Background Context

Over the past 10 years, health care has been one of the nation's fastest growing industries, currently accounting for approximately 13 percent of the U.S. Gross Domestic Product. According to recent reports of the Bureau of Labor Statistics, over nine percent of the total workforce is employed in the health care field. Rapid technological and biomedical advances have made the U.S. health care system the finest in the world. Yet it faces many challenges in the decades ahead, including an increasingly diverse client population, remodeled delivery systems, and new technology. To meet such challenges, health services of tomorrow must be radically different from those of today. Inpatient care will come to mean "intensive care." If current trends continue, most care will be delivered in outpatient centers or even in the client's home.

The decade of the 1990s has brought increasing awareness that revisions in health care delivery and financing are needed. Health care reform proposals have been written at the national, state, and organizational levels all across the nation. Six principles have provided the foundation for reform: quality, security, simplicity, responsibility, choice, and savings. The ultimate goal is to deliver quality care at a price society can afford. To achieve this goal, one element of health care reform stands out as fundamental and essential: the education and training of the nation's over 10 million health care workers. Their level of knowledge and skill is critical.

In recognition of the need for a highly skilled health care workforce, the U.S. Department of Education has funded the National Health Care Skill Standards Project (NHCSSP), a collaborative endeavor among health services, labor, and the education community to better prepare tomorrow's health care worker by developing skill standards today. The NHCSSP is one of 22 skill standards projects funded either by the U.S. Department of Labor or the U.S. Department of Education. The NHCSSP is directed by Far West Laboratory for Educational Research and Development (FWL), in collaboration with the National Consortium on Health Science and Technology Education (NCHSTE), the Service Employees International Union (SEIU), and over one hundred health care organizations and educational institutions. The NHCSSP has involved representatives of key constituencies in a comprehensive process of research, review, revision, and pilot implementation to ensure that the standards created meet the existing and continually changing needs of the industry.

The results of that process are the National Health Care Skill Standards presented here. They make explicit the knowledge and skills health care workers need in order to deliver health care, particularly the critical elements required for producing "quality care." They can also be tailored to meet the practical, real-life needs of practitioners and educators. This document contains these skill standards, as well as guidelines for their implementation.