Making the business case for quality and making the business case for nursing are popular subjects in nursing executive and other health care leader circles these days. The recognition that health care is a business and that nursing care is a big part of that business may seem obvious to many. However, the effort to understand the financial ties between nursing, quality, and the hospital's bottom line has historically been challenged by limited data. It has also been hampered by an industry norm, which, while imperfectly classifying nursing care as a cost rather than a revenue source, has inexplicably not recognized the need for accurate nursing cost accounting. The current dialogue and work to gain better information and understanding about how our profession contributes to both quality care and the organization's fiscal health is exciting and holds the promise of making a difference to both the outcomes experienced by our patients and the professional lives experienced by our nursing colleagues.
Health care will continue to evolve and change. (This would be true even if we were not facing the unknowns of health care reform.) One thing that will not change is that finance will be a limiting factor in what we can do for those who need our services. Part of our responsibility to our communities is to understand and utilize money in an informed, thoughtful manner. Nursing executives and managers must be both clinical leaders and business people, even in nonprofit organizations. The business of health care requires that we have accurate data, along with an ability to articulate the correlations between appropriately resourced nursing care and the organization's quality and financial outcomes.
In recognition of the magnitude and importance of this subject, both this and the following issue of Nursing Administration Quaterly are dedicated to financial topics for nursing leaders. The authors in this edition have approached the discussion of nursing and financial resources in a variety of ways. One group presents results from completed studies that will have financial ramifications for health care organizations (Levin et al; Barkauskas et al; Loan et al); some detail specific well-established projects with their early financial and quality results (C. Anderson and K. Spengler; Merritt; Walker et al); others describe very early work expected to provide organizations with new information for making better nursing leadership decisions (E. Faye Anderson et al; Schifalacqua et al). The article by Cara, Nyberg, and Brousseau reminds us that caring and economics must coexist. The editorial team hopes that these articles will pique your interest and stimulate dialogues in your organizations. We wish you well as you proceed with your own business case for nursing, quality, and finance.
-Kathleen D. Sanford, DBA, RN, CENP, FACHE
Senior Vice President and Chief Nursing Officer Catholic Health Initiatives Denver, Colorado