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To improve health care, bring in the nurses – stat

Some of the largest health care systems in America do not have any nurses serving on their boards of directors. That is a huge oversight, especially in a time of rapid change in health care delivery, when consumers and providers would benefit from having nurses’ frontline perspective present in boardrooms as health care policy decisions are made.

Last month, nurse leaders from 21 national nursing and other health-related organizations came together to change that. The nursing leaders launched the national Nurses on Boards Coalition, which has a goal to put 10,000 nurses on boards of corporate and nonprofit health care organizations by 2020.

The effort is a direct response to the Institute of Medicine’s call in 2010 for nurses to play more pivotal decision-making roles on boards and commissions in improving the health of all Americans. The institute’s landmark report, “The Future of Nursing: Leading Change, Advancing Health,” established that strong leadership from nurses is an essential element in transforming health care delivery and improving patient care.

It seems the institute’s call has not reached much of America.

The American Hospital Association’s Trustee Magazine in September summed it up best: “Without a nurse trustee, boards lack an authority on the patient experience, quality and safety, and perspective from the largest part of the hospital workforce.”

The absence of nurses in leadership positions comes as hospitals, medical groups and insurance companies claim they’ve become more patient-friendly in a health care system increasingly putting more emphasis on prevention.

While doctors fill 20 percent of hospital board seats, nurses comprise just 6 percent, reported Trustee Magazine, which cited the most recent American Hospital Association governance survey.

The dearth of nurses serving on boards stands in stark contrast to the fact that nurses comprise the largest segment of the U.S. health care workforce – at 3 million strong. More than any other health care provider, nurses bring the perspective of the patient.

Consider that nursing practice covers health promotion, disease prevention, coordination of care, cure and palliative care when cure is not possible.

Nurses provide the majority of care in hospitals, nursing homes, clinics and outpatient settings. They are on the front lines in making sure care is delivered safely, effectively and compassionately in these and other settings. And nurses are the ones who not only tend to patients’ physical health needs but also respond to their social, mental and spiritual needs.

With federal health care reform, health care providers are in the midst of reworking care delivery to make it more accessible, accountable and affordable, while putting an emphasis on prevention and primary care.

Nurses already play a huge role on the front lines. It’s time they begin playing a role in the boardroom, too, bringing both their practical sensibilities and view of patient care experiences to the table.

The nation’s largest health care philanthropy, the Robert Wood Johnson Foundation, and the 38 million-member AARP, believe nurses must have a voice in the boardrooms of the health care organizations we trust to care for us. Backed by the foundation and AARP, the Future of Nursing: Campaign for Action is driven by the Institute of Medicine’s evidence-based recommendations. Nurse representation is our best hope of truly achieving high-quality care that is accessible, affordable and compassionate.

Susan B. Hassmiller, Ph.D., R.N., F.A.A.N., is the Robert Wood Johnson Foundation senior adviser for nursing and director of the Future of Nursing: Campaign for Action. Susan Reinhard, R.N., Ph.D., F.A.A.N., is a senior vice president at AARP, where she directs its Public Policy Institute and is chief strategist for AARP’s Center to Champion Nursing in America.