Promoting innovative nursing practice during radical health system change

Between 1995 and 1999, the United States veterans healthcare system underwe nt a radical transformation. The reinvention effort remains a work in progr ess, but the results have documented improved access to care, significantly higher service satisfaction, and substantially higher quality of care, whi le reducing per patient costs by 25%. Although turbulent at times, the chan ges instituted during this period created a dynamic milieu for nursing that has provided fertile ground for innovation and unprecedented opportunities to improve patient care.