Integrating Nurses into Complex Care Teams

January 2019

On Thursday, January 17, 2019 , the Playbook presented a webinar exploring how nurses can be integrated into complex care teams.

They addressed the following questions:

  • What is the future of telehealth?
  • How can nurses treat the whole person, including social determinants of health?
  • Where is policy headed, and how might nurses play a role in influencing it?

This interactive online discussion, moderated by Kathy Duncan, RN, faculty at the Institute for Healthcare Improvement, provided opportunities to share ideas and ask questions about these topics. The panelists had expertise in both nursing and policy. 

Here were a few of the takeaways:

  • It’s essential to find the right combination of human contact and technology, said Mary Naylor, PhD, RN, FAAN, Marian S. Ware Professor in Gerontology, and Director of the NewCourtland Center for Transitions and Health, University of Pennsylvania School of Nursing. The recently passed CHRONIC Care Act enables Medicare Advantage to expand telehealth. The resources on the Playbook can help nurses to determine when an in-person visit is appropriate, when a telephone call can supplement, and so on.
  • Nurses need to adopt a mindset that goes beyond the visit, said Susan Reinhard, PhD, RN, FAAN, Senior Vice President and Director, AARP Public Policy Institute and Chief Strategist, Center to Champion Nursing in America. It’s important to think about how individuals with complex needs and their caregivers will manage at home, and to provide appropriate guidance and resources. 
  • Nurses are experts in communication, said Sarah L. Szanton, PhD, ANP, FAAN, Health Equity and Social Justice Endowed Professor and Director, Center for Innovative Care in Aging. They need to use those skills to communicate with their communities and policymakers. If you frame your work in terms of saving money and improving lives, she said, it will gain widespread support. 

Posted to The Playbook on
Level of Evidence
Expert Opinion
What does this mean?