In October 2016, the State of Vermont signed an unprecedented agreement (The All-Payer Accountable Care Model) with the Federal Government to completely reform how health care is delivered and paid for in Vermont. This innovative agreement builds on sweeping 2011 legislation that set Vermont on a course towards payment reform designed to eliminate the fragmentation, overtreatment, and high costs associated

Multiple national reports identify actionable recommendations to transform education and practice to meet the needs of health care and healthcare delivery beyond the hospital walls. The Josiah Macy Jr. Conference (2016) focused on transforming primary care and changing healthcare culture to support expansion of roles for registered nurses (RNs). Partnerships between academia and clinical practice are

Globally, an estimated 25% of individuals suffer from mental disorders. Approximately 50% of Americans will experience mental disorders in their lifetime. The cost of this U.S. mental health crisis is estimated at $444 billion per year when lost economic productivity is included, with only about one-third of the total dollars going to care itself. The generalist RN workforce is an untapped resource

Each year millions of people are readmitted to hospitals across the nation; many of these readmissions are preventable. Successful care coordination and transition management strategies are critical steps needed to meet Partnership for Patients goals of reducing harm and improving the quality and safety of health care. Decreasing variance in healthcare delivery can improve quality, safety, and improve

The nation is struggling with the challenges and inefficiencies in the current healthcare environment, the increased demand for primary care services, and growing shortage of primary care providers to meet that demand. Although nurse practitioners (NPs) are highly educated, licensed, and certified healthcare professionals who are qualified to provide primary care services, the restrictive policies

With an aging nursing workforce and rising patient acuity levels, healthcare institutions are challenged to meet the demand for competent nursing care Swedish Medical Center (SMC) adopted an aggressive approach for building a new graduate residency program to promote new graduates' opportunity to tap into the valuable expert knowledge and wisdom of retiring nurses. Nursing leadership chose to take

Upon implementation of the Affordable Care Act (ACA), many managed care organizations (MCOs) initially increased their nurse practitioner (NP) contracting. This trend has not continued, potentially frustrating ACA efforts to expand primary care provider capacity. In this study, about 25% of the responding MCOs did not contract with NPs as primary care providers. only 62.5% of respondent MCOs offering

Repealing the Affordable Care Act (ACA) was a promise made by President-elect Donald Trump. Altering the ACA is a complex process and it is likely to be at least 2019 before any new program would be in place completely. We can hope there will still be an emphasis on providing high-quality healthcare efficiently, which promotes healthcare institutions to use nurses to their full scope of practice.

Internationally educated nurses migrating for work in other countries help address short and long-term staffing shortage issues. A transitional educational program was designed and implemented to prepare Mexican nurses with the competencies needed to work in any clinical setting in the United States. Through an intensive, full-time, 6-month transitional education program that included a living stipend

The severe economic recession from December 2007 to December 2010 substantially affected registered nurse (RN) employment. The objective of this study was to determine if the association between RN workforce supply and its potential determinants differed during the period from 2008 to 2012. Older, experienced RNs were more likely to work in 2010, compared to 2008, but less likely to work in 2012 compared

A nursing workforce initiative in Maryland sought to graduate additional nursing students to become registered nurses and to increase the number and preparation levels of nursing faculty. Between FY 2006 and FY 2015, nearly $100 million was awarded through 109 competitive institutional grants at 27 nursing programs across the state; 950 faculty received awards through fellowships, scholarships, and

The current initiatives to improve the academic preparation of nurses have added emphasis to the presence or prediction of thousands of dollars of debt, which may influence personal decisions about returning to school. In this study, nearly 40% of survey respondents reported less than $25,000 in college debt and 23.5% reported greater than $25,000 of prior college debt. Slightly less than a third of

Creating an environment that allows for ease of communication is imperative to meet the demands of health care that is focused on quality, safety, and outcomes. As a way to improve the communication between and identification of nursing staff by the interprofessional team, a process was created to aide in timely identification and communication between health care members. Enhanced communication can

The High-Level Commission on Health Employment and Economic Growth was created by the United Nations to tackle the projected global shortfall of health care workers. The Commission developed recommendations addressing job creation, gender and women's rights, education, training and skills, health service delivery and organization, technology, and crises and humanitarian settings. The Commission report

Ambulatory care registered nurses (RNs) have a pivotal role in educating, encouraging, motivating, and supporting patients to be engaged in their care and achieve their health care goals. To improve health outcomes, patients need to be engaged in attaining these goals. RNs are instrumental in this process and well-controlled studies will demonstrate their impact on helping patient's engage in their

This study draws on psychological contract theory, according to which organizational members reciprocate detrimental treatment they perceive with negative work-related attitudes and behaviors. Organizational attitudes were predicted by both breach and violation. This study demonstrates the importance of psychological contract breach and violation to nurses. Nursing administrators and leaders are advised

The literature is rich with evidence that a nurse's work environment impacts his or her experience of factors related to turnover intent. However, one area of inquiry that has received little attention is the work environment of nursing faculty. The aim of this study was to gain an understanding of participants' lived experiences related to work environment quality and it's link with retention; use

Patient throughput allows for the efficient flow of patients through the hospital, ensuring timely and appropriate level of care. Evidence supports the implementation of hospital-wide patient throughput initiatives. Hospitals who have prioritized patient throughput have realized improvements in quality patient care, patient satisfaction, as well as a positive financial impact. Hospitals have implemented

Improving the efficiency of health care is a national priority. The purpose of this study was to estimate trends in the efficiency of nursing care. Specifically, the baseline and rate of change in efficiency in the association between select hospital and nursing unit characteristics (e.g., nurse staffing levels) and indicators of patient safety (e.g., fall rates and hospital-acquired pressure ulcer

As we move toward a value-based health care system and payment models based on individual performance of providers, nurses are faced with a dilemma. Should we as a profession actively pursue the development of individual nurse performance metrics, analysis, benchmarks, and practice standards, similar to those being implemented for physicians? Or should we wait until these metrics are imposed by payers

Staffing solutions are evolving at remarkable speed. It no longer takes large, complicated, technical teams to create powerful, reliable, high-quality solutions. Today's cloud-based solutions can be implemented in hours and configured as fast as an organization can tolerate. These new, well-designed systems are highly intuitive and adopted rapidly. Data can be displayed in different ways for different

As this election campaign, like many, has been more about personality than policy, it is important to remember that positions on policy are the real substance of election outcomes. Although health care is ranking lower than other national issues in the minds of voters, it remains a vital topic. Nurses need to stay informed on this important issue, especially regarding the policy proposals from both

Mentoring programs can enhance nursing satisfaction, improve retention, ensure optimal patient outcomes, and may have a positive organizational effect in developing leadership skills in nursing. In this study, the effects of a formal mentoring program were explored on a sample of 18 professional nurse leaders (nine mentors and nine proteges) at a university hospital in Turkey. After receiving a formal

Interest in care transitions has intensified in light of emphasis placed on hospital readmissions. This study provides a comparative analysis of the costs of providing transitional care through a program for cardiac patients against hospital readmission costs. The advanced practice registered nurse-managed BRIDGE model reduced health care costs associated with readmissions that were in excess of program

Accountable Care Organizations (ACOs) are a promising new model for payment reform in the complex and fragmented health care system in the United States. Nursing vision and leadership are essential for the success of an organization participating in an ACO. By understanding the political, financial, and cultural facilitators and barriers to change, as well as models for helping organizations transition