Why “care coordination” and why now? Care coordination has been proposed as a solution to many of the seemingly intractable problems of American health care: high costs, uneven quality, and too frequent disappointing patient outcomes. More resources are devoted to health care per capita in the United States than in any other nation, yet our fragmented system is often characterized by communication failures and non-beneficial or redundant healthcare tests and services. This results in an unacceptable risk of error and an increase in cost, in terms of both resources and human suffering.
Many independent elements of U.S. health care are high quality, but these need to be better aligned to serve patients and the people and institutions that care for them. Current financial and structural incentives restrict potential for better patient care outcomes and effective resource allocation. Rather, they intensify the weaknesses inherent in the non-coordinated, independently functioning pieces of our health care system. The development and implementation of effective systems and processes to cure this current misalignment can benefit tremendously from the experience, professional competencies, and long-standing ethos of registered nursing.
Coordination of care is not a new idea, and it is certainly not new to registered nurses. In the context of a partnership guided by patients’ and families’ needs and preferences, the registered nurse is integral to patient satisfaction and care quality, as well as the efficient use of health care resources. Patient-centered care coordination is a core professional standard and competency for all nursing practice. Registered nurses understand that they are an essential component of the care coordination process to improve patients’ care outcomes, facilitate effective inter-professional collaboration, and decrease costs across patient populations and health care settings. What is well known to registered nurses, however, has not often been recognized outside of nursing. This white paper was initiated to highlight both the qualitative and quantitative accomplishments of registered nurses in care coordination.