Chapters 3 through 5 have argued for the need to transform the nursing profession to achieve the vision of a reformed health care system set forth in Chapter 1. Achieving this vision, however, will also require a balance of skills and perspectives among physicians, nurses, and other health professionals. Yet data are lacking on the numbers and types of health professionals currently employed, where they are employed, and in what roles. Understanding of the impact of bundled payments, medical homes, accountable care organizations, health information technology, comparative effectiveness, patient engagement,and safety, as well as the growing diversification of the American population, will not be complete without information on and analysis of the contributions of the various types of health professionals that will be needed. For cost-effectiveness comparisons, for example, different team configurations, continuing education and on-the-job training programs, incentives, and workflow arrangements—all of which affect the efficient use of the health care workforce—must be evaluated. Having these data is a vital first step in the development of accurate models for projecting workforce capacity. Those projections in turn are needed to inform the transformation of nursing practice and education argued for in Chapters 3 and 4, respectively. levitra vs tadalafil side effects immediately cialis inizio effetti also cialis.com personally how long after taking tadalafil can i take viagra.
Given the crucial role of nurses with respect to the quality, accessibility, and value of care, the nursing profession itself must undergo a fundamental transformation if the committee’s vision for health care is to be realized. As this report argues, the ways in which nurses were educated and practiced during the 20th century are no longer adequate for dealing with the realities of health care in the 21st century. Outdated regulations, attitudes, policies, and habits continue to restrict the innovations the nursing profession can bring to health care at a time of tremendous complexity and change. Health care workforce effectiveness research—Researchers should develop data and support research to evaluate the impact of new models of care delivery on the health care workforce and the impact of workforce configurations on health care costs, quality, and access. This effort should include coordination with other federal agencies to ensure that key data elements are incorporated into federal surveys, claims data, and clinical data. Research should include evaluation of strategies for increasing the efficient education, preparation, and distribution of the health care workforce. Finally, workforce research needs to be included in federal pilot and demonstration projects involving payment innovation, introduction of new technologies, team-based care models, and other advances. farmacias que vendem tadalafil then www.cialis.com free trial also buy cialis initially tadalafil viagra price. In 2008, the Government Accountability Office determined that there were few projections of the future need for primary care providers, and those that existed were substantially limited (Steinwald, 2008). Arguably, it is simpler to project the future supply of health professionals than to project future demand for their services. It is difficult to predict, for example, the pattern of increased demand for primary care after full implementation of the ACA adds 32 million newly insured people to the health care system. Will there be a short, marked spike in demand, or will the surge be of longer duration that leaves more time to adapt?
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