Author: Jonathan Burroughs
Publisher: ACHE Management
ISBN: 9781567936810
Category : Medical
Languages : en
Pages : 0
Book Description
Winner of the 2016 ACHE James A. Hamilton Book of the Year Award Healthcare organizations are facing many challenges in this new era of healthcare reform, one of which is to establish a new operating model for the organized medical staff. Deeply rooted in tradition, the current medical staff model can no longer hold in an environment where quality, safety, service, and cost-effectiveness are required for healthcare organizations to not only survive but truly thrive. In this book, the author, an experienced physician leader and healthcare consultant, describes key changes that must be made to redesign the medical staff model. He provides specific guidance and examples to help healthcare leaders and executives work with their physician leaders to face these changes successfully. Well-regarded contributors and subject matter experts offer additional examples and insights with special content throughout the book. The author provides an in-depth look into: The evolution of the physician culture from autonomy to collaboration and accountability that must take place for US healthcare providers to remain competitive in an increasingly global economy Select strategic medical staff development planning and credentialing/privileging approaches that are needed to ensure physician-organization alignment Components of an effective and rigorous performance management system that enables leaders to help physicians achieve mutually agreed-on goals and metrics and align them with those of the organization Medical staff performance assessment and improvement activities, including peer review best practices, ways to incentivize excellence, and how to address issues in a timely, compassionate way Negotiation of performance expectations with management and the hospital's board that are consistent with the organization's strategic plan Physician engagement and alignment strategies that will enable physicians and management to work together to achieve the goals of population health and reduced operating costs Healthcare executives and administrators, physician executives, and board leaders can use this book as a guide to learn from organizations that have successfully integrated and aligned with their medical staffs into a collaborative environment. Examples of organizations with medical staffs that have made a complete commitment to the success of their enterprises and the health of their communities are incorporated throughout the book.
Redesign the Medical Staff Model
Author: Jonathan Burroughs
Publisher: ACHE Management
ISBN: 9781567936810
Category : Medical
Languages : en
Pages : 0
Book Description
Winner of the 2016 ACHE James A. Hamilton Book of the Year Award Healthcare organizations are facing many challenges in this new era of healthcare reform, one of which is to establish a new operating model for the organized medical staff. Deeply rooted in tradition, the current medical staff model can no longer hold in an environment where quality, safety, service, and cost-effectiveness are required for healthcare organizations to not only survive but truly thrive. In this book, the author, an experienced physician leader and healthcare consultant, describes key changes that must be made to redesign the medical staff model. He provides specific guidance and examples to help healthcare leaders and executives work with their physician leaders to face these changes successfully. Well-regarded contributors and subject matter experts offer additional examples and insights with special content throughout the book. The author provides an in-depth look into: The evolution of the physician culture from autonomy to collaboration and accountability that must take place for US healthcare providers to remain competitive in an increasingly global economy Select strategic medical staff development planning and credentialing/privileging approaches that are needed to ensure physician-organization alignment Components of an effective and rigorous performance management system that enables leaders to help physicians achieve mutually agreed-on goals and metrics and align them with those of the organization Medical staff performance assessment and improvement activities, including peer review best practices, ways to incentivize excellence, and how to address issues in a timely, compassionate way Negotiation of performance expectations with management and the hospital's board that are consistent with the organization's strategic plan Physician engagement and alignment strategies that will enable physicians and management to work together to achieve the goals of population health and reduced operating costs Healthcare executives and administrators, physician executives, and board leaders can use this book as a guide to learn from organizations that have successfully integrated and aligned with their medical staffs into a collaborative environment. Examples of organizations with medical staffs that have made a complete commitment to the success of their enterprises and the health of their communities are incorporated throughout the book.
Publisher: ACHE Management
ISBN: 9781567936810
Category : Medical
Languages : en
Pages : 0
Book Description
Winner of the 2016 ACHE James A. Hamilton Book of the Year Award Healthcare organizations are facing many challenges in this new era of healthcare reform, one of which is to establish a new operating model for the organized medical staff. Deeply rooted in tradition, the current medical staff model can no longer hold in an environment where quality, safety, service, and cost-effectiveness are required for healthcare organizations to not only survive but truly thrive. In this book, the author, an experienced physician leader and healthcare consultant, describes key changes that must be made to redesign the medical staff model. He provides specific guidance and examples to help healthcare leaders and executives work with their physician leaders to face these changes successfully. Well-regarded contributors and subject matter experts offer additional examples and insights with special content throughout the book. The author provides an in-depth look into: The evolution of the physician culture from autonomy to collaboration and accountability that must take place for US healthcare providers to remain competitive in an increasingly global economy Select strategic medical staff development planning and credentialing/privileging approaches that are needed to ensure physician-organization alignment Components of an effective and rigorous performance management system that enables leaders to help physicians achieve mutually agreed-on goals and metrics and align them with those of the organization Medical staff performance assessment and improvement activities, including peer review best practices, ways to incentivize excellence, and how to address issues in a timely, compassionate way Negotiation of performance expectations with management and the hospital's board that are consistent with the organization's strategic plan Physician engagement and alignment strategies that will enable physicians and management to work together to achieve the goals of population health and reduced operating costs Healthcare executives and administrators, physician executives, and board leaders can use this book as a guide to learn from organizations that have successfully integrated and aligned with their medical staffs into a collaborative environment. Examples of organizations with medical staffs that have made a complete commitment to the success of their enterprises and the health of their communities are incorporated throughout the book.
Essential Operational Components for High-Performing Healthcare Enterprises
Author: Jonathan Burroughs
Publisher: ACHE Management
ISBN: 9781640550001
Category : Medical
Languages : en
Pages : 0
Book Description
"While the future of US healthcare is unclear the move toward value-based care is undoubtedly its next major shift. Reimbursement payment programs have already begun this metamorphosis and are increasingly being tied to quality measures. With the urgency of revolutionary change in the background, the healthcare organization must transform its care and business models to evolve into a next-level healthcare enterprise. In Essential Operational Components for High-Performing Healthcare Enterprises, Jon Burroughs and other nationally respected experts highlight the building blocks necessary to transform a healthcare organization into an integrated delivery system. In this operational model, hospitals and other entities in the system work together to achieve common clinical and business goals. Shifting from reactive to proactive, healthcare leaders must move the mindset and strategy of the healthcare system, from caring for the ill to preventing illness. This radical book proposes a framework of innovative strategies for shifting to a fully engaged, aligned, and integrated delivery system: - Effective leadership - The role of clinical staff - Strategic planning - Clinically integrated networks - Health information management - Population health - Actuarial risk and cost management The push for efficiency, quality, and cost reduction demands change in every area of the US healthcare system. Essential Operational Components for High-Performing Healthcare Enterprises defines the fundamental enterprise-wide elements that all healthcare organizations will need to embrace to excel in a value-based world"--
Publisher: ACHE Management
ISBN: 9781640550001
Category : Medical
Languages : en
Pages : 0
Book Description
"While the future of US healthcare is unclear the move toward value-based care is undoubtedly its next major shift. Reimbursement payment programs have already begun this metamorphosis and are increasingly being tied to quality measures. With the urgency of revolutionary change in the background, the healthcare organization must transform its care and business models to evolve into a next-level healthcare enterprise. In Essential Operational Components for High-Performing Healthcare Enterprises, Jon Burroughs and other nationally respected experts highlight the building blocks necessary to transform a healthcare organization into an integrated delivery system. In this operational model, hospitals and other entities in the system work together to achieve common clinical and business goals. Shifting from reactive to proactive, healthcare leaders must move the mindset and strategy of the healthcare system, from caring for the ill to preventing illness. This radical book proposes a framework of innovative strategies for shifting to a fully engaged, aligned, and integrated delivery system: - Effective leadership - The role of clinical staff - Strategic planning - Clinically integrated networks - Health information management - Population health - Actuarial risk and cost management The push for efficiency, quality, and cost reduction demands change in every area of the US healthcare system. Essential Operational Components for High-Performing Healthcare Enterprises defines the fundamental enterprise-wide elements that all healthcare organizations will need to embrace to excel in a value-based world"--
The Healthcare Imperative
Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 0309144337
Category : Medical
Languages : en
Pages : 852
Book Description
The United States has the highest per capita spending on health care of any industrialized nation but continually lags behind other nations in health care outcomes including life expectancy and infant mortality. National health expenditures are projected to exceed $2.5 trillion in 2009. Given healthcare's direct impact on the economy, there is a critical need to control health care spending. According to The Health Imperative: Lowering Costs and Improving Outcomes, the costs of health care have strained the federal budget, and negatively affected state governments, the private sector and individuals. Healthcare expenditures have restricted the ability of state and local governments to fund other priorities and have contributed to slowing growth in wages and jobs in the private sector. Moreover, the number of uninsured has risen from 45.7 million in 2007 to 46.3 million in 2008. The Health Imperative: Lowering Costs and Improving Outcomes identifies a number of factors driving expenditure growth including scientific uncertainty, perverse economic and practice incentives, system fragmentation, lack of patient involvement, and under-investment in population health. Experts discussed key levers for catalyzing transformation of the delivery system. A few included streamlined health insurance regulation, administrative simplification and clarification and quality and consistency in treatment. The book is an excellent guide for policymakers at all levels of government, as well as private sector healthcare workers.
Publisher: National Academies Press
ISBN: 0309144337
Category : Medical
Languages : en
Pages : 852
Book Description
The United States has the highest per capita spending on health care of any industrialized nation but continually lags behind other nations in health care outcomes including life expectancy and infant mortality. National health expenditures are projected to exceed $2.5 trillion in 2009. Given healthcare's direct impact on the economy, there is a critical need to control health care spending. According to The Health Imperative: Lowering Costs and Improving Outcomes, the costs of health care have strained the federal budget, and negatively affected state governments, the private sector and individuals. Healthcare expenditures have restricted the ability of state and local governments to fund other priorities and have contributed to slowing growth in wages and jobs in the private sector. Moreover, the number of uninsured has risen from 45.7 million in 2007 to 46.3 million in 2008. The Health Imperative: Lowering Costs and Improving Outcomes identifies a number of factors driving expenditure growth including scientific uncertainty, perverse economic and practice incentives, system fragmentation, lack of patient involvement, and under-investment in population health. Experts discussed key levers for catalyzing transformation of the delivery system. A few included streamlined health insurance regulation, administrative simplification and clarification and quality and consistency in treatment. The book is an excellent guide for policymakers at all levels of government, as well as private sector healthcare workers.
Transforming Health Care
Author: Charles Kenney
Publisher: CRC Press
ISBN: 1439863091
Category : Business & Economics
Languages : en
Pages : 240
Book Description
For decades, the manufacturing industry has employed the Toyota Production System the most powerful production method in the world to reduce waste, improve quality, reduce defects and increase worker productivity. In 2001, Virginia Mason Medical Center, an integrated healthcare delivery system in Seattle, Washington set out to achieve its compe
Publisher: CRC Press
ISBN: 1439863091
Category : Business & Economics
Languages : en
Pages : 240
Book Description
For decades, the manufacturing industry has employed the Toyota Production System the most powerful production method in the world to reduce waste, improve quality, reduce defects and increase worker productivity. In 2001, Virginia Mason Medical Center, an integrated healthcare delivery system in Seattle, Washington set out to achieve its compe
Crossing the Quality Chasm
Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 0309132967
Category : Medical
Languages : en
Pages : 359
Book Description
Second in a series of publications from the Institute of Medicine's Quality of Health Care in America project Today's health care providers have more research findings and more technology available to them than ever before. Yet recent reports have raised serious doubts about the quality of health care in America. Crossing the Quality Chasm makes an urgent call for fundamental change to close the quality gap. This book recommends a sweeping redesign of the American health care system and provides overarching principles for specific direction for policymakers, health care leaders, clinicians, regulators, purchasers, and others. In this comprehensive volume the committee offers: A set of performance expectations for the 21st century health care system. A set of 10 new rules to guide patient-clinician relationships. A suggested organizing framework to better align the incentives inherent in payment and accountability with improvements in quality. Key steps to promote evidence-based practice and strengthen clinical information systems. Analyzing health care organizations as complex systems, Crossing the Quality Chasm also documents the causes of the quality gap, identifies current practices that impede quality care, and explores how systems approaches can be used to implement change.
Publisher: National Academies Press
ISBN: 0309132967
Category : Medical
Languages : en
Pages : 359
Book Description
Second in a series of publications from the Institute of Medicine's Quality of Health Care in America project Today's health care providers have more research findings and more technology available to them than ever before. Yet recent reports have raised serious doubts about the quality of health care in America. Crossing the Quality Chasm makes an urgent call for fundamental change to close the quality gap. This book recommends a sweeping redesign of the American health care system and provides overarching principles for specific direction for policymakers, health care leaders, clinicians, regulators, purchasers, and others. In this comprehensive volume the committee offers: A set of performance expectations for the 21st century health care system. A set of 10 new rules to guide patient-clinician relationships. A suggested organizing framework to better align the incentives inherent in payment and accountability with improvements in quality. Key steps to promote evidence-based practice and strengthen clinical information systems. Analyzing health care organizations as complex systems, Crossing the Quality Chasm also documents the causes of the quality gap, identifies current practices that impede quality care, and explores how systems approaches can be used to implement change.
Redesign the Medical Staff Model
Author: Jonathan H. Burroughs
Publisher:
ISBN: 9781567936827
Category :
Languages : en
Pages : 247
Book Description
Publisher:
ISBN: 9781567936827
Category :
Languages : en
Pages : 247
Book Description
The Role of Telehealth in an Evolving Health Care Environment
Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 0309262054
Category : Medical
Languages : en
Pages : 159
Book Description
In 1996, the Institute of Medicine (IOM) released its report Telemedicine: A Guide to Assessing Telecommunications for Health Care. In that report, the IOM Committee on Evaluating Clinical Applications of Telemedicine found telemedicine is similar in most respects to other technologies for which better evidence of effectiveness is also being demanded. Telemedicine, however, has some special characteristics-shared with information technologies generally-that warrant particular notice from evaluators and decision makers. Since that time, attention to telehealth has continued to grow in both the public and private sectors. Peer-reviewed journals and professional societies are devoted to telehealth, the federal government provides grant funding to promote the use of telehealth, and the private technology industry continues to develop new applications for telehealth. However, barriers remain to the use of telehealth modalities, including issues related to reimbursement, licensure, workforce, and costs. Also, some areas of telehealth have developed a stronger evidence base than others. The Health Resources and Service Administration (HRSA) sponsored the IOM in holding a workshop in Washington, DC, on August 8-9 2012, to examine how the use of telehealth technology can fit into the U.S. health care system. HRSA asked the IOM to focus on the potential for telehealth to serve geographically isolated individuals and extend the reach of scarce resources while also emphasizing the quality and value in the delivery of health care services. This workshop summary discusses the evolution of telehealth since 1996, including the increasing role of the private sector, policies that have promoted or delayed the use of telehealth, and consumer acceptance of telehealth. The Role of Telehealth in an Evolving Health Care Environment: Workshop Summary discusses the current evidence base for telehealth, including available data and gaps in data; discuss how technological developments, including mobile telehealth, electronic intensive care units, remote monitoring, social networking, and wearable devices, in conjunction with the push for electronic health records, is changing the delivery of health care in rural and urban environments. This report also summarizes actions that the U.S. Department of Health and Human Services (HHS) can undertake to further the use of telehealth to improve health care outcomes while controlling costs in the current health care environment.
Publisher: National Academies Press
ISBN: 0309262054
Category : Medical
Languages : en
Pages : 159
Book Description
In 1996, the Institute of Medicine (IOM) released its report Telemedicine: A Guide to Assessing Telecommunications for Health Care. In that report, the IOM Committee on Evaluating Clinical Applications of Telemedicine found telemedicine is similar in most respects to other technologies for which better evidence of effectiveness is also being demanded. Telemedicine, however, has some special characteristics-shared with information technologies generally-that warrant particular notice from evaluators and decision makers. Since that time, attention to telehealth has continued to grow in both the public and private sectors. Peer-reviewed journals and professional societies are devoted to telehealth, the federal government provides grant funding to promote the use of telehealth, and the private technology industry continues to develop new applications for telehealth. However, barriers remain to the use of telehealth modalities, including issues related to reimbursement, licensure, workforce, and costs. Also, some areas of telehealth have developed a stronger evidence base than others. The Health Resources and Service Administration (HRSA) sponsored the IOM in holding a workshop in Washington, DC, on August 8-9 2012, to examine how the use of telehealth technology can fit into the U.S. health care system. HRSA asked the IOM to focus on the potential for telehealth to serve geographically isolated individuals and extend the reach of scarce resources while also emphasizing the quality and value in the delivery of health care services. This workshop summary discusses the evolution of telehealth since 1996, including the increasing role of the private sector, policies that have promoted or delayed the use of telehealth, and consumer acceptance of telehealth. The Role of Telehealth in an Evolving Health Care Environment: Workshop Summary discusses the current evidence base for telehealth, including available data and gaps in data; discuss how technological developments, including mobile telehealth, electronic intensive care units, remote monitoring, social networking, and wearable devices, in conjunction with the push for electronic health records, is changing the delivery of health care in rural and urban environments. This report also summarizes actions that the U.S. Department of Health and Human Services (HHS) can undertake to further the use of telehealth to improve health care outcomes while controlling costs in the current health care environment.
Taking Action Against Clinician Burnout
Author: National Academies of Sciences, Engineering, and Medicine
Publisher: National Academies Press
ISBN: 0309495474
Category : Medical
Languages : en
Pages : 335
Book Description
Patient-centered, high-quality health care relies on the well-being, health, and safety of health care clinicians. However, alarmingly high rates of clinician burnout in the United States are detrimental to the quality of care being provided, harmful to individuals in the workforce, and costly. It is important to take a systemic approach to address burnout that focuses on the structure, organization, and culture of health care. Taking Action Against Clinician Burnout: A Systems Approach to Professional Well-Being builds upon two groundbreaking reports from the past twenty years, To Err Is Human: Building a Safer Health System and Crossing the Quality Chasm: A New Health System for the 21st Century, which both called attention to the issues around patient safety and quality of care. This report explores the extent, consequences, and contributing factors of clinician burnout and provides a framework for a systems approach to clinician burnout and professional well-being, a research agenda to advance clinician well-being, and recommendations for the field.
Publisher: National Academies Press
ISBN: 0309495474
Category : Medical
Languages : en
Pages : 335
Book Description
Patient-centered, high-quality health care relies on the well-being, health, and safety of health care clinicians. However, alarmingly high rates of clinician burnout in the United States are detrimental to the quality of care being provided, harmful to individuals in the workforce, and costly. It is important to take a systemic approach to address burnout that focuses on the structure, organization, and culture of health care. Taking Action Against Clinician Burnout: A Systems Approach to Professional Well-Being builds upon two groundbreaking reports from the past twenty years, To Err Is Human: Building a Safer Health System and Crossing the Quality Chasm: A New Health System for the 21st Century, which both called attention to the issues around patient safety and quality of care. This report explores the extent, consequences, and contributing factors of clinician burnout and provides a framework for a systems approach to clinician burnout and professional well-being, a research agenda to advance clinician well-being, and recommendations for the field.
Transforming Mental Healthcare
Author: Sunil Khushalani
Publisher: CRC Press
ISBN: 1351582461
Category : Business & Economics
Languages : en
Pages : 194
Book Description
One in five U.S. adults experiences a mental illness within a given year. With more than 550,000 people working to support this underserved community, the mental healthcare system has grappled with inadequacies and shortcomings in safety, quality, and care delivery. There is a wide range of problems, from access-to-care issues and errors, to complications stemming from poor care. Our country is also on an unsustainable path as our healthcare expenditure keeps growing. To add to all of this, we are facing a rampant epidemic of burnout among healthcare workers. Modern advancements introduced with many promises—such as electronic medical records, newer medications, or advanced treatments—have created unique challenges when ushered into a highly regulated healthcare system. What does it take to provide patients with everything they need—the right quality of care, at the right time, and at the right cost—to keep them healthy? Which process steps add value? Which steps are wasteful? A widely accepted fact is that a conservative 30-50% of every step in the mental healthcare process does not help patients feel better or stay better. When considering delays in care, workarounds, excessive documentation, and an overuse of auditing, the care system has moved highly skilled clinicians away from providing value, as administrative tasks continue to encroach on their time. There is a clear need to rethink and redesign the system of care. This book is a primer for understanding the current state of the mental health system and the performance improvement skills and leadership acumen needed to address existing challenges. Sheppard Pratt, the award-winning, leading institution for mental healthcare in America, provided the focus on mental healthcare and became the laboratory for this body of work over the course of eight years. It hired a seasoned systems thinker with improvement expertise to work with mental health professionals and solve some of their most complex and chronic problems. The book is a result of the collaboration between a practicing psychiatrist in a leadership role and the systems engineer. Working together, they demonstrate how to think about redesigning care and redefining the nature of work to enhance value for both the people served and the healthcare workforce. They crafted a multi-pronged approach towards culture change at Sheppard Pratt, including implementing a course on "Learning to Improve," which introduced staff to a performance improvement methodology. There are several vignettes interwoven throughout the book that describe the complexities and constraints of the system. Solving some of these challenges creates a new paradigm of work while minimizing waste and enhancing value.
Publisher: CRC Press
ISBN: 1351582461
Category : Business & Economics
Languages : en
Pages : 194
Book Description
One in five U.S. adults experiences a mental illness within a given year. With more than 550,000 people working to support this underserved community, the mental healthcare system has grappled with inadequacies and shortcomings in safety, quality, and care delivery. There is a wide range of problems, from access-to-care issues and errors, to complications stemming from poor care. Our country is also on an unsustainable path as our healthcare expenditure keeps growing. To add to all of this, we are facing a rampant epidemic of burnout among healthcare workers. Modern advancements introduced with many promises—such as electronic medical records, newer medications, or advanced treatments—have created unique challenges when ushered into a highly regulated healthcare system. What does it take to provide patients with everything they need—the right quality of care, at the right time, and at the right cost—to keep them healthy? Which process steps add value? Which steps are wasteful? A widely accepted fact is that a conservative 30-50% of every step in the mental healthcare process does not help patients feel better or stay better. When considering delays in care, workarounds, excessive documentation, and an overuse of auditing, the care system has moved highly skilled clinicians away from providing value, as administrative tasks continue to encroach on their time. There is a clear need to rethink and redesign the system of care. This book is a primer for understanding the current state of the mental health system and the performance improvement skills and leadership acumen needed to address existing challenges. Sheppard Pratt, the award-winning, leading institution for mental healthcare in America, provided the focus on mental healthcare and became the laboratory for this body of work over the course of eight years. It hired a seasoned systems thinker with improvement expertise to work with mental health professionals and solve some of their most complex and chronic problems. The book is a result of the collaboration between a practicing psychiatrist in a leadership role and the systems engineer. Working together, they demonstrate how to think about redesigning care and redefining the nature of work to enhance value for both the people served and the healthcare workforce. They crafted a multi-pronged approach towards culture change at Sheppard Pratt, including implementing a course on "Learning to Improve," which introduced staff to a performance improvement methodology. There are several vignettes interwoven throughout the book that describe the complexities and constraints of the system. Solving some of these challenges creates a new paradigm of work while minimizing waste and enhancing value.
The Future of Nursing
Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 0309208955
Category : Medical
Languages : en
Pages : 700
Book Description
The Future of Nursing explores how nurses' roles, responsibilities, and education should change significantly to meet the increased demand for care that will be created by health care reform and to advance improvements in America's increasingly complex health system. At more than 3 million in number, nurses make up the single largest segment of the health care work force. They also spend the greatest amount of time in delivering patient care as a profession. Nurses therefore have valuable insights and unique abilities to contribute as partners with other health care professionals in improving the quality and safety of care as envisioned in the Affordable Care Act (ACA) enacted this year. Nurses should be fully engaged with other health professionals and assume leadership roles in redesigning care in the United States. To ensure its members are well-prepared, the profession should institute residency training for nurses, increase the percentage of nurses who attain a bachelor's degree to 80 percent by 2020, and double the number who pursue doctorates. Furthermore, regulatory and institutional obstacles-including limits on nurses' scope of practice-should be removed so that the health system can reap the full benefit of nurses' training, skills, and knowledge in patient care. In this book, the Institute of Medicine makes recommendations for an action-oriented blueprint for the future of nursing.
Publisher: National Academies Press
ISBN: 0309208955
Category : Medical
Languages : en
Pages : 700
Book Description
The Future of Nursing explores how nurses' roles, responsibilities, and education should change significantly to meet the increased demand for care that will be created by health care reform and to advance improvements in America's increasingly complex health system. At more than 3 million in number, nurses make up the single largest segment of the health care work force. They also spend the greatest amount of time in delivering patient care as a profession. Nurses therefore have valuable insights and unique abilities to contribute as partners with other health care professionals in improving the quality and safety of care as envisioned in the Affordable Care Act (ACA) enacted this year. Nurses should be fully engaged with other health professionals and assume leadership roles in redesigning care in the United States. To ensure its members are well-prepared, the profession should institute residency training for nurses, increase the percentage of nurses who attain a bachelor's degree to 80 percent by 2020, and double the number who pursue doctorates. Furthermore, regulatory and institutional obstacles-including limits on nurses' scope of practice-should be removed so that the health system can reap the full benefit of nurses' training, skills, and knowledge in patient care. In this book, the Institute of Medicine makes recommendations for an action-oriented blueprint for the future of nursing.