Chicago nurses: Reform emphasizes business side of health care

(Daily Herald) Nurses always have been among those on the front lines of health care, so what do they have to say about the health care reform recently upheld by the U.S. Supreme Court?

The Daily Herald caught up with Cathy Smithson and Kathleen Ferket of the Illinois Organization of Nurse Leaders, in town this week for a convention in Lombard, to get their thoughts.

Smithson, who serves as president of the organization that works to advance nursing leadership, said the coming changes put more emphasis on the business side of nursing and require nurses to understand that the better care they provide, the more likely their hospital is to be reimbursed by insurance companies.

Ferket, chairwoman of the organization’s policy and advocacy committee and executive director for patient care services at Northwest Community Hospital in Arlington Heights, said the reforms make all health care providers — not just doctors — more accountable for patient outcomes.

Here is an edited version of the conversation.

Q. What is your reaction to the Supreme Court’s ruling to uphold almost all provisions of the Patient Protection and Affordable Care Act?

Ferket: Even though many of us were unsure about what was going to happen with the Supreme Court ruling, we recognized the train was already out of the station. Accountable care and many of the initiatives involved in health care reform are already being enacted. The whole phenomenon of the hospital being the central point of care for patients is really expanding to primary care throughout the community.

Q. What will change most for nurses and nurse leaders when health care reform is fully implemented?

Smithson: We will be having a different structure of care — how we deliver it and where we deliver it. We will be looking for those creative, innovative strategies that will help us think about the way we take care of individuals in the future.

Ferket: How do we work smarter? How do we work more efficiently? How do we teach nurses at the bedside that the concerns around health care reimbursement are really tied to patient satisfaction? The nurse is with the patient more than any other care provider in the hospital, so nurses have to really, truly understand the value of the care that they deliver.

Q. Do you expect to see more patients once more people are required to have health insurance? Will there be a need for more nurses?

Smithson: I don’t know that it’s so much more patients. It’s just ensuring that the individuals who need care have accessible, affordable care. As we see the nursing workforce age and retire and the population age and have more health needs, there’s a disparity between numbers of nurses and the needs.

Ferket: The retirement curve for nursing is very similar to the aging workforce and the Baby Boomers, so we have to continue to fuel the pipeline for new nurses. It’ll be very important for us to make sure nurses can practice in all settings. The people who will be in hospitals will be the sickest of the sick because the most expensive model of care is in the hospital setting.

Q. What comes next in the transition?

Smithson: The next thing is accepting the responsibility that this leads to with identifying the partners we need to work with to make sure nursing care is able to comply with the rules and regulations.

Ferket: We are now tying outcomes to health care in general. It’s just not a physician who’s accountable for care, but everyone involved in the care of a patient. I think a nurse maybe recognized that was her relationship with the patient, but it’s so much broader than that now. It’s really population-based, where we’re working on things like decreasing obesity — it’s all of that preventive stuff because where we’re going to be burdened as a society is with the number of chronic diseases.