Nursing has a long and rich history of advocating for population health management. Nursing's care model is the use of nursing knowledge to examine factors impeding the health of the populace. This began with Florence Nightingale. She studied the impact of environmental factors, water, sanitation, temperature, and cleanliness to prevent the spread of illness. The daily practice of frontier nurses, visiting nursing service, home care, public health, community health nurses, and nurse-managed clinics to engage and educate communities and neighborhoods about preventing disease and illness is representative of the activities called upon to successfully implement population health management. Our history is full of exemplars from the past and the present about nursing's contribution to helping the nation attain and sustain a state of health. So what's different in the 21 century? What is all the fuss about population health now? It's the triple aim. The demand to lower the total cost of health care by reducing utilization of acute care services, engagement of consumers to manage their health, elimination of health system waste, and deployment of the best practices that result in better health at a lower cost across the continuum of health care.
Nursing began its work in population health by reaching out to consumers and deploying innovative strategies to increase access to safe, quality, population-centered health care services. Nurses went to neighborhoods, community clinics, schools, worksites, tenants, and slums when other members of the health profession were reluctant to serve the public. Nurses, steeped in the richness of our tradition of human caring for all equally without regard for race, ethnicity, gender, age, or ability to pay, have consistently promoted the principles and value of population health.
Population health management aims to reduce the financial risks inherent within our current health system while expanding access to health care services. Success in population health management is measured by the reduction in the total cost of care for covered lives including costs associated with medications, acute care hospital admissions and readmissions, hospital length of stay, hospital-acquired conditions, diagnostic procedures, and emergency department visits.
In this issue, we highlight several examples of efforts to design and launch population health management programs. Many models have emerged over the last decade, and the authors in this issue of Nursing Administration Quarterly provide you with excellent examples, from the role of technology in population health to a personal story about the impact of declining health on one nurse's life. Nurses engaged in efforts to improve the health of the nation by leading programs aimed at achieving quality health care outcomes while decreasing the total cost of care are the new pioneers. Indeed, like frontier nurses of the past, nurse leaders must engage consumers as active and participating members of the team aimed at keeping individuals healthy while initiating programs as depicted in this edition that promote health of the population through the provisions of innovative and purposeful caring-the essence of nursing's work.
-Linda Burnes Bolton, DrPH, RN, FAAN
Vice President and Chief Nursing Officer
Cedars-Sinai Medical Center
Los Angeles, California
Rhonda Anderson, DNSc (hon), RN, FAAN, FACHE
Chief Executive Officer
Cardon Children's Medical Center
Mesa, Arizona