory board both for English and Spanish speaking consumers, and finally, how to link evidence-based care and patient-centered care through patient preferences.
It is impossible to address every aspect of care amidst the changes facing all of us who seek to recalibrate our practice settings to align with transparency, accountability, and the ever-increasing fiduciary complexities. However, we believe this issue serves as a way to envision and create new ways of integrating new ideas into your setting regarding these topics. Those organizations that choose to adapt and change, even under the uncertainty of reform, will set the pace for those who do not.
We believe these thoughtful and sometime provocative articles by our experts serve as a template of sorts for how we transform our environments to take care of our patients and families, regardless of setting and across the continuum of care. We look forward to your feedback on this issue, End Users of Health Care.
The guest editors would like to thank Ms Adrienne Olney for her assistance with this issue.
-Susan Lacey, PhD, RN, FAAN
Program Director, AACN-Critical Care,
Clinical Scene
Investigator (CSI) Academy
American Association of Critical Care Nurses
Columbia, Aliso Viejo, California
-Karen Cox, PhD, RN, FACHE, FAAN
Executive Vice President
Co-Chief Operating Officer
Children's Mercy Hospitals and Clinics
Kansas City, Missouri