203chapter EIGHT
The Role of the DNP in Quality
Improvement and Patient
Safety Initiatives
Catherine Johnson
In 2010, the Affordable Care Act (ACA) was passed into law and with its passage came
increased expectations that health care professionals would transform the current health
care system. This transformation would be achieved through improvements in the
quality and safety of patient experiences in health care systems, resulting in improved
patient outcomes at a lower cost. At the same time that the ACA was passed, the Institute
of Medicine (IOM, 2010) released a report titled The Future of Nursing: Leading Change,
Advancing Health, promoting this expectation for the nursing profession. This report
challenged nursing as a profession to realize the role of nurses as advocates and lead-
ers in this transformational process. This report recognized that nurses are in the prime
position, given their numbers and adaptability, to effect significant changes in health
care system’s development and delivery. Through their experience in developing part-
nerships with both patients and other health care providers, nurses were thought to
demonstrate the skills and professional commitment to improve every environment in
which they work. The IOM report states that nurses are:
Poised to help bridge the gaps between coverage and access, to coordinate
increasingly complex care for a wide range of patients, to fulfill their potential
as primary care providers to the full extent of their education and training,
and to enable the full economic value of their contributions across practice
settings to be realized. In addition, a promising field of evidence links nurs-
ing to high quality care for patients, including protecting their safety. (IOM,
2010, p. 29)
At the same time, Robert Wood Johnson Foundation- Gallup Top Line Report (RWJ-
Gallup, 2010) released a report, Nursing Leadership From Bedside to Boardroom, which pro-
vided findings from a survey of 1,504 opinion leaders, including university, insurance,
corporate, health service, government, and industry thought leaders regarding their
level of trust and confidence in nurses’ ability to influence health care reform. Survey
findings indicated that these leaders did not consider nurses to be health care reformers.