Clinical TopicsPatient SafetyProfessional DevelopmentWorkplace Management

National Priorities – a guide for nursing pratice


The U.S. healthcare system is intended to provide access to safe, effective, and affordable health care. However, today’s system is not meeting those aims. Nurses must be engaged in the process of making fundamental change in how health care is provided for the system to deliver on that promise.
The National Priorities Partners (NPP), a collaborative effort of 28 major national organizations (including ANA) that collectively influence every part of the healthcare system, is working to facilitate needed change. The NPP organizations believe that it will require the work of all stakeholders to achieve the transformational change that is needed for the United States to have a high-performing, high-value healthcare system. NPP was convened by the National Quality Forum (NQF) to address the challenges in health care today. ANA, represented by CEO Linda J. Stierle, MSN, RN, NEA-BC, has been actively involved in NPP since its inception.
As a first step, the Partners have issued the report, “National Priorities & Goals: Aligning Our Efforts to Transform America’s Healthcare. The six priority areas include:
•     Patient and family engagement
•     Population health
•     Safety
•     Care coordination
•     Palliative and end-of-life care
•     Overuse
The NPP goals’ relevance to nursing practice is obvious. Patient advocacy, care coordination, and compassion are foundational to what nurses do every day.
The national priorities and goals were chosen because they collectively and individually address four major challenges: eliminating harm, eradicating disparities, reducing disease burden, and removing waste—issues that are important to all nurses in America. For over a century, ANA has convened the American nursing community and represented nurses in important discussions regarding patient safety and health reform.
ANA will not allow itself to be distracted from its core mission—fostering patient safety—a priority for NPP.
Throughout the NPP process, ANA’s CEO Stierle sought the perspective of the larger nursing community, which was shared with the Partners. ANA garnered much respect from the Partners (and others involved with health reform) as a result of these efforts. The NPP report acknowledges the input received from the NQF nursing organizational members as well as the broader nursing community—input solicited through the process fostered by ANA.
The success of numerous projects noted in the report offers suggestions for how nursing is working to bring about change in the healthcare system. The importance of nurses to ensuring the delivery of safe care has many implications, given the shrinking RN workforce. A very important step to achieving safety is enlarging the educational pipeline to prepare nurses and to improving the work environments where nurses practice. A 2008 ANA poll of more than 10,000 RNs nationwide revealed significant concerns over how nurse staffing affects patient safety and the quality of care and contributes to the growing nursing shortage. The results highlight the need for adequate nurse staffing and show the responding nurses’ perspectives on how staffing levels impact their work environment:
•    73% did not believe the staffing on their unit or shift is sufficient.
•    59.8% said they knew of someone who left direct care nursing due to concerns about safe staffing.
•    Of the 51.9% who were considering leaving their current position, 46% cite inadequate staffing as the reason.
•    51.7% said they thought the quality of nursing care on their unit had declined in the last year.
•    48.2% would not feel confident having someone close to them receiving care in the facility where they work.
ANA has ensured that the Partners are aware that nurses are essential to maintaining patient safety. Numerous studies have been shared with them that illustrate the relationship between having a sufficient number of nurses and the composition of the nursing staff, and preventing or reducing adverse events and improving the quality of care. The report notes the need to strengthen the professional workforce in order to provide optimal care to each and every patient.
I encourage you to review the full report (available at and use the priorities and goals to help guide your practice in improving patient safety.

Rebecca M. Patton, MSN, RN, CNOR
American Nurses Association

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