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How nursing will evolve under value-based care

As the healthcare industry transitions, nurses will have a huge role in leading the charge to help patients tackling chronic disease to proactively manage their health and keep them out of the hospital.

When we think of champions of health, perhaps there is no bigger advocate for patients than the nurse. Rooted firmly on the front lines of patient health, the role of the nurse has always been one of steadfast supporter. The person next in line (outside of the patient) who, arguably, knows and collaborates closest with the patient and their family, and understands their health needs best.

The nursing profession has evolved over time to adapt to fluctuating health care landscapes, but perhaps the biggest changes are still to come as the healthcare industry continues to head in a direction seeking quality of services over quantity and patient populations change. Nursing is positioned to grow—big.

According to the Bureau of Labor Statistics (BLS), employment of registered nurses is projected to grow 15 percent from 2016 to 2026, much faster than the average for all occupations. Driving the demand for health services, among other variables, is a rapidly growing and aging baby boomer population, many of whom have chronic disease. These older Americans also have a preference to age at home, a testament to another big jump—home health aides are projected to grow 47.3 percent.

What this trend potentially means is that more nurses will be adapting to broader roles outside of the hospital setting, with a greater focus on helping patients sustain their health on a much wider level. Wider than what acute care affords. Hospitals, increasingly under the gun to discharge patients as soon as possible, are expected to be a catalyst for more patients entering long-term care facilities, outpatient care centers, and needing home-based health care.

The growth projected for the nursing workforce over the next several years to meet the increased demand for health services is a good thing. Yet, much of the patient population fueling this surge will require a level of care that’s personalized, hands-on, and that can be sustained over time.

As this important sector of healthcare booms, along with the numbers of aging adults with chronic conditions, how can we best support nurses to deliver the high level of patient-centered care that these shifting roles demand? Can technology help?

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Changing the lens
By 2029, baby boomers will comprise 73 percent of the 65 and over population. Over 30 million of them will be managing serious chronic health issues. Patients with chronic conditions account for “81 percent of hospital admissions, 91 percent of prescriptions filled, 76 percent of all physician visits, and more than 75 percent of home visits.”

Furthermore, “Eighty-five percent of adults aged 65 years have at least one chronic disease, 62 percent have two or more chronic diseases, and 23 percent have five or more chronic conditions and these 23 percent account for two-thirds of all Medicare spending,” according to Orthopedic Nursing.

Nurses will have a huge role in leading the charge to sustain these patients—helping them to proactively manage their health and keeping them out of the hospital. Innovative programs that emphasize prevention and that offer comprehensive patient education can go a long way. Engaging the patient and supporting them in a way that fosters self-management and the ability to make and maintain major lifestyle changes is critical. Changing the lens from one that’s solely provider-focused to one that incorporates the patient’s input and perspective as part of the equation can help achieve this.

Digital health tools can be hugely impactful to help nurses deliver this level of care. And EHRs alone aren’t going to cut it. EHRs were designed mainly for provider visits—to drive value for hospitals by converting office visits into billing codes, but they can’t support what’s at the core of value-based care—they were never meant to.

For the nurses entering the workforce as well as the veterans, this is a new job, and it warrants new tools. Tools that are going to capture and integrate valuable data, coordinate care among all parties involved, provide clinical decision support, and give nurses the resources to help educate, engage, motivate, and empower patients to fully participate in their own well-being.

Technology can help make complex workflows more manageable for nurses as they navigate these new roles, and will be key, especially for nurses managing patients with chronic conditions outside of the hospital or office setting. Investing in digital health tools that can consolidate all of these measures—workflows, patient data, provider and patient interactions and so forth—into a unified source, will be a game changer and essential to deliver truly holistic care and ensure patients who need ongoing engagement receive it and don’t fall through the cracks.

The road ahead
Using technology to create better workflows and practices for nurses can also help alleviate fatigue and burnout, which takes its toll and can eventually trickle down to patients.

A survey from last year found that nearly half of responding nurses (49.8 percent) are considering leaving the profession. The top reason nurses want to leave was due to “feeling overworked” (27 percent), followed by 16 percent who shared that they don’t enjoy their job anymore. Additionally, 46 percent said their workloads had increased.

Findings from another survey revealed that 85 percent of hospital nurses find that their jobs make them feel fatigued overall, 63 percent said that their work has caused burnout, and 44 percent worry patient care will suffer because of fatigue. The BLS projects that although large job growth is expected for home health aides, the high emotional demands of that job specifically may also cause many workers to leave and need to be replaced.

Better support for patients is vital but supporting the individuals responsible for the well-being of these patients should be a no brainer. Sure, there is a hefty number of nurses projected to care for the patient populations expected to boom, however, to keep them sustained in these roles and to avoid costly turnover, nurses need more tools that meet the shifting requisites of the job.

Just as we’re discovering how valuable and integral the patient voice is to delivering impactful care, feedback from nurses across all spectrums of care, is critical to maintaining a healthy, happy, productive workforce.

This changing approach to health care was born from an influx of too many people sick with chronic disease not getting better, rising health care costs, too many providers not on the same page and not communicating, and too many people ignoring the one person vital to ensuring the end result is a positive one—the patient.

Nurses are on the front lines ready to lead this change, the question is, are we preparing them adequately to do so?

Photo: Susan Chiang/Getty Images

 

 

 

 

 

 

 

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