Reflections on: Prybil LD. Nursing engagement in governing health care organizations: past, present, and future. J Nurs Care Qual. 2016;31(4):299-303.
In this article, Prybil presented an analysis of nurses' participation on health care boards. The results were both disappointing and difficult to read. Prybil's analysis of recent studies indicated that the numbers of nurses on boards have not changed much in the past decade. The arguments cited by Prybil for having nurses on boards are relevant. There is an additional reason for nurses to be on boards that need some expansion: Transition of care and continuity of care from one facility or caregiver to the next have to be strategized correctly, implemented, and evaluated for effectiveness. Nurses keep those transition points of care as well as the patient as the focus in boardroom discussions as new models of care are being developed.
The majority of transitions for continuity of care rest in the institutions that are nursing run and delivered. Nurses understand the realities of transferring patients as well as the pitfalls. Communication, documentation, and relationships with other organizations are key to effective transitions for patient care. Nurses are often the facilitators for the patient's last communication and handoff to another facility or care provider. Knowledge of the practices and effectiveness of these next steps of patient care is needed in the boardroom. It is the nurse in the boardroom who truly understands the organizational flow of patient care, issues in transition of care, and effectiveness in the next steps of continuity of care that enable patients to remain outside the walls of the emergency department or hospital. Without the nurse as patient advocate in the boardroom, decisions about care may be less effective for the patient, patient's family, and health care institution.
Health care boards are deliberating coordinated models of care across the continuum that need to be cost-effective, provide quality care, and prevent unnecessary readmissions. As governance members, nurses add value that shape the discussions and decisions about transitions and the continuum of care based on the nurse's knowledge about health care operations, communication processes, effective care processes, and the complexities of coordinated care across the continuum.
Plans, challenges, and strategies to implement quality care in all aspects of health care planning along with allocation of capital are current discussions in the boardroom. Nurses are needed for these deliberations and decisions. It is with hope that the next board analysis will demonstrate nurses are on health care boards at a higher frequency.
-Carolyn Hope Smeltzer, EdD, RN, FAAN
CHS: Consulting Healthcare Services
Chicago, Illinois
JNCQ Editorial Board member
[email protected]