Robert Johson

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Robert Wood Johnson’s Foundation Institute of Medicine’s 2011 findings regarding upcoming demands of the healthcare system and its patient population indicate required transformations spanning nursing education and scope of practice to national level roles of leadership and influence for the RN and graduate level professional. In the 1990’s the VA expanded the role of its nurses as part of its restructuring with measured outcomes providing evidence that support this approach as both successful financially and an integral part of a primary care system. Additionally, with President Obama re-elected for a second term in office and his healthcare program moving forward, this directing MD formula will likely become the dominant future American care format. While lower costs and improved patient care were its primary tasks, re-conceptualizing the role of the nurse proved a vital aspect to accomplishing these goals for many organizations. For example, Kaiser Permanente, a non-profit, pay in advance, referring physician program, streamlined its enterprise for the following benefits: improved coordination of care, chronic disease management, and collaboration amongst health team members. Interestingly, it, too, discovered the need to redefine nursing. Similarly, In Pennsylvania, the Geisinger Health Care System followed suit, transforming both framework and caregiving dynamics with positive results mirroring that of VA and Kaiser. Ultimately, all successful models cited in the study entailed re-conceptualizing nursing roles in order to expedite efficiency of function and funds. “While the number of NPs and physician assistants are steadily increasing the number of medical students and residents entering primary care are declining.” (p88) It is proposed that the nation’s growing population of NPs fill this primary care workforce gap, especially in more rural areas where physicians are lacking or non-existent. Studies show that states in which NPs are...
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