Aim: The purpose of this study is to leverage application of Six Sigma DMAIC Cycle in examining the expanded role of nurses in the United States for delivering improved health care during and posthospitalization of patients. Method: This study makes use of the operations management service tools, such as service blueprints and poka-yokes (mistake-proofing), as well as the DMAIC (Define, Measure, Analyze, Improve, and Control) method of the Six Sigma (these concepts are explained in the article) to define the failures of the process, reduce variability, improve the care process, and propose solutions. Fifty-three nurses from hospitals and small medical clinics responded to survey for this study. Results: This study reveals that nurses feel that increasing the number of nurses in hospitals would improve the care of patients. Nurses feel they could take on certain tasks currently only performed by doctors after receiving proper training. This would reduce the workload of doctors. Conclusions: Analysis of the current open-ended health care process allowed determining failure points and how to prevent such failures. Recommended poka-yokes include greater involvement of nurses in education and counseling patients during hospitalization and posthospitalization. Structured home visits and nurses role in improving communication with patients to foster better understanding and self-care compliance would decrease the number of unplanned readmissions. Expanding the current education process in nursing schools and nursing roles is crucial to implement a closed-loop health care delivery system, which incorporates suggested poka-yokes.

Aim:The purpose of this study is to investigate expanding the role of nurses in the current U.S. health care system from the standpoint of nurse-patient interactions and nursing interventions to improve patient care and reduce overall health care costs. Background: Many failures in nurse-patient interactions in the hospital and in postrelease setting can be eliminated with different forms of patient-centered care that include patient education, support, and counseling. Method: This study makes use of extensive review of literature from academic databases to analyze increased Nurse Practitioner (NP) role in nurse-patient interactions during patients' in-hospital experience and postrelease environment. Conclusions: Expanding the role of nurses would improve the overall health care system in the United States and save money over the long run. Long-term follow-up with patients would promote a healthier lifestyle and reduce the likelihood of return to the hospital. NPs are uniquely positioned to potentially serve as change agents within health care systems. Implications: Nursing educators and managers will need to work closely with policy makers to implement the expanded role of nurses to improve the U.S. health care system.

No abstract