Michael Bleich served as chair for the planning group for the education forum in Houston. The half-day forums were not meant to be an exhaustive examination of all settings in which nurses practice nor an exhaustive examination of the complexity of the nursing profession as a whole. Given the limited amount of time for each of the three forums, a comprehensive review of all facets and all players of each of the main forum themes was not possible. Rather, the forums were meant to inform the committee on important topics within the nursing profession and to highlight some of the key challenges, barriers, opportunities, and innovations that nurses are confronted with while working in an evolving health care system. Many of the critical challenges, barriers, opportunities, and innovations discussed at the forums overlap across settings and throughout the nursing profession and also are applicable to other health providers and individuals who work with nurses.

The following sections of this appendix offer brief summaries and highlights from each of the three forums on the future of nursing: acute care, care in the community, and education. Appendix A of this report includes the agendas for the forums, and the full text of the forum summaries are available at www.iom.edu/nursing and are also included on the CD-ROM in the back cover of this report.


The Initiative on the Future of Nursing held its first forum on October 19, 2009, at Cedars-Sinai Medical Center in Los Angeles. This forum was designed to explore the challenges and opportunities for nurses in acute care settings and the changes needed to improve the quality, efficiency, and effectiveness of patient care. The forum focused on three topics within the context of acute care: quality and safety, technology, and interdisciplinary collaboration. Acute care settings were particularly important for the committee to examine, because well over half of all nurses work in acute care settings, where they are patients’ primary, professional caregivers and the individuals most likely to intercept medical errors. However, because hospital systems and acute care settings are often complex and chaotic, many nurses spend unnecessary time hunting for supplies, filling out paperwork, and coordinating staff time and patient care, reducing the time they are able to spend with patients and delivering care.

Nearly 300 people attended the acute care forum and heard presentations and discussions with 30 experts, including welcoming remarks from Thomas Priselac, president and chief executive officer of the Cedars-Sinai Health System and chair of the Board of Directors for the American Hospital Association, and a keynote presentation from Dr. Marilyn Chow, vice president of National Patient Care Services at Kaiser Permanente in Oakland, California. During the forum, 19 individuals offered testimony for the committee’s consideration. These individuals provided organizational and personal perspectives on the future of nursing in acute care settings.

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