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Nursing Management:
doi: 10.1097/01.NUMA.0000409927.84837.6c
Department: Editorial

The changing face of chronic illness

Section Editor(s): Hader, Richard PhD, NE-BC, RN, CHE, CPHQ, FAAN

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Author Information

Editor-in-Chief; Senior Vice President and Chief Nurse Officer, Meridian Health System, Neptune, N.J.

Eighty years old is the new sixty,” is the mantra when describing the aging demographic. People are living longer, healthier, and more productive lives, and medical conditions once considered acute with high morbidity and mortality are now frequently referred to as chronic ailments. Many of these diseases, if managed well, have a good probability of a long-term, stable outcome. Sounds positive, right? Theoretically it does. However, despite well-established literature on a number of chronic illnesses, healthcare providers don't consistently follow the most current clinical guidelines, which minimizes the delivery of efficient and effective care. The perpetuation of a lack of standardization in chronic disease management is driving healthcare costs to an unsustainable level, necessitating the need for all healthcare practitioners to work collaboratively to solve this economic and quality crisis.

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More Americans than ever before are eligible for healthcare coverage through Medicare funding. We can all appreciate the fact that when this program was established, most potential beneficiaries never lived long enough to receive benefits from the program. Improved access and management of healthcare services have dramatically lengthened survival rates. This has resulted in a high use rate of the system, leading to accelerated spending that's having a major drain on the economic environment. To actively manage chronic diseases, it's our responsibility as healthcare leaders to find methods based within a scientific framework that are cost-effective while maintaining the highest quality and outcome.

Over the course of 2012, Nursing Management journal will publish a series of articles on several chronic conditions, including diabetes, behavioral health, and HIV. These articles will explore the etiology behind the disease, highlight current national guidelines and protocols to actively intervene, and offer suggestions on how nurses and other healthcare professionals can translate current scientific evidence into the daily care of patients with these diseases.

One of the most important paradigm shifts for healthcare providers to embrace is that care needs to be delivered over an extended period of time. The days of quick and episodic care are over. There needs to be better coordination throughout the entire continuum of care and services, from prevention and education through diagnosis, planning, intervention, and maintenance.

Overspending for chronic disease management is directly related to a lack of coordination and standardization of care. Tests and treatments often aren't coordinated between various healthcare providers because there isn't an appropriate flow of information from one provider to another. This causes duplication of care, drives costs, and does little or nothing to improve the care provided.

Making great strides in the care of chronic illness needs to be foremost on the agenda of all nurse leaders in 2012 and beyond. Nurse leaders are in a great position to assume the responsibility of patient care coordination throughout the entire healthcare system. Actively participating in establishing chronic healthcare initiatives will benefit patients, the organization, and the overall healthcare delivery system. Start collaborating with your healthcare colleagues and begin managing chronic care.

NURSING.MANAGEMENT@WOLTERSKLUWER.COM

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© 2012 by Lippincott Williams & Wilkins, Inc.

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