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Future of Nursing: Campaign for Action Future of Nursing Summit
November 3, 2011
Sr. Advisor for Nursing for the Robert Wood Johnson Foundation Director of the Future of Nursing Campaign for Action
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Health Care System Challenges
Fragmentation
Health care disparities
Aging and sicker population
Primary care shortage
High costs
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RWJF’s Commitment to Improving Care
• RWJF mission: to improve health and health care for all Americans
• Need to address challenges facing nursing to address challenges facing our health system
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Institute of Medicine Report
High-quality, patient-centered health care for all
will require a transformation of the health care delivery
system
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Year One Progress • The IOM report is one of the most viewed reports
on the Institute website – As of June 2011, downloads of the report numbered
23,651
– In a year, the report generation more than 64 million media impressions
• The Campaign for Action website had 154,580 pages views and 48,644 unique visitors in eight months
• Groups have coalesced in nearly every state to take action on the IOM recommendations
• Health and Human Services Secretary Kathleen Sebelius praised the IOM report recommendations in a January 2011 interview in the New England Journal of Medicine
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Campaign Vision
All Americans have access to high-quality, patient-centered care in a health care system where
nurses contribute as essential partners in achieving success.
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• Initiative of AARP, the AARP Foundation and the Robert Wood Johnson Foundation
• Launched in December 2007
• Mission: Ensure all Americans have a highly skilled nurse when and where they need one
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Campaign for Action
Education
Practice
Collaboration Leadership
Data
Campaign for Action
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Campaign for Action Assets
Evidence-based
RWJF/AARP Commitment
Strategic Advisory
Committee Broad-based Partnerships
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Education
Increase the proportion of nurses with BSNs to 80 percent by 2020
Double the number of nurses with doctorates by 2020
Implement nurse residency programs
Promote lifelong learning
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Education
• Evidence – Significant association between educational level and patient
outcomes
– Six percent of associate-degree graduates get advanced degrees, enabling them to teach and serve as primary care providers, compared to 20 percent of BSN graduates
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How the Campaign is Advancing Education
• 450 participants • Listserv facilitated discussions • Determine and share best practices
Learning Collaborative
• State sharing • Resource guides • Web archive
Regional Webinar Series
• Nursing expertise • Coordination in region and nationally • Communication • Facilitation and collaboration
Regional Nurse
Experts
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Practice • All practitioners should practice
to the full extent of their education and training
• Optimal care: – Physicians, nurses and other health
professionals work in a team-based model of care delivery
– Models of care maximize time that providers can spend on their respective roles and responsibilities to patients
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Practice • Evidence: Systematic review of published literature
between 1990 and 2008 indicate patient outcomes of care provided by APRNs are equivalent or better than MD
– Patient satisfaction – Length of stay – NPs: BP, glucose, lipid control – CNMs: Fewer C-sections, fewer episiotomies
• Studies show that APRNs permitted to practice to full extent of education and training provide equal or better care
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Practice
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How the Campaign is Removing Barriers to Practice and Care
• Convening national stakeholders to implement strategies within their own organizations
• National forum on rural health to examine barriers to APRN practice
• Connecting Action Coalitions with resources and information to make change in their states
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Collaboration
• Integrated, collaborative, patient-centered health care teams
• Interprofessional education, training and practice
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Leadership
• Nurses bring important viewpoint to management and policy discussions
• Prepare more nurses to help lead improvements in health care quality, safety, access and value
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Leadership
• Gallup survey of 1,500 opinion leaders* said nurses should have more:
– Influence in reducing medical errors, increasing quality of care, promoting wellness
– Input and impact in planning, policy development and management
* RWJF, 2010
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Nurse Leaders in the Boardroom
• Survey of 1,000 U.S. hospitals* found:
– Nurses account for only 6 percent of board members
– Physicians account for 20 percent of board members
– Other clinicians are 5 percent of board members
* American Hospital Association, 2011
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Leadership at Every Level
• Evidence: TCAB – Nurses create, test and implement changes to improve patient
care
• Results – Falls with harm, “code blue” calls, 30-day re-admissions
declined
– 71 percent of floor nurses felt their ideas counted after TCAB, up 13 percent
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How the Campaign is Advancing Leadership
• Nurse Leaders in the Boardroom state pilots
• Tri-Council for Nursing
• Webinar series: The Value of Nurse Leadership in a Transformed Health Care System
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The Response: Campaign for Action
www.championnursing.org/nurse-leaders-resource
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Data
• Improve health care workforce data collection to better assess and project workforce requirements
– Research on health care workforce is fragmented
– Need data on all health professions
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How the Campaign is Advancing Data
• National Council of State Boards of Nursing and Forum of State Nursing Workforce Centers
– Jointly collecting state data in 2012 using the Forum’s Minimum Nurse Supply Dataset
– Collaboratively gathering and analyzing the data
– Publishing a report in early 2013
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Diversity
• Nurses should reflect patient population in terms of gender, race and ethnicity
• All nurses should provide culturally competent care
Increase workforce diversity
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RWJF AARP
Advisory Committee
Diverse Stakeholders
Policy-makers
Communications
Grantmaking
Research, Monitoring, Evaluation
Action Coalitions
Campaign Strategies
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Champion Nursing Coalition
– Aetna
– American Hospital Association
– American Public Health Association
– CIGNA
– Johnson & Johnson
– Convenient Care Association
– National Business Coalition on Health
– National Hispanic Medical Association
– National Partnership for Women and Families
– National Rural Health Association
– Target
Forty-eight health care, business and consumer organizations, including:
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Champion Nursing Council
– American Academy of Nursing
– American Association of Colleges of Nursing
– American Organization of Nurse Executives
– American Nurses Association
– Forum of State Nursing Workforce Centers
– National Black Nurses Association
– National Hispanic Nurses Association
– National Council of State Boards of Nursing
– National League for Nursing
– National Student Nurses’ Association
Twenty-seven national nursing organizations, including:
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Technical Assistance
• Tailored technical assistance program to provide
Action Coalitions with expertise, tools and other support needed to make change.
• TA structure:
– Campaign liaison
– Content resources
– Planning tools and information
– Communications support program
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Progress
• CCNA launches Learning Collaborative on Advancing Education Transformation
• AACN and Jonas Center for Nursing Excellence collaborating to enhance efforts to increase doctorally prepared faculty
• Leapfrog Group encouraging Magnet status for hospitals
• National Hispanic Medical Association working to improve interdisciplinary education
• Target promises to engage clinical nurses in leadership
National Organizations
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Progress
• Florida, New York, California: community college transition to state college and community college/state college partnerships
• Connecticut, Washington: articulation models
• Georgia: online doctoral programs • Montana: rural nurse residency program
States
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Campaign Resources
• Visit us on the Web at: www.thefutureofnursing.org and www.championnursing.org
• Follow us on twitter at: www.twitter.com/futureofnursing
• Join us on Facebook at: http://facebook.com/futureofnursing