venting hospital readmissions and other adverse events, lies directly in the scope of nursing practice. Yet clinical education does not afford the opportunity to follow patients across health care settings. Thus transitional care, as well as all other cross-setting models of care, are infrequently practiced and thus even less frequently taught. Despite its increasing recognition as the foundation for effective care into the future, team-based care and multidisciplinary care management remain if anything the province of classroom instruction and rarely connected to the practice setting. Primary care and community-based approaches to care represent a minority share of the nursing curriculum even as the demand for these services is predicted to grow. The consequence is the production of succeeding generations of nurses that are not well positioned—in numbers and skills—to meet the needs of a redesigned delivery system.
Meaningful collaboration between nursing education and health care delivery redesign will encourage the alignment in their goals, which is critical to their joint success. Opportunities to advance such collaboration, and mechanisms for its support, should be actively sought. For example, Medicare-funded pilot studies and demonstration programs testing programs that rely on nursing-led interventions, such as ACOs or transitional care, should include representatives from nursing education—its leadership as well as key stakeholders, such as the regulatory bodies that determine the terms and scope of nursing education and practice—in activities associated with the design, review, implementation, evaluation, and dissemination of these initiatives. In similar form, health professions schools testing models of interprofessional education and other models of team-based care education should include representatives from the clinical directors of medicine and nursing in health systems and other key stakeholders from the clinical practice communities.
In reciprocal fashion, this collaboration should inform nursing education as to where gaps exist in educational offerings and skills development to meet the needs of a redesigned delivery system. Closing the gaps will involve thoughtful appraisal of where and how to integrate these new areas of knowledge and clinical experiences into the current curricular offerings. Faculty expertise will need to be developed in a number of these care models. The premium on clinical placements will require consideration of how simulation learning environments may augment current clinical experiences. HRSA should empanel a Technical Advisory Group whose purpose would be to make recommendations on the role and opportunities for relevant agencies within the federal government to support the development of new programmatic and curricular offerings to build this needed skill set, including a full review of the grants and initiatives within Title VIII and other sources of federal funding for nursing education. The report from the Technical Advisory Group should include a discussion of the role of other critical stakeholders, e.g., state regulatory bodies, health care private foundations, professional associations, etc., in better aligning health professions education with the unfolding reforms from health care reform and related initiatives.