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Core Competencies for Health Professionals (IOM, 2003a, p. 4)
Provide patient-centered care. Identify, respect, and care about patients; differences, values, preferences, and expressed
needs; relieve pain and suffering; coordinate continuous care; listen to, clearly inform, communicate with, and educate
patients; share decision making and management; and continuously advocate disease prevention, wellness, and promotion
of healthy lifestyles, including a focus on population health.
Work in interdisciplinary teams. Cooperate, collaborate, communicate, and integrate care in teams to ensure that care is
continuous and reliable.
Employ evidence-based practice. Integrate best research with clinical expertise and patient values for optimum care, and
participate in learning and research activities to the extent feasible.
Apply quality improvement. Identify errors and hazards in care; understand and implement basic safety design principles,
such as standardization and simplification; continually understand and measure quality of care in terms of structure, process,
and outcomes in relation to patient and community needs; and design and test interventions to change processes and
systems of care with the objective of improving quality.
Utilize informatics. Communicate, manage knowledge, mitigate error, and support decision making using information
technology.

patient care.As a practicing professional,you can use 4. The ANA supports a single-payer health-care
the competencies to guide future professional devel- system (ANA, 2005, p. 2).
opment and ensure positive impact on health-care Although updated in 2008, the ANA’s policy still
reform while improving quality and safety. maintains the same four principles.
Role of Nursing in System Reform Influence of Nursing
The ANA’s Agenda Nurses are empowered through self-determination,
In 1989, taking a leadership position regarding meaning, competence, and impact (Whitehead,
health-care reform, the ANA began to address Weiss, & Tappen, 2007, p. 71). Additionally, nurses
concerns regarding quality, safety, and cost of care play vital roles in collective bargaining and decision
as well as the potential health-care reform within making within their organizations, empowered
the United States Working with more than 60 through professional organization such as the
nursing and health-care organizations, the ANA ANA (see Chapter 5).
published Nursing’s Agenda for Health Care Reform Nurses are respected and trusted health-care
(ANA, 1991). This document was positioned as its professionals. To influence change in the health-
blueprint for reform. care system, professional nurses must first acknowl-
Building on the ANA’s report from 1991, the edge power within the profession and recognize
ANA’s Health Care Agenda (ANA, 2005) describes their central role in health care. To be effective,
the organization’s policy on health system reform. nurses must leverage their professional expertise
This policy includes four basic principles: and the trust and respect they have garnered. It is
critical that nurses speak up and seek an active role
1. Health care is a basic human right. A restruc-
in shaping health-care reform:
tured health-care system should include univer-
sal access to essential services. ■ Become informed. Research topics of interest
2. The development of health policies that incor- to you and your practice. Rely on the Internet
porate the IOM’s six aims of health care will and your professional organizations as resources
save money. for current policy and legislative topics.
3. The health-care system must be reshaped and ■ Plan. After selecting a topic, prepare your plan:
redirected away from the overuse of expensive, gather facts and figures that will support your
technology-driven, acute, hospital-based ideas and position. Outline them, and address
services in the model we now have to one your audience in person, on paper, or via the
in which a balance is struck between high- Web. The most influential people are prepared
technology treatment and community-based and believe in their topic.
and preventive services, with emphasis on ■ Take action. Shape public opinion by the
the latter. method of your choice. Start small, and build