Editorial: Transforming America’s Sick Care System into a True Health Care System by: Ann Cella, MA, MEd, RN, NEA-BC; Meredith King-Jensen, MA, MSN, RN; and Dana Deravin Carr, DrPH, MS, MPH, RN-BC, CCN

n EDITOR IAL Transforming America’s Sick Care System into a True Health Care System

With the passage of the 2010 Patient Protection and Affordable Care Act (ACA), the 21st Century has initiated the transformation of the United States health care system. As the largest single group of clinical health care professionals within the health system, registered nurses are fundamental to the critical shift needed in health services delivery. With the goal of transforming the current “sick care” system into a true “health care” system, nurses’ education and practice within a holistic framework that views the individual, family, and community as an interconnected system that can keep us well and help us heal has been validated and encouraged. Finally, the paradigm shift from the bio-medical model to the wellness model.

In this volume of The Journal of the New York State Nurses Association, you will find an array of articles, research, and opinions by nurses spurred by this paradigm shift. This consortium of new knowledge and innovations contribute to our professional body of knowledge and facilitates the improvement in the quality of patient care, and our workplaces. Nurses must work in healthy work environments to facilitate quality patient care.

As you read The Journal articles, you will notice a theme: the author’s realization of the impact of health care reform on nursing practice and on the workplace environment. Governmental monetary incentives are described as instrumental at determining and assuring quality patient care measures. Current perceptions of the patients’ hospital experience hold great value in measuring quality patient care, while compliance to best practices and improving efficiencies are also recognized and rewarded. As nurses, we affect all quality measures. We are, therefore, instrumental to the financial viability of our health care system.

Nurses who provide the direct care to our patients are the true leaders of our profession. As leaders, nurses in all practice settings must demonstrate a commitment to continued lifelong learning, education, and research. Leadership development must be enriched by our continuing education programs and facilitated by our employers.

Patients, by virtue of living longer and with numerous co-morbidities, also affect health care reform. The plan of care for patient’s special and individualized needs require astute and experienced nurses. The transition of patient care from “less” hospital to “more” home, requires nurses in all settings to address the variables which directly affect patient outcomes, including the physiological, psychosocial, cultural, and spiritual needs of patients.

Patient safety is the foundation of quality patient care. The nurse is quintessential to the reduction of adverse patient outcomes. The nurse’s role in supervision and coordination of care is primary. Nursing must take the lead to protect and sustain the profession with great emphasis on patient safety. Striving for excellence in patient care requires the nurse to identify quality measures: clinical efficiency; core measures; patient experiences; and nurse sensitive indicators. It is therefore honorable to recognize the nurses who use their discretionary time to publish and share their knowledge among us. They give us insight into what is possible. The articles in this publication of The Journal contain provocative topics which can promote energetic discussion opportunities between and among our peers. The written word continues to encourage the vision.

Ann Cella, MA, MEd, RN, NEA-BC Meredith King-Jensen, MA, MSN, RN Dana Deravin Carr, DrPH, MS, MPH, RN-BC, CCN