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: 2017_NEC_MA
Issue: March/April 2017
Credits: None available.
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 critical to expanding learning opportunities beyond traditional acute care settings. Development of primary care expertise in nursing faculty and adjunct faculty, in collaboration with primary care and ambulatory care nursing leaders, is essential. Academic-practice partnerships must advocate for removing regulatory and practice barriers to allow RNs to practice to the full scope of education and training. Recommendations from national reports extend beyond enhanced roles in primary care practice and have global implications for all RNs practicing in ambulatory care.
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Identification: 2017_NEC_JF
Issue: January/February 2017
Credits: None available.
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Identification: 2017_NEC_JA
Issue: July/August 2017
Credits: None available.
In the ambulatory care setting where care is episodic, occurs over time, and is impacted by multiple, interprofessional care team members, it is difficult to measure the specific impact of the registered nurse (RN). Many innovative processes are being developed and individual RNs are finding unique ways to benchmark quality that are nurse sensitive and improve outcomes for patients. The American Academy of Ambulatory Care Nursing Ambulatory Care Nurse-Sensitive Indicator Industry Report: Meaningful Measurement of Nursing in the Ambulatory Patient Care Environment focused on the clinical practice and the quality improvement/research role of the RN and identified nine clinical practice dimensions and three quality/research dimensions. Roles of the ambulatory care RN and exemplars classified according to those roles and dimensions are provided.
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Identification: 2016_NEC_ND
Issue: November/December 2016
Credits: None available.
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 care.
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Identification: 2016_NEC_MJ_02
Issue: May/June 2016
Credits: None available.
There are multiple demands and challenges inherent in establishing staffing models in ambulatory health care settings today. If health care administrators establish a supportive physical and interpersonal health care environment, and develop high-performing interprofessional teams and staffing models and electronic documentation systems that track performance, patients will have more opportunities to receive safe, high-quality evidence-based care that encourages patient participation in decision making, as well as provision of their care. The health care organization must be aligned and responsive to the community within which it resides, fully invested in population health management, and continuously scanning the environment for competitive, regulatory and external environmental risks. All of these challenges require highly competent providers willing to change attitudes and culture such as movement toward collaborative practice among the interprofessional team including the patient.
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Identification: 2016_NEC_MJ_01
Issue: May/June 2016
Credits: None available.
The value of the ambulatory care nurse remains undocumented from a quality and patient safety measurement perspective and the practice is at risk of being highly variable and of unknown quality. The American Academy of Ambulatory Care Nursing and the Collaborative Alliance for Nursing Outcomes propose nurse leaders create a tipping point to measure the value of nursing across the continuum of nursing care, moving from inpatient to ambulatory care. As care continues to shift into the ambulatory care environment, the quality imperative must also shift to assure highly reliable, safe, and effective health care.
Identification: 2016_NEC_MA
Issue: March/April 2016
Credits: None available.
The nation has been on a quest to advance quality in providing health care services and improving patient outcomes. The challenge has been to identify and define metrics that will demonstrate improvement. Acute care settings have a fairly well-established system of quality measurement, but ambulatory care systems are in less-developed stages. Imperative to accurate quality measurement in ambulatory care is to identify and define metrics that reflect the value of registered nurses to improved patient care and outcomes as well as to the organization. The American Academy of Ambulatory Care Nursing (AAACN) established a task force to determine appropriate measures of nursing quality. The task force spent 2 years investigating measures and produced an Industry Report that addresses measures of nursing quality. This article is the first in a series of articles that will reveal and discuss the contents of the Industry Report.
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Identification: 2016_NEC_JA
Issue: July/August 2016
Credits: None available.
The American Academy of Ambulatory Care Nursing’s Nurse-Sensitive Indicator Task Force was charged with identifying and developing meaningful measures for the ambulatory care environment. Several strategies were used to identify measures that would reflect the value of the role of the nurse in this setting. One such strategy was to conduct a comprehensive review of the health care environment as a whole and the measures within it, to identify measures that already existed that could easily be adapted to the role of the nurse in ambulatory care settings. Because of the complexity of the ambulatory care patient care environment, the group sought to reach momentum in indicator development by starting with the proposal of measures that would be less complex to develop, pilot, and adapt in organizations across the country.
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Identification: 2015_NEC_SO
Issue: September/October 2015
Credits: None available.
Written by members of the AAACN and edited by Kitty M. Shulman, MSN, RN-BC
Identification: 2015_NEC_MJ
Issue: May/June 2015
Credits: None available.
The delivery of health care is quickly changing from an acute care to a community-based setting. Faculty development and mastery in the use of new technologies, such as high-definition simulation and virtual communities are crucial for effective student learning outcomes. Students’ benefits include opportunities for hands-on experience in various patient care scenarios, realtime faculty feedback regarding their critical reasoning and clinical performance, interdisciplinary collaboration, and access to a nonthreatening learning environment. The results of this study provide some evidence of the benefits of developing faculty and nursing curricula that addresses the shift from an illness-based, acute hospital model, to a community and population health-based preventive model.
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