Quality and Safety in Nursing - Группа авторов

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      In this chapter we explore nurses’ engagement in the policy‐making process utilizing the rational decision‐making approach, which provides a level of familiarity and reasonableness. However, we also begin to look at policy‐making through a lens of political reasoning, to understand how it is that we need to relate to the political will of the people we serve. Nurses’ ability to continue to be successful in influencing policy will require the adoption of both. Nurses do have somewhat of an advantage in the latter, in that their lived experiences at the front lines with patients and families generate passion and stories that allow them to be persuasive. It is up to nurses to use these opportunities to create the metaphors and analogies that inform a political community rather than only a market‐driven one.

      Many collective efforts have been initiated over the last 30 years to drive quality and safety improvement through policy channels. This chapter describes both formalized and innovative efforts that continue to grow out of a need to address health delivery challenges, using organizational structures and alliances whose missions were substantially focused on quality and safety. The list is necessarily broad and incorporates federal agencies as well as professional organizations and alliances. Certainly this list is not exhaustive; the intent has been to include those efforts in which nursing has or needs to have a voice in the formal agenda, solutions, and policy formulations. In addition, this chapter touches on some of the additional opportunities for policy input through regulation and rule‐making that inevitably emerge from massive policy enactment.

      This chapter incorporates the result of three decades of effort, including the passage and implementation of the ACA and the many provisions within it that support health care quality and safety. It also speaks to the ongoing efforts to press forward with quality despite many political attempts to end the ACA. It includes other recent policy efforts to advance health and health care that focus on the health disparities that make federal and state efforts to improve quality fragmented at best. Efforts to modify reimbursement and minimize barriers to effective patient care delivery will also be examined.

      The urgent need to become more inclusive of consumer groups and other partners to promote safety, quality and—yes—health equity has spurred innovation, new initiatives, and newcomers. Nurses who engage with consumer innovators may find themselves with more opportunities to influence policy, by seeking first to understand the consumer point of view, and then to engage on an equal footing through shared partnerships. The following represents a sampling of exciting newer opportunities to engage on behalf of quality and safety.

      Patient Family Centered Care Partners

      Patient Family Centered Care Partners (PFCCpartners; https://pfccpartners.com) is a small organization with a large vision for improving the quality, safety, and experience of health care through the development of authentic partnerships, from the bedside caregiving relationship to the boardroom where programs and policies are established. It was founded in 2010 in response to a request by the health care community in southern California for a resource and support network to establish patient family‐centered care practice. Its founder is a patient family advisor with more than 20 years’ experience in partnering with hospitals, health care organizations, national health policy organizations, and care teams. This organization is committed to collaborating with patients, families, physicians, health care administrators, nurses, therapists, social workers, and all those invested in improving health care.

      Planetree International

      Not a newcomer, but certainly one that has established itself in the arena of quality and safety, is Planetree International (https://planetree.org). Integrating the patient and family voice in health care delivery has been at the heart of Planetree’s work since a patient founded it in 1978. Planetree’s health resource center, one of the first of its kind, provided consumers with a broad array of information about quality and safety. It became a model for hundreds of similar centers around the country. Planetree established the country’s first patient‐centered care model, with open medical records, patient‐directed visitation, and attention to spiritual and emotional needs. This model is now used in more than 700 clinical sites in 25 countries and is impacting more than 9 million patients and health care providers globally to view the care journey differently.

      As a response to the COVID‐19 pandemic, Planetree took the initiative to develop a document that it promulgated widely: Guidelines for Preserving Family Presence in Challenging Times (Planetree International, 2020). This set of guidelines outlines considerations for maximizing the therapeutic benefits of family presence and participation while in the middle of a response to COVID‐19.

      Project Patient Care

      Composed of a diverse community of patients, family members of patients, caregivers, health care professionals, and organizational leaders, Project Patient Care (www.projectpatientcare.org) is an independent nonprofit organization working to prevent medical errors and continuously improve health care quality. Focused on the ambulatory experience, this organization has most recently determined tools for best measuring patients' engagement while not overburdening them with lengthy survey instruments.

      National Partnership for Women & Families

      Also not a newcomer but more actively engaged than ever in the policy‐making that affects social determinants and health disparities that concern nurses, the National Partnership for Women & Families (www.nationalpartnership.org) has been and continues to be a strong advocate for the following policies: the Pregnancy Discrimination Act, the Civil Rights Act, the Family and Medical Leave Act, the ACA, state‐wide paid family leave programs, and numerous local and state paid sick days laws. A longstanding supporter of equal rights for women and equal pay, the Partnership has taken on the work of advancing racial equity. It is also advocating that Congress protect US workers in its response to the COVID‐19 emergency.

      The National Partnership has also taken the lead for the Consumer Partnership for eHealth. A unique coalition of more than 50 leading consumer and patient organizations (representing more than 127 million Americans), this partnership works to advance health information technology (IT) and health information exchange in ways that measurably improve the lives of individuals and their families.

      National Governors Association

      Normally involved in working with the President to address matters of national security and defense, since the beginning of the pandemic early in 2020 and the resulting economic slump, Governors have been directing their states’ resources where they are needed most and where they will achieve the greatest impact. Governors have been actively engaged in delivering state services to protect public health and to stimulate economic recovery and growth. They are working with state legislators to make appropriate policy and implement their states' own emergency measures to improve safety for patients, health care workers, and residents and to prevent spread of the virus to other states and communities. The National Governors Association (www.nga.org) has provided platforms for Governors to communicate with each other and to easily follow what is happening in other states across the country on a daily basis.

      Academy of Oncology Nurse & Patient Navigators

      The Academy of Oncology Nurse & Patient Navigators (AONN+; Скачать книгу