Role Redesign: What Has It Accomplished?

Abstract

This article describes the trends that are stimulating the redesigning of roles in health care, the concerns created by this redefinition, and the anticipated future challenges of continuing role redesign. While the evolution of roles will continue, the kind of models we should develop for the future remains unclear. Meanwhile, we are continuing to make monumental changes in health care systems without knowing whether we are improving patient care or making it worse. Health care is a rapidly evolving industry whose rate of change has been escalated by the vastly increased sense of competition, dwindling resources, and rising demand by payers, patients, and communities for high quality, low cost, convenient service. We now find health care in a state of chaos with many politicians, consultants, and industry leaders offering dramatic solutions. Although, this rush to redesign seems difficult, our history is replete instances of with similar rethinking of roles. Because our profession is fragmented over so many nursing organizations (more than 80 now), it has been difficult to develop, critique, and oversee the redesigns that have often been imposed from outside of nursing.