Pamela Austin ThompsonFinance and nursing professionals have a lot in common. They both want their organizations to be successful. They both operate in environments that are becoming increasingly complex and ambiguous. They both believe they are critical players in the race to adapt to healthcare reform and, more specifically, the Affordable Care Act.

So why do we act like we know nothing or care little about each other’s values and priorities? Why is there ever a need to discuss improvement the relationship that exists between the two disciplines? However, if we framed our work differently, we might have a better chance of creating a highly productive relationship that produces outcomes that benefit our organizations. We have the common competencies of business skills, knowledge of the healthcare environment, leadership, relationship management, and professionalism. Those competencies are critical to moving our organizations from the first curve to the second curve—from fee-for-service and volume-driven paradigms to the value-based purchasing models of the future. We are forever linked as colleagues in this payment journey. We each carry critical knowledge of how to make the portage. How do we leverage our combined skills to create dynamic finance/nursing teams?

Two areas of focus are ideal for this collaboration.

Delivery of safe, high-quality care. Patients do not expect to get infections when they come to a hospital. The Centers for Medicare & Medicaid Services does not plan to pay for infections that were acquired in the hospital. Nursing plays a key role in bedside programs aimed at reducing adverse events, such as central line-associated bloodstream infections. Finance and patient care providers should work side by side to expand such processes.

Readmissions are a key quality concern. One strategy to reduce avoidable readmissions is to ensure that patients with high-risk diagnoses are discharged with appropriate follow up. Finance and nursing leaders can work together to design discharge systems that are cost effective.

Nursing functions at the bedside, with the patient and family-up close and personal. Finance is geographically removed from where the care is provided—where the clinical decisions are made. As a result, decisions made to reduce cost may not be directly linked to what happens at the bedside, where decisions might not fully consider payment implications. When we move to bundled payments, the question facing both care providers and finance personnel is, How will we know what to bundle? Providing high-quality care is what we will be paid for in the future. The two disciplines are both intimately involved in the pursuit of this outcome—so they must work together and communicate on how best to achieve it.

Imagine the game of Battleship where you make decisions and move without knowing what the other player’s board looks like. Luck and cunning is not how we will win the battle for high-quality care and fair payment.


Pamela Austin Thompson, MS, RN, CENP, FAAN, is CEO, American Organization of Nurse Executives, Washington, D.C.

Thompson to Present at ANI

Pamela Austin Thompson, MS, RN, CENP, FAAN, is a scheduled feature speaker at ANI 2014: The HFMA National Institute in Las Vegas, June 22-27. Her presentation, "Catalyzing Change: Aligning Nurses and Finance Professionals to Drive Value," will explore successful collaborative strategies for developing a deeper relationship between nursing and finance.

Publication Date: Thursday, May 01, 2014