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Three ways to help nurses advance your population health initiatives


Widespread adoption of population-focused nursing practice will likely take place over the next five to 10 years. Here’s how to stay ahead of the curve.

Nurses can play an integral part in population health, but leadership and technology training needs to be a larger part of nurse training. That’s according to a Robert Wood Johnson Foundation (RWJF) study released in September 2017.

The report finds that public health nursing at local and state agencies, in community and ambulatory settings, and in schools will continue to grow as population health strategies help identify where the biggest healthcare gaps exist.

How nurses benefit population health initiatives

Many population health strategies include looking at patients holistically, including social, economic, and cultural determinants, and nurses are already trained in those areas to deliver patient care, according to the study.

Paul Kuehnert, DNP, RN, FAAN, assistant vice president for RWJF Program staff,

“Nurses are trained to think holistically, to consider the context of a patient’s life and how that impacts his or her health,” says Paul Kuehnert, DNP, RN, FAAN, assistant vice president for RWJF Program staff,  who commissioned the study. Whole care also means assessments of the patient’s healthcare environment, which can include acute, ambulatory, home, behavioral health and community interventions. “Because of the nature of their roles, nurses often spend more face-to-face time with patients, which allows them to gain insight into the community and societal factors that impact patients’ lives and health. Armed with this insight, nurses can work with primary care physicians to help connect patients to resources within the community that can improve their overall well-being.”

How to better utilize nurses

1.      Encourage collaboration and dialogue

Unfortunately, nurses aren’t trained for leadership positions and are rarely a part of population health strategy development, the study finds. Kuehnert says that scope of practice regulations that vary based on the state, often restrict nurses’ time and ability to expand their roles.

“Culturally and historically, nurses-unless they hold formal leadership roles-tend not to view themselves as leaders. Nurses must understand, internalize, and act on the knowledge that nurses can be and are leaders, irrespective of their titles-and that by collaborating with policymakers, businesses, health systems, and more, nurses can exponentially increase the impact they have, well beyond the healthcare setting,” Kuehnert says.

2.      Help them use data to focus efforts

Increasing nurses’ capacity to make data-driven decisions is another part of the future of population health nursing. According to the study, nurse care coordination for low-risk patients that utilize healthcare services the most has been found to be the most cost-effective way to improve outcomes. Of all patients with high healthcare utilization, 60% to 75% can be classified as low-risk populations.

“We’ll also need to better prepare nurses for key evolving population-focused nursing roles in fields that include care management, chronic disease management, and population data analysis. These roles require core clinical knowledge and understanding combined with skills and abilities to identify and evaluate community resources, make and track referrals to community-based services, and measure outcomes,” Kuehnert says.

3.      Increase their technology literacy

Rapid advancements in telehealth, EHRs and mobile devices are a part of clinical care, prevention, and health communications that will continue to integrate into daily use for clinicians.

“Education should provide students with the technical skills they need to compile and analyze population and community data in order to understand the impact of the community conditions on patients’ health,” Kuehnert says. “And how they, as nurses, can influence change within their communities to improve health.”

Kuehnert says the insights nurses gain about patients’ life circumstances need to be systematically shared to inform care by the entire multidisciplinary team.

“We need to share bright spots of nursing leadership for population health improvement and spread them widely,” he says. “Widespread adoption of population-focused nursing practice will likely take place over the next five to 10 years as mindsets and expectations shift in nursing and healthcare.”

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