Arizona nursing connections: Conclusion of AzNA's Practice Grant

Arizona Nurse, Jul 2001

While nurses may have to convince many different groups of their credibility and commitment to change Medicare policies and service delivery. the CNOs demonstrated that our major audience, consumers, and in particular, older adults, are right there with us cheering us on. CNO members did not hesitate to write thousands of letters to their Congressional representatives. When asked by one of Arizona's legislators what was the best thing about the CNO, one CNO member pointed to his nurse partner and said - "You're looking at her." Nurses must capitalize on the trust and strong support of consumers, our patients, to change Medicare for the better.

What might be the impact of the project for nursing?

As the first nurse-managed demonstration for community-based Medicare services, the CNO has set the stage for infusing nursing practice innovations into Medicare. As a result of the CNO, numerous stakeholder groups, including consumers, legislators and the federal government, have become more aware of nursing's considerable ability to refine the delivery of health care for older adults. Many of the clinical elements refined in the CNO model, including case management, individual and group health promotion and illness prevention interventions and evidence-based guidelines for chronic illness management, can be expected to be integrated and reimbursed in future Medicare demonstrations.

It is essential that nurses lead and participate in these demonstrations to assure that the insights and lessons gained in the CNO and other nursing demonstrations are capitalized on and expanded. The CNO has provided important lessons about how nursing models will be evaluated by politicians and policy-makers. As a result of the CNO experience, nurses should be better prepared to design and implement nursing models targeted to critical quality and cost outcomes.

Where can the reader obtain more information?

Contacts: Gerri Lamb, PhD, RN, FAAN, CNO Director 1991-1999, Associate Dean, University of Arizona College of Nursing, 1305 N. Martin Ave., Tucson, AZ 85721, 520-626-6767 or glamb@nurisng.ariozna.edu. Rebecca Dahl, PhD, RN, CNO Director 1999-2000, Clinical Research Coordinator, Pima Research Foundation, 445 N. Silverbell Road, Tucson, AZ 85745, 520-624-8935 or rwdahl @hotmail.com. Publications: Ethridge, P. (1997). The Carondelet experience, Nursing Management, 28(3), 26-34.

Llundeen, S. P. (1997). Community nursing centers--issues for managed care, Nursing Management. 28(3), 3540.

HEALTH CARE INTEGRATED EDUCATIONAL SYSTEM (HCIES) What were the original goals of the project?

The HCES is a comprehensive and integrated system for health care education within the Maricopa Community College District. It is designed to respond to the dynamic and evolving nature of the health care system in collaboration with the local health care community while being sensitive to access for diverse populations. All programs and educational offerings within the HOES emphasize the achievement of relevant competencies and ensure value to the individual, the employer and the community. The goals are: