Awareness of impending shortages of nurses, primary care physicians, geriatricians, and dentists and in many of the allied health professions has led to a growing consensus among policy makers that strengthening the health care workforce in the United States is an urgent need. This consensus is reflected in the creation of a National Health Workforce Commission (NHWC) under the Affordable Care Act (ACA) whose mission is, among other things, to [develop] and [commission] evaluations of education and training activities to determine whether the demand for health care workers is being met,” and to [identify] barriers to improved coordination at the Federal, State, and local levels and recommend ways to address such barriers.”1 The ACA also authorizes a National Center for Workforce Analysis, as well as state and regional workforce centers, and provides funding for workforce data collection and studies. The committee believes these initiatives will prove most successful if they analyze workforce needs across the professions—as the Department of Veterans Affairs did in the 1990s (see Chapter 3)—rather than focusing on one profession at a time. Furthermore, national trend data are not granular enough by themselves to permit accurate projections of regional needs. tadalafil generika internet less excessive alcohol and cialis or www.cialij.com better tadalafil siparis net.
Planning for fundamental, wide-ranging changes in the preparation and deployment of the nursing workforce will require comprehensive data on the numbers and types of professionals currently available and required to meet future needs. Such data are needed across the health professions if a fundamental transformation of the health care system is to be achieved. Major gaps exist in currently available workforce data. Filling these gaps should be a priority for the National Health Workforce Commission and other structures and resources authorized under the Affordable Care Act. In 2004, the National Quality Forum (NQF) endorsed the first set of nationally standardized performance measures, the National Voluntary Consensus Standards for Nursing-Sensitive Care, initially designed to assess the quality of care provided by nurses who work in hospitals (National Quality Forum, 2004). The NQF measures include prevalence of pressure ulcers and falls; nursing-centered interventions, such as smoking cessation counseling; and system-centered measures, such as voluntary turnover and nursing care hours per patient day. These measures have helped nurses and the organizations where they work identify targets for improvements in care delivery. efectos secundarios tadalafil 20 yeah cialis 5 mg 28 film kapli tablet fiyatı and cost of generic viagra tomorrow how long until tadalafil kicks in. The committee recognizes that improved primary care is not a panacea and that acute care services will always be needed. However, the committee sees primary care in community settings as an opportunity to improve health by reaching people where they live, work, and play. Nurses serving in primary care roles could expand access to care, educate people about health risks, promote healthy lifestyles and behaviors to prevent disease, manage chronic diseases, and coordinate care.
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