FOR IMMEDIATE RELEASE
March 2, 2001

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ANA Commends Institute of Medicine for 21st Century Health System Recommendations

Washington, DC -- The American Nurses Association (ANA) applauds the Institute of Medicine (IOM) for its report, released yesterday, detailing recommendations for a broad overhaul of the nation's health care delivery system in order to innovate and improve the quality of care Americans receive in the future.

The ANA agrees with the Crossing the Quality Chasm: A New System for the 21st Century report's assertion that "research on the quality of care reveals a picture of a system that frequently falls short in its ability to translate clinical knowledge and technology into practice." And ANA further supports the report's finding that "the health care system, as it is currently structured, cannot consistently deliver effective care in a safe, timely and efficient manner."

"This report reinforces what nurses across America have been saying all along: that it is the system itself that is in need of fixing, and that there is an urgent need for massive reorganization and reform of all systems issues," said ANA President Mary Foley, MS, RN.

The ANA supports many of the IOM study recommendations, including the call for an information-technology-based, multidisciplinary approach to improving care -- especially for such common chronic conditions as heart disease, asthma and diabetes -- and for comprehensive services to patients.

The ANA also supports the IOM's recommendation that the U.S. Department of Health and Human Services (HHS) monitor and track quality improvements in the six dimensions of safety, effectiveness, responsiveness to patients, timeliness, efficiency and equity. And, ANA is particularly supportive of the committee's 10 new rules intended to make the health system more patient centered and empowering, as well as safer, more efficient and quality- and performance-focused.

"Nurses, as continuous care providers, have long advocated and, when possible, practiced several of the rules set forth by the committee, including care that is based on continuous healing relationships and safety as a system property," said Foley. "And, ANA's Nursing-Sensitive Quality Indicators are already fulfilling the committee's evidence-based decision-making requirement, by correlating sufficient staffing and quality nursing care with improved patient outcomes."

ANA further believes that its Nursing-Sensitive Quality Indicators serve as an example of an innovative effort to improve quality that should be taken into account when redesigning payment systems. "The current payment systems are oriented primarily toward reimbursements and fail to take into account interventions by other health care providers, especially nurses," said Foley. "And these systems further do not recognize or reward quality health care practices or quality patient outcomes. What is needed is an extensive review and overhaul of reimbursements with an eye toward quality and innovation."

Recognizing that payments and reimbursements represent only one area in need of reform, ANA also calls for a further discussion of all the elements that comprise a satisfying workplace. "We need to focus on the human aspects of patient care, including the satisfaction levels of health care providers, and nurses in particular," Foley said. "Through the American Nurses Credentialing Center's Magnet Nursing Services Recognition Program, ANA has identified 14 forces of magnetism that reveal a link between increased nursing satisfaction and better patient outcomes. We believe the Magnet program identifies the environment in which excellence in nursing is delivered, and we hope that this model will be taken into account in the restructuring process."

Another key recommendation in the report addresses the need for examining and reforming the clinical education and training of health care providers. While ANA agrees with this suggestion, one present-day concern is the lack of funding parity across all federally supported health care education programs. "What we need is a more balanced approach to funding nursing education," Foley noted.

Among the report's conclusions is that current care systems are inadequate, and that a higher level of quality cannot be achieved by "further stressing" those systems. "Trying harder will not work," the report says. "Members of the health care workforce are already trying hard to do their jobs well."

ANA agrees with this assessment. "If we want safer, higher-quality care, we need to look at the processes, not the people," Foley asserted. "And re-examining, revamping and reorganizing the work environment to better serve patients, along with the persons who care for them, is essential."

The Crossing the Quality Chasm report is the second and final report of the Committee on the Quality of Health Care in America, which was appointed by former President Clinton in 1998 to identify strategies for improving health care delivery in the United States. The Committee's first report, To Err is Human: Building a Safer Health System, was released in 1999 and generated significant public debate on the specific concern of patient safety. The second report focuses more broadly on the need for fundamental reform of the U.S. health care system and emphasizes that incremental changes to the current system are no longer feasible.

When the To Err is Human report on medical errors was released, the ANA agreed with the report's assertion that the majority of errors result not from human recklessness but from failures in the health care system itself, and noted that the report reinforced the need to address all systems issues, including staffing.

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The American Nurses Association is the only full-service professional organization representing the nation's 2.6 million Registered Nurses through its 54 constituent associations. ANA advances the nursing profession by fostering high standards of nursing practice, promoting the economic and general welfare of nurses in the workplace, projecting a positive and realistic view of nursing, and by lobbying the Congress and regulatory agencies on health care issues affecting nurses and the public.

2001 press releases

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