FRACTURES ON THE FAULT LINE: NURSING'S CALL TO ACTION
I am excited to launch this issue of Nursing Administration Quarterly. Over a year ago, the Editorial Board agreed on the theme and I am pleased that Guest Editors Joyce Batchelor and Noreen Bernard pulled together a fantastic group of authors sharing what they have done to address some of health care's "fractures." As we know, the pandemic exposed many of health care's flaws and fractures, and, now, they are in need of repair.
Since 2020, hospitals incurred budget deficits and their operating margins shrunk; many only survived because of government funding. We are now rebuilding, operating margins are growing, and, hopefully, will not be going back to what was before. We have an inequitable financial system as we are reimbursed differently depending on the payer, and there is no single national structure in America dedicated to paying for health care; thus, we have a very complex health care system.
The federal government makes most of the rules that apply to health care reimbursement. Health care entities typically receive reimbursement in a prospective method from government and private insurers, which are increasingly requiring quality measures with a focus on value. This is a marked change from prior eras when straightforward patient volume drove reimbursement. Nurse leaders are in an excellent position to drive health care quality, which will not only ensure that patients are safely and effectively treated but also ensure that optimum reimbursement for services is realized.1 As nurse leaders, we have little control over the way we are reimbursed and are left to manage our expenses in the best way possible to ensure quality patient care. With labor costs consuming up to 75% to 80% of the overall operating budget, the increased use of (expensive) travelers, the nursing shortage, high pharmaceutical costs, chronic diseases, and supply chain issues, it is no wonder that we have a shortage of nurse leaders and those working are stressed and becoming burnt-out!
Our issue authors have shared with us ways to leverage technology, build transition programs, develop new models of care and new models of precepting/mentoring, and more. What are you doing in your organization to repair the fractures you see?
Enjoy the issue and, thank you for all you do for nursing, our patients, and our communities.
-KT Waxman, DNP, MBA, RN, CNL, CHSE, CENP, FSSH, FAONL, FAAN
Editor-in-Chief
Nursing Administration Quarterly
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