Local nurse tapped to craft Blueprint for Managed Care

Connecticut Nursing News, Jun-Aug 1998

Washington, D.C. February 5, 1998-Local nurse leader, Joan L. Quinn, MS, BSN, was appointed to a national expert panel convened by the American Nurses Association (ANA) to develop Nursing's Blueprint for Managed Care. Fueled by the rapid transformation of the health care system, the Blueprint is ANA's effort to spearhead nursing's endeavors to ensure the profession plays a strong role in shaping managed care.

The widespread implementation of managed care has left health care organizations sacrificing quality of care in the name of cost-cutting. Although managed care systems have presented some new opportunities for registered nurses (RNs), perhaps the most short-sighted approach to cutting costs is to reduce the number of RNs who provide direct patient care. When RN staffing is decreased, patient care suffers because there either are not enough nurses to deliver care or the few nurses who remain have such large patient loads, care may be compromised.

Registered nurses, as key players in the delivery of care, are increasingly challenged by the impact of these new systems of organizing and financing health care services. The concerns posed by managed care necessitate that the nursing profession assert its powerful voice in its timehonored role as patient advocate by calling for public policies that protect consumers, enhance accountability for quality, and promote access to the full range of health care services. "Nurses, as the front-line providers of health care in this country, know better than anyone what works about managed care and what doesn't," said ANA President, Beverly Malone, PhD, RN, FAAN. "Taking the lead on this issue is an integral part of the ANA's ongoing initiative to protect and improve the safety and quality of patient care nationwide."

In surveys, Americans report growing dissatisfaction with the trend toward managed care. Overwhelmingly, consumers are saying they don't trust a health care system that won't guarantee them safe care delivered by. RNs. The National Coalition on Health Care found that seven out of 10 people believe quality of care is compromised to save money, while findings from a Picker Institute study for the American Hospital Association illustrated strong consumer concerns about the effects on quality of care of cutting nursing staff and replacing nurses with minimally skilled workers. Furthermore, an August 1997 Harris poll revealed that 54 percent of surveyed Americans-up from 43 percent in 1996-believe that the growth of managed care is harmful to patient care.

The Blueprint is a companion to the ANA's Nursing's Agenda for Health Care Reform-the 1991 vision that was successful in its mission of ensuring that nursing had a seat at the table when key policy decisions on health care were being made. The ANA Board of Directors approved the initiation of the Blueprint in March 1997, and to ensure maximum participation in its development, the state nurses associations selected regional representatives based on their expertise and work experience to comprise the working group, which is chaired by Dr. Malone. Meeting in Washington, D.C., October 14-15, 1997, the group of 26 nursing leaders established overarching principles for the Blueprint and a time line for development of a core document that will articulate nursing's perspective. The group will work throughout 1998, and will reach out to the other nursing organizations to develop a consensus within the entire professional community.