By Mary D. Naylor, PhD, FAAN, RN. Dr. Naylor is the Marian S. Ware Professor in Gerontology and director of the NewCourtland Center for Transitions and Health at the University of Pennsylvania School of Nursing. She is also the National Program Director for the Robert Wood Johnson Foundation program, Interdisciplinary Nursing Quality Research Initiative, aimed at generating, disseminating, and translating research to understand how nurses contribute to quality patient care. She was appointed to the Medicare Payment Advisory Commission in 2010. 

Building on the Future of Nursing report’s call for nurses to fully engage with fellow health care professionals, a new report from the Institute of Medicine, Best Care at Lower Cost, calls on nurses and others in the health care system to apply emerging tools, technologies, and approaches to yield lower costs and better health outcomes. I had the great fortune to serve as a member of the study committee.

The complexity problem. The report couldn’t be more timely or relevant, particularly for nurses and the patients they serve, given the complexity of the current health care system. Administrative and workflow inefficiencies limit hospital nurses from spending more than about 30% of their time on direct patient care. With increasing specialization, modern medicine now includes nurses in more than 50 specialties. To successfully coordinate a patient’s care, nurses need to communicate and collaborate with patients, family caregivers, physicians, pharmacists, social workers, and many other team members.

The complexity […]