The federal deficit looms large, and health care and hospitals remain attractive sources for spending reductions. As trustees, it is important that we share the hospital story to ensure that our patients remain visible and have a voice in the budget debate. To that end, the AHA's advocacy efforts in 2011 fall into the following three general areas:

Delivery transformation. America's hospitals are committed to creating better, safer, more efficient and affordable care. The AHA is working to preserve what is good in health care reform, fix what is wrong, and advance the goals of Health for Life, the AHA's roadmap for improving the health care system. Through our Hospitals in Pursuit of Excellence initiative, we will continue to support performance improvement and provide members with multiple forums to exchange information and best practices to accelerate progress in quality and patient safety. And we will continue to encourage dialogue on such critical issues as end-of-life care, medical liability reform, disparities and spending variation.

Essential resources for patients and communities. Organizations across the board have become accustomed to doing more with less, and hospitals are no exception. But without fair, equitable reimbursement, hospitals cannot provide the care that communities need and continue to improve their performance. The AHA is working to protect hospital payments and to address expiring health care programs. It also will push to maintain funding and policies that help hospitals address workforce issues.

Roadblocks to reducing costs. Excessive regulations, outdated laws and a lack of clear federal guidance can inhibit the innovation and cooperation essential to better care delivery. They also drain time, funding and attention that could be focused more effectively on patient care. The AHA is working to reduce bureaucratic red tape and legal barriers impeding clinical integration by advocating for user-friendly

antitrust guidelines and seeking to modernize laws and regulations to allow providers to work together more closely. In addition, we'll seek to simplify the regulatory requirements for meaningful use of certified electronic health records.

Penny Brooke (Penny.Brooke@nurs.utah.edu) is COG chair and a trustee of Intermountain Health Care Central Urban Region in Salt Lake City.