The presentations offered the committee with insight into the important role that frontline nurses play across acute care settings, as well as the challenges and barriers that these frontline nurses face in their daily work. It was apparent from the presentations that there are a number of successful and promising innovative models being used in acute care settings across the country. However, these models are infrequently transferred widely. The discussion at the forum provided the committee with an opportunity to consider how rapidly advancing technology, interdisciplinary relationships, and changes in the way acute care is delivered will affect the nursing profession and how nurses will need to be educated to be adequately prepared for their varying roles and responsibilities.
A number of important points emerged at the forum:
The knowledge of frontline nurses that they gather from their interactions with patients is critical to reducing medical errors and improving patient outcomes.
Involving nurses at a variety of levels across the acute care setting in decision making and leadership benefits the patient, improves the organizations in which nurses practice, and strengthens the health care system in general.
Increasing the time that nurses can spend at the bedside is an essential component of achieving the goal of patient-centered care.
High-quality acute care settings require integrated systems that use technology effectively while increasing the efficiency of nurses and affording them increased time to spend with patients.
Multidisciplinary care teams characterized by extensive and respectful collaboration among team members improve the quality, safety, and effectiveness of care.
Many of the innovations that need to be implemented in the health care system already exist somewhere in the United States, but barriers to their dissemination keep them from being adopted more widely. As Dr. Marilyn Chow observed, “the future is here, it just isn’t everywhere.”
In the morning before the forum began, individual committee members participated in a series of site visits to a variety of acute care units within Cedars-Sinai Medical Center. They spoke with nurses, other care providers, and administrators about the challenges nurses encounter in their work in acute care settings. The units that were visited within the Medical Center ranged from critical care, emergency department, and surgical units to child and maternal health and obstetrics units. Following the site visits and the forum, a group of Robert Wood