■ Rising to the Challenge of Health Care Reform With Entrepreneurial and Intrapreneurial Nursing Initiatives Anne Wilson, Nancy Whitaker, and Deirdre Whitford. In The Online Journal of Issues in Nursing, 2012, Volume 17, Issue 2, Manuscript 5. http://dx.doi.org/10.3912/OJIN.Vol17No01Man05

Abstract

Rising to the Challenge of Health Care Reform With Entrepreneurial and Intrapreneurial Nursing Initiatives Anne Wilson, Nancy Whitaker, and Deirdre Whitford. In The Online Journal of Issues in Nursing, 2012, Volume 17, Issue 2, Manuscript 5. http://dx.doi.org/10.3912/OJIN .Vol17No01Man05The concepts of entrepreneurship and intrapreneurship have been intermittently popular because various authors explored their relevance to and use for enhancing nursing and health care practice and delivery. This article by Wilson, Whitaker, and Whitford provides an expansive global and updated view of entrepreneurship and intrapreneurship among nurses through examination of several important nursing initiatives that are having a positive influence on health care delivery within the context of health care reform.To introduce the topic, the authors state two initial key assumptions. First, health care reform is happening worldwide in response to expanding needs driven by aging of the population, increases in chronic diseases, and rising costs of health care. Second, the health care workforce must comprise the correct number and quality of roles, must have the appropriate skill mix, and must provide for full utilization of all roles to meet evolving health needs. Because nurses usually represent the largest proportion of professionals within the health care workforce, the role of nursing will be pivotal in designing and implementing innovations to enhance care, quality, and cost-effectiveness. Despite their pivotal role, nurses are often not full partners in the assessment and design of better approaches to health care services.These authors posit that the "human factors" component of health care innovation, as distinct from technology-driven innovation, will be achieved through nurses creating and fulfilling roles and functions that bridge gaps in health care across settings. The skill sets that will advance these innovations have their foundation in entrepreneurial and intrapreneurial values and expertise.Nurse entrepreneurs are defined as self-employed proprietors who are directly accountable to the clients who receive and pay for their services. To be successful, whether in providing direct care, consultation, or other activities, nurse entrepreneurs must creatively conceptualize and then offer services and/or products that are judged valuable. Nurse intrapreneurs are paid employees of health care organizations, who embrace and practice innovations skills, often to address identified needs in the patients and populations they serve. Arriving at a precise number of nurse entrepreneurs and intrapreneurs is impossible, but it is clear that they are present, their numbers are probably increasing, and they are playing crucial roles in improving health care. …