Introduction
Harvey Fineberg
Good evening, everybody. Welcome. It is a pleasure for me to be able to greet all of you at tonight’s Rosenthal Lecture.
For the last 15 years, through the generosity of the Rosenthal Foundation, we have been able to sponsor each year a talk or symposium which deals with a topic of immediate and lasting importance to health care. This year is no exception, and in fact it is a special occasion because today’s lecture coincides with the release of our report, Keeping Patients Safe: Transforming the Work Environment of Nurses.
Now, it has sometimes been said that nurses are neglected. I have never understood that opinion because from my vantage point—occasionally as a patient, more frequently as a practicing clinician, and always as an educator—I have never failed to be impressed with the significance of nursing to health care, and that is not a sentiment that I am the only one to feel.
There is a wonderful expression of the importance of nursing by Lewis Thomas in his Essay on the Youngest Science: Notes of a Medicine Watcher in which he observes that hospitals are “held together, glued together, and able to function as an organism by the nurses and nobody else.”
So, we are not here because there is a question about the fundamental importance of nursing and of nurses. Rather, the committee who dealt with the question about the work environment of nursing started with the question of how to enable nurses in hospitals and other health-care settings to function within environments that are safe and provide the highest quality of care for our patients. This is the motive for our analysis and this report, which follow a great tradition at the Institute of Medicine:
working on questions of patient safety and the quality of care. It is part of what we think of as our Quality Chasm series.
This is a study that looks simultaneously at the role of a very critical profession—nursing—and the function of key institutions, nursing homes, hospitals, other centers for health care. Because of this complexity, it was an effort that naturally called upon a wide multi-disciplinary group to look at and to try to understand the current work environment for nursing and what could be done to improve things.
I am especially pleased that the members of our panel agreed tonight to participate and to offer their reflections based on the report which has been released, but I want to take a moment before introducing the three who will be speaking to at least identify some of the others here who were members of the committee that produced the report. Andrew Kramer is professor of medicine and head of the Division of Health Care Policy and Research at the University of Colorado in Denver. Marilyn Chow is the Vice President for Patient Care Services at Kaiser Permanente. Pamela Mitchell is Associate Dean for Research at the University of Washington School of Nursing. Gwen Johnson is a staff nurse at Howard University Hospital in Washington, D.C. Mary Lou de Leon Siantz is associate Dean for Research at Georgetown University’s School of Nursing. I want to thank all of you, and I am sure we all would like to join in thanking all of you, for your work in the preparation and completion of this important report. Thank you very much.
Now, it is my pleasure to introduce the first of our three speakers who will be sharing with us their perspectives on keeping patients safe by transforming the work environment of nursing.
The first speaker, who also chaired the committee, is Dr. Donald Steinwachs. Don is the Chair of the Department of Health Policy and Management at Johns Hopkins University’s Bloomberg School of Public Health, and he is an individual whose own work exemplifies the kind of critical research in health services that is so sorely needed to improve the quality of care for all patients.
He has covered many topics, ranging from the effectiveness of care to the ways in which different organizational and financial arrangements may influence the quality, utilization, and cost of services.
As chairperson, his breadth of experience and scope of expertise were invaluable for integrating the many disciplines and vantage points that informed our report. It is a pleasure to acknowledge, to thank, and to introduce Donald Steinwachs.
