Optimizing nursing skills for better #veterans care, can still get the proper care they need. #VeteransMatter 

#NewYark : The Department of Veterans Affairs (VA) continues to face the challenge of trying to meet a growing number of increasingly complex demands with too little funding. For example, the department has seen record growth in veteran health care needs — in some large hospitals a 20 percent increase in patient needs — while facing a nearly $3 billion budget shortfall.

As an economist, I look at the most efficient way to use scarce resources. In my work on health care policy, I specifically look at health care in terms of costs, efficiencies and patient outcomes. To meet this challenge, the VA must find areas where it can increase efficiencies without lowering the quality of patient care. To put it another way, how can it better use the resources and tools that it already has? One area that stands out is how the VA is utilizing — or underutilizing, as the case may be — Advanced Practice Registered Nurses (APRN), such as certified nurse practitioners and nurse anesthetists.

APRNs are registered nurses educated at master’s or post-master’s levels and trained in specific practice areas. Although APRN education is standardized, their licensing standards are set state by state, and thus, their ability to practice to the full extent of their training varies by state. When a resource — human or otherwise — isn’t being used to its full value there is inefficiency in the system. We all know enough to recognize that inefficiencies increase costs, and in the case of the VA, the inefficiencies have also increased veterans’ wait times, among other things.

Over the last year, the VA has been conducting an exhaustive review of the rules and regulations that set forth the practice guidelines for all VA nurses. Included are proposed changes that would allow all APRNs to practice to the full extent of their education and training. Congress is also looking at this: Both H.R. 1247 and S. 2279 would permit APRNs to practice in VA facilities to the full extent of their education and training.

Standardizing scope of practice for APRNs and fully utilizing these valuable resources could potentially increase veteran access to care and reduce costs without reducing the quality of care veterans receive. The potential benefits are numerous.

Allowing APRNs to practice to the full extent of their education and training makes them viable alternatives to physicians in many cases; in practice, this means that for some medical treatments, the VA will have increased the number of providers available to veterans. With more providers available, average wait times decrease across the board. The faster a veteran can see a provider, the better his or her health outcome.

Veterans’ health care needs continue to grow and become more complex in nature. The VA has to make changes in order to meet these needs. Allowing APRNs to practice to the full extent of their education and training would go a long way toward eliminating wait times and helping veterans get timely, high-quality health care.

⦁ Alice Louise Kassens is a John S. Shannon endowed professor of economics at Roanoke College, serves on the board of the Joint Advisory Board of Economists for the Commonwealth of Virginia, and is a senior analyst for the Institute for Policy and Opinion Research at Roanoke College. By Agencies.