The following articles were published in the Perspectives in Ambulatory Care department of the Nursing Economic$ journal and authored by members of the American Academy of Ambulatory Care Nursing. The PIAC column captures the essence and makes sense of today's changing ambulatory care market.
Identification: 2019_NEC_JF
Issue: January/February 2019
Credits: None available.
The American Academy of Ambulatory Care Nursing convened an Invitational Summit of national leaders to assist with strategic planning for promulgation of the care coordination and transition management (CCTM™) model. The conference was devoted to CCTM and the roles of registered nurses (RNs) across the care continuum to ensure safety and quality health care. The specific emphasis was on embedding the CCTM RN in healthcare policy and payment reform, as well as integration into academic and ongoing education across all care settings and specialties.
Author(s):
Identification: 2018_NEC_SO
Issue: September/October 2018
Credits: None available.
Nurses have the potential to positively impact patient outcomes and make changes in care delivery models to improve care and decrease cost. Registered nurses are the ideal team members to expand the capacity in primary care; however, their true impact and utilization has been underutilized. To show the impact nurses can have, nurse leaders and researchers must leverage nursing-sensitive indicators (NSIs) and make comparisons with demographic and role information. To make these comparisons and provide the most cost-effective, efficient, and high-quality care to patients in the ambulatory care setting, nurse leaders and healthcare leaders need to gather data on the various NSIs for benchmarking. The more data that can be gathered, the better comparisons can be made and staffing models can be modified.
Author(s):
Identification: 2018_NEC_ND_02
Issue: November/December 2018
Credits: None available.
The growth of ambulatory care nursing as a profession and how it is delivered has evolved over time. The specialty’s theoretical professional growth began in 1998 with the development of the first conceptual model. Conceptualizing professional ambulatory care nursing has been an exciting challenge for the past 2 decades. The journey participants included multiple registered nurses from numerous settings whose intellectual efforts and contributions advanced professional ambulatory care practice to this present state of conceptual understanding. Future leaders will continue the journey to keep this specialty practice clearly delineated conceptually, building on the work already accomplished.
Author(s):
Identification: 2018_NEC_ND_01
Issue: November/December 2018
Credits: None available.
Team-based care is needed across all ambulatory sites to provide care that is collaborative, patient-centered, timely, efficient, and equitable. This project clearly defined two distinct bodies of work present in every ambulatory setting across network practice sites: synchronous work and asynchronous work. Prior to this analysis, most practice sites were using the same staff to complete both types of work, resulting in fragmentation of work and inefficiencies in timely completion. Pilot studies were completed in a sampling of practice sites to test if assigning staff to specific types of work would result in better efficiencies and timely completion of work. In all pilots, this theory was upheld, leading to major changes in how work was separated and assigned.
Author(s):
Identification: 2018_NEC_MJ
Issue: May/June 2018
Credits: None available.
The United States spends more than other high-income countries on health care, while continuing to lag behind in quality, access, life expectancy, and care coordination. Patient populations and where they receive care is changing drastically, with volumes shifting from the inpatient, episode-centered model to an outpatient, health promotion centered model. Ambulatory care nurses are uniquely positioned within the healthcare continuum to lead the transformation of care for diverse patient populations. One strategy that enables the ambulatory care nurse to practice all dimensions of his or her specialty role is the development of a clinical advancement system(CAS). CAS, or clinical ladders, are one strategy that can assist nurses in acquiring skills necessary to support excellent practice as well as improve quality patient care outcomes.
Author(s):
Identification: 2018_NEC_MA
Issue: March/April 2018
Credits: None available.
Care planning and care coordination are quality metrics for Medicare Access and CHIP Reauthorization Act (MACRA). Registered nurses in ambulatory care were surveyed to assess current care coordination practices and identify opportunities for RNs to promote quality under the law. Findings can assist in understanding the ways nurses in ambulatory care currently contribute to quality outcomes and identify additional opportunities for registered nurses to lead efforts to continue to improve quality under MACRA.
Author(s):
Identification: 2018_NEC_JF
Issue: January/February 2018
Credits: None available.
The importance of establishing transition to practice and nurse residency programs in all practice settings is clearly supported in the literature. Developing a standardized program ensures use of evidence-based practice materials avoiding wide variance among curriculums. Investing in time to develop academic practice partnerships will promote necessary changes in nursing education as the role of the RN evolves. Partnerships provide an avenue to develop a new workforce that is not only directed at inpatient care, but also encompasses specialty care including ambulatory practice. As healthcare delivery continues to expand into non-hospital settings, demand for nurses in outpatient care will continue to grow. It is important ambulatory and community-based care settings play an active role in developing their own RN workforce.
Author(s):
Identification: 2017_NEC_SO
Issue: September/October 2017
Credits: None available.
The AAACN Ambulatory Care Registered Nurse Residency Program is distinct from orientation by providing a coordinated and comprehensive transition into an ambulatory care clinical environment. The Ambulatory Care Registered Nurse Residency Program is designed to strengthen the transition support for new registered nurse (RN) graduates and RNs new to the ambulatory care specialty. Residency programs have the potential to promote the role of the RN and his or her commitment to the profession of nursing. A broad, integrated, and comprehensive structure is critical to successful implementation and sustainability.
Author(s):Identification: 2017_NEC_ND
Issue: November/December 2017
Credits: None available.
The Quality and Safety Education for Nurses (QSEN) initiative has played an important role in transforming how nursing can improve quality and safety in education and practice. Assessing whether a nurse is competent to perform the duties of his or her job role involves more than completing a skills checklist. The American Academy of Ambulatory Care Nursing’s Ambulatory Care Registered Nurse Residency Program used the QSEN framework to support development of competencies that will provide the new nurse to the ambulatory care setting with the knowledge, skills, and attitudes to provide safe quality care.
Author(s):
Identification: 2017_NEC_MJ
Issue: May/June 2017
Credits: None available.
The driving forces that are motivating many advanced practice nurses (APNs) to create new, high-value practices within the ambulatory care setting reflect the need for better, higher quality patient care, a deep commitment to spending healthcare dollars wisely, and most importantly, the relentless search for nursing interventions that lead to real improvement in the health of patients. Business planning provides the path through which new APN-run ambulatory practices become a reality and a success. A well-developed and sophisticated business plan is an essential first step in setting up a successful APN practice that reinforces APNs' contributions to health care, and leads to real rewards for patients and families, APNs, and the healthcare industry.
Author(s):