Value and nursing

I'm reading more on the need to determine nursing's value to patient care and the organization's bottom line. What elements of value relate to assessing nursing's value going forward? ECONOMIC VALUE Nurses play an important role in influencing and reducing healthcare costs because their efforts control patient-generated costs to the health system; for example, by preventing complications, reducing hospital admissions, and advancing patient-care impact and outcomes. However, it's difficult to clearly enumerate nurses' specific actions that demonstrate these values. They do have a significant impact on the sustainability of the healthcare system going forward. With improvements in and growing use of artificial intelligence algorithms that can tease out specific related value contributions in these arenas, nurses can show their direct impact on efficient patient care. There's a slow but steady move to value-based purchasing models in healthcare. In these models, positive, high-quality care can be rewarded directly, and low-quality service outcomes can be penalized over time using objective and aggregated metrics that directly influence the determination of nurses' financial contribution to healthcare delivery. These approaches enable nurses to demonstrate directly their contribution to care impact. Nurses can focus on the processes and activities they manage that precisely show the nurse's role in contributions to costs and efforts, potentially clarifying the cost-benefit relationship of identified nursing patient-care activities. Hospitals using nursing-sensitive, value-based purchasing approaches are incentivized to align specific nursing practices with better patient outcomes that shorten hospital stays, lower rates of adverse events, and reduce readmissions. Advanced practice nurses can further address costs by demonstrating better clinical practices that lower provider-driven costs and advance positive clinical outcomes. IMPACT VALUE An increased focus on specific nursing activities can help reduce mortality rates, medication errors, patient falls, hospital-acquired infections, and the length of hospital stays. By aligning related cost algorithms linked to these practice enhancements, cost reductions can be attached to the improvements in care efficiency and patient experience. An intentional nurse focus on impacting the health of the community, social determinants of health initiatives, health practice education, improved local health policies, and political and social health advocacy at every level of governance can positively demonstrate the direct impact value of nurses.2 Using impact metrics, Magnet® recognition could focus on the hospital nurse's role in demonstrably impacting the health of the communities in which these hospital systems operate. Emerging from all of these foci, nurses can lead the development of innovative initiatives that significantly alter these nursing activities and build the infrastructure and framework that sustain the refocus on creating healthy outcomes and healthy communities. A newer innovation that creates the Nursing Human Capital Value Model integrates three economic frames: human capital theory, production theory, and value theory.3 This effort links nursing human capital contribution (education, knowledge, skills, competencies) with nursing processes and activities (production) and directly related clinical outcomes (impact, value). These integrated elements create a synergy of effects that demonstrate nurses' contributions to advancing the effectiveness, efficiency, and efficacy of nursing practice and health outcomes.4 CHANGE IS COMING Over the next decade, advances in technology, increased evidence of nursing's impact on care effectiveness and health outcomes, and the use of algorithms and metrics that support nurses economic and service impact will combine to specifically enumerate nurses' contributions to healthcare. These innovations will challenge past models of managing nursing resources and finally validate nurses' specific impact on healthcare costs and quality. Nurse leaders will be deeply engaged in these activities in a way that supports their development and ensures their success.