Imagine Skyping your nurse, Anna, for morning check-ins the week after your shoulder surgery, or live-streaming your vitals through your smart device so she can re-evaluate your medications. During recovery, you video-conference regularly with your care team, but Anna reminds you that whenever you’re up to it, she’d love to see you in the office as well.
This health care scenario is closer than you think, and Kaiser Permanente is leading the way with evolving care models and workforce planning strategies designed to deliver exceptional care now and into the future.
Nurses are key
The Institute of Medicine, in its 2010 Future of Nursing report, envisions a time not too distant when high-quality health care is seamless, affordable, accessible, patient-centered and evidence-based, and “primary care and prevention are central drivers” of the system. The institute sees transformation of the nursing profession as critical to achieving that vision, and makes specific recommendations such as improving nursing education, cultivating nurse leadership and improving data collection for workforce planning.
Kaiser Permanente’s integrated health care delivery model already incorporates and delivers on the IOM’s vision elements. Still, tomorrow’s workforce must be prepared and ready to meet consumer needs of the future — so the organization is laying the groundwork today. And like the IOM, Kaiser Permanente recognizes that nurses are crucial in the coming transition.
Workforce of tomorrow
There are 3 million nurses in the U.S. — 49,778 at Kaiser Permanente —serving in front-line roles throughout the care continuum, as well as in management, policy, education, research and more.
“As the largest provider group in the country, nurses represent a huge opportunity to improve health at individual, community and population levels,” said Judith G. Berg, executive director at California Institute for Nursing & Health Care, a nonprofit dedicated to developing the nursing workforce.
“Workforce planning goes beyond just headcount numbers,” said Catherine Dower, director of National Nursing Research and Policy at Kaiser Permanente. “It’s about anticipating what our members will need in the future, and making sure we’re providing the right care at the right time. It means looking at ‘pipeline’ issues, such as nurse turnover, retirement and succession planning, to ensure appropriate staffing that gives our members the best and safest care possible. And with care models evolving so quickly, it’s about planning for shifting and newly emerging roles.”
Possible roles for nurses of tomorrow, as explored by the CINHC, include informatics specialist, care coordinator and primary care partner, among others.
The great value in rethinking care-team roles — especially for nurses — has been highlighted by a recent Kaiser Permanente initiative called Team Based Care, which has shown that innovative approaches to workforce planning can lead to better outcomes for patients and providers.
The ‘heart of nursing’
Kaiser Permanente’s Team Based Care model recently rolled out at 17 sites in the Northwest Region in Oregon and Washington. Aimed at improving the care experience of patients aged 65 and over with complex needs, the initiative has gotten high satisfaction rates from patients while decreasing emergency room visits, hospital readmission rates and costs for both patients and Kaiser Permanente.
Team Based Care restructured the provider-patient relationship to be more patient-centric. Patient goals and desires for care are at the center of an interdisciplinary, coordinated care team that includes a nurse, physician, social worker, navigator and others.
The nurse establishes a close relationship with patients, helping them clarify their needs, goals and desires, and incorporates those into an individualized care plan. She or he monitors the patient, handles care coordination, makes recommendations and wellness decisions, advocates for the patient, and proactively manages care.
“Nursing is all about the human response to illness,” said Kathy Jensen-Dawson, RN, at Team Based Care Services at the Mount Scott Medical Office in Clackamas, Oregon. “Having the time to get to know the patient as a person — their clinical and non-clinical needs — allows me to use my holistic skills to provide better care. That’s really the heart of nursing for me.”
Excellence and leadership
Through teams, including its National Nurse Leadership Council, Kaiser Permanente promotes and supports the leadership, education and professional development of its nursing workforce through a range initiatives. All are designed to empower nurses to do what they do best: provide compassionate, excellent care that transforms lives.
The results can be seen in the success of models like Team Based Care, and in studies like the one published by the University of Pennsylvania School of Nursing in 2015 that recognized Kaiser Permanente nursing excellence as being key to high-quality care and better patient outcomes. Marilyn Chow, vice president of National Patient Care Services and Innovation, said the study reflects “our investment in nursing, and our commitment to hire and nurture our important nursing workforce.”