Role Changes
To shift the care delivery system, role clarity needs to
occur. Nurse executives must work with NMs to redefine
their role and develop a system for patient engagement
that ultimately impacts the role of all nurses
within the healthcare system. A report from the Nursing
Alliance for Quality Care outlined key distinctions
between the role of direct care nurses and NMs related
to patient engagement.3 Direct care nurses are responsible
for working with patients and families to
most optimally manage their care or experience.3 They
can move from providing care to partnering with patients
to enhance self-care management. It is critical
that patients are involved in their care to achieve optimal
health, foster disease prevention, and reduce
acute episodic hospital admissions.11 Conversely, NMs
are responsible for managing a microsystem of care.
With the support of executive leadership, they lead
direct care nurses in making system-level changes that
facilitate the ability of people to more actively engage
in their care. Health reform offers providers incentives
for initiatives that support patient engagement, but
reduces reimbursement if clinical quality and satisfaction
targets are not met. NMs play a critical role in