Integrating value-informed practice into all levels of nursing education

Integrating value-informed practice into all levels of nursing education

by Lori Wightman DNP, RN, NEA-BC, PCC, FAONL

Integrate value-informed practice into all levels of nursing education using Lean/Six Sigma principles

Value-informed Practice: Academic Preparation of Nurses

The American Association of Colleges of Nursing’s 2021 new Essentials guide for entry-level and advanced-level nursing education outline core competencies in quality, safety, costs, accountability, and value. (The Essentials: Core Competencies for Professional Nursing Education, 2021) While quality and safety have long been a mainstay of nursing education, it has generally been taught without regard to cost.

If care is not affordable then we contribute to health care disparities especially in socially and economically vulnerable populations. The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity (2021) calls for the nursing profession to take an active role in reducing health care disparities through access and value.

Nurses need to adopt a value-informed practice where quality, safety, and cost are considered in the quest for outcomes.

While the need for nurses to drive value is not new, incorporating health care economics into nursing curriculum has been slow especially at the entry-level to practice. Many would suggest that nursing curriculum is at full capacity – any changes would lead to an increased financial burden for students by lengthening the program. Any subtractions from the curriculum would be around clinical experience which has already taken significant reductions over the years.

A second barrier is related to the faculty beliefs around safety, quality, and costs. Many were trained in the era of a fee-for-service payment model which led to over utilization of services with little regard for cost. They may even lack understanding of current economics in healthcare which makes teaching the topic daunting.

Yakusheva, Rambur, and Buerhaus (2022) indicate that for faculty to teach value-informed practice, the faculty need to understand a) how the organization measures and reports nurse sensitive outcomes and b) how nurses’ actions contribute to improving quality of outcomes as well as how to decrease the cost of producing the outcomes. While I agree with their assessment, it does not go far enough. Faculty need to be prepared in how to improve processes and outcomes in healthcare such as A3 thinking and Lean tools. If not, then nursing programs need to reach out to other academic colleagues to help gain understanding and solidify partnerships in curriculum development and delivery.

An example of this partnership exists in Saint Louis, Missouri. Goldfarb School of Nursing has partnered with the McKelvey Engineering School at Washington University to integrate engineering principles like Lean and Six Sigma into their curriculum.

Call to Action

• Nursing programs need to integrate the constructs of cost and value into curriculum at novice and advanced levels of preparation.
• Nursing programs seek partnership with other academic partners to optimize nurse curriculum for the future.

American Association of the Colleges of Nursing (2021). The Essentials: Core Competencies for Professional Nursing Education. Retrieved online August 16, 2023.

National Academy of Medicine (2021). The Future of Nursing 2020-2030: Charting a path to achieve health equity. The National Academies Press: Washington, DC.

Yakusheva, O., Rambur, B., & Buerhaus, P. I. (2022). Value-informed nursing practice: What is it and how to make it a reality? Nursing Outlook (70) 211-214.

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