How Ambulatory Care Nurses are Shaping the Future of Healthcare

By Laura Brummett, Writer for Nurse.com
LinkedIn: Laura Brummett
LinkedIn: Nurse.com

​Nurses are the backbone of healthcare, but they’re not always recognized for their integral contribution to patient outcomes.

The American Academy of Ambulatory Care Nursing (AAACN) has released the second edition of its Ambulatory Care Nurse-Sensitive Indicator (NSI) Industry Report, a major step forward in recognizing and measuring the value that ambulatory care nurses bring to the table. This report highlights the critical role nurses play in improving patient outcomes and calls for a shift in how nursing is valued — economically, professionally, and structurally.

Rachel Start, MSN, RN, NEA-BC, FAAN, a representative of AAACN, hopes the report can help give nursing the validation and respect it deserves.

“We really feel like nursing is key to not just transforming but honestly revolutionizing healthcare,” she told Nurse.com. “While the report is focused on valuable metrics in ambulatory care, it really reflects measures that encompass a broader view of increasing patient outcomes that are positive.”

This report is about making sure that work is recognized, supported, and used to push real change in the healthcare system, Start said.

What are nurse-sensitive indicators?

Nurse-sensitive indicators (NSIs) measure the impact of nursing care on patient outcomes. In ambulatory settings, where patients are seen outside of the hospital, these indicators help show the true value of nursing. NSIs track things like patient safety, care coordination, chronic disease management, and even patient satisfaction.

But clear metrics tying ambulatory care nursing to patient outcomes have been historically lacking.

That’s where the newest AAACN report steps in. It lays out meaningful ways to measure and prove what nurses already know: The care they provide makes a huge difference in patient health and overall healthcare costs.

Nurses are the key to fixing healthcare gaps

The AAACN NSI Report goes beyond just listing metrics — it speaks to the bigger picture. As healthcare shifts toward value-based care, ambulatory nurses are in a prime position to lead the charge.

But as Start points out, nurses aren’t always viewed in the same light as doctors or clinicians.

“Most of our financial models have us within the expense bracket rather than in a revenue-producing bracket,” she said. “And that’s why we’re a little bit stunted from doing the care coordination, transitions management, and population health that we believe patients need right now. Furthermore, we believe we can implement some access points that haven’t been trialed in healthcare before.”

Right now, many chronic disease management programs, telehealth check-ins, and care coordination efforts are driven by nurses, but the reimbursement structures don’t always reflect that.

The report makes the case that these services should be recognized and supported, not just as “extra” tasks, but as essential, billable parts of care.

How can nurses use this report in their own practice?

This report isn’t just for administrators — it’s built for practicing nurses, too. It highlights real-world examples of how ambulatory nurses are already driving change, plus tools and strategies to help nurses push for better patient outcomes in their own workplaces.

Some takeaways for nurses:

• Advocate for telehealth services. The report highlights how telehealth can improve access, especially for chronic disease patients. If your workplace isn’t fully utilizing telehealth, this is an area where nurses can step up and lead.
• Use NSIs to show the impact of nursing care. Metrics matter. If you’re looking to improve staffing models or advocate for more resources, tracking NSIs can help make a solid case for what nurses need.
• Engage in professional governance. The report highlights the importance of nurses having a say in decision-making at every level.

“We have the public’s trust, and yet we haven’t felt the power that I think we could be feeling through that contract with society,” Start said. “The public is looking to us. They’re looking for anybody that can help fix healthcare and help improve outcomes, access, and equity.”

Nurses must have a voice in shaping policies, staffing decisions, and new care models, Start said. Professional governance ensures that nursing expertise is guiding those conversations.

The future of ambulatory nursing

Ambulatory care nurses are still underutilized, but that’s changing. Start and other nursing leaders see a future where ambulatory nurses:

• Play a bigger role in preventing hospital readmissions
• Lead chronic disease management programs
• Drive health equity efforts by addressing social determinants of health
• Have economic models that recognize and support their work

And while the report highlights what’s missing — such as more research on nurse staffing ratios in ambulatory settings — it also lays out a clear roadmap for where the profession is headed.

Nurses in ambulatory settings already know they’re making a difference, and the AAACN NSI Report is hoping to advocate for better policies and more recognition across the system.

This article was originally published on the Nurse.com blog and is republished here with permission.