The Effects of Health Care Industry Changes on Health Care Workers and Quality of Patient Care

A number of recent studies have called for an overhaul of licensure for health care professionals. Common themes of these studies are increased flexibility in scopes of practice (much of this driven by the desire to cut costs), assuring continued competence of health providers, and assuring patient access to care and to information. As efforts are made to reform the current system of occupational regulation, key issues to consider are supervision, delegation, and accountability. For example, nurses have expressed concerns about liability for the actions of nurse aides or technicians working “under the RN license” when supervised by an RN as part of a patient-focused care team.

Nancy M. Pindus and Ann Greiner

Urban Institute

November 1997

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