Academic Nursing Advances Health Care Transformation

May 2016
David Vlahov

The American Association of Colleges of Nursing (AACN) recently released a commissioned report titled Advancing Healthcare Transformation: A New Era for Academic Nursing. By building on the Future of Nursing report from the Institute of Medicine, Manatt Health examined the opportunities for schools of nursing within or aligned with academic health centers (AHCs) to become firmly integrated in advancing health care transformation.

The AHCs are hubs of innovation for developing and testing new models of care. Nurses, of course, are key to the success of transforming health care in this new environment, especially as the Affordable Care Act facilitates experiments that move away from fee-for-service and toward value-based payments tied to metrics for quality, safety and value in the context of population health.

Over the past few years, schools of nursing have already begun contributing to these important changes through all aspects of our tripartite mission of research, education and practice. Some schools have demonstrated fiscally responsible nurse-managed clinics for student health and medically underserved community settings. Mary Naylor, PhD, RN – our UCSF Presidential Chair – has provided ample evidence for fiscally prudent transitional care models for complex care management in acute to community settings. At the San Francisco VA Health Care System, we have ample experience with joint medicine and nursing faculty models, which provide nonhierarchical, team-based care using the lens and strength of each profession. In many of these clinical settings, we are both training students and conducting the research necessary to deliver evidence-based solutions.

The AACN-sponsored Manatt report advances this agenda by offering a number of critical observations and recommendations that derive from a process that was both thorough and inclusive. The authors interviewed a wide range of stakeholders, including deans of nursing and medical schools, chief nursing executives, health system CEOs and university presidents. Manatt drew on its stellar reputation to convene a summit with many of these stakeholders to sort through priorities, barriers and facilitators.

One key ingredient for the successful integration of schools of nursing with AHCs to transform health care is joint appointments for campus and health center leadership. For example, in some institutions the dean of nursing is an associate chief nurse executive (CNE) and the CNE is an associate dean in the school. In other institutions, the dean might be a full member on the health center’s board of directors.

There are a number of other recommendations that speak to the essential central theme: Schools of nursing and AHCs must work together to create an organizational climate that not only brings all players to the table, but gives them the confidence and structure to innovate together. That is the best way to plan and achieve a successful transition to a new era in health care.