Virginia Action Coalition Shirley Gibson, MSHA, RN,

FACHESusan Motley, CAE, CEO

Virginia Nurses AssociationNovember 17, 2011

To define the RWJF/AARP Center for Championing Nursing initiative

To define the Virginia Action Coalition

To describe the five workgroups To review next steps

Objectives

IOM Future of NursingCampaign for Action

One Year Anniversary

Link to video

Linda Burnes-BoltonVice Chair

IOM Future of Nursing

Americans have access to high quality, patient-centered care in a health care system where nurses contribute as essential partners in achieving success

Vision

• Field strategy to move key nursing issues forward at local, state and national levels

• In 15 states before moving nationwide

• Capture best practices, track lessons learned and identify replicable models

Short and long term

Action Coalition Goals

Campaign for Action:Key Messages

Leadership

Access to Care

Workforce Data

Education

High-quality patient centeredcare

Inte

rpro

fessio

nal

Colla

bora

tion

1. Remove scope of practice barriers2. Expand opportunities for interprofessional

collaboration3. Implement nurse residency programs4. Increase proportion of nurses with BSN to 80% by 20205. Double the number of nurses with doctorates6. Ensure that nurses engage in lifelong learning7. Prepare and enable nurses to lead change and

advance health8. Build an infrastructure for data collection

Future of Nursing Recommendations

2010 Landmark IOM Report: Future of Nursing: Leading Change, Advancing Health

November 2010 RWJF/AARP Center for Championing Nursing Summit

State Action Coalitions – 5 pilots, New Jersey, New York, Michigan, Mississippi, California

Wave II – 10 States – Idaho, Utah, Colorado, New Mexico, Illinois, Indiana, Louisiana, Virginia, Florida

and Idaho

How action coalitions got started!

Submitted February 2011 - input from more than sixty stakeholders

Awarded designation in March 2011 RWJ Foundation and AARP Center to

Champion Nursing in America Focuses on technical support and exchange of

best practices Catalyst to convene diverse stakeholder

around common themes

Virginia’s Action Coalition Application

Nurses should practice to the full extent of their education and training

Nurses should achieve higher levels of education and training through an improved educational system that promotes academic progress and explore residency programs

Nurses should be full partners, with all members of the healthcare team in redesigning healthcare

Develop strategies to ensure that nursing is skilled to provide leadership at all levels

Effective workforce planning and policy making require better data collection and an improved information infrastructure

Virginia Action Coalition Goals

Kickoff : June 16, 2011 Nursing Roundtable Five workgroups with more than 150 participants ww.vaifn.org website Blog and wiki that are the result of the media

training that Chelsea, Lindsey and Linda participated in with AARP

Feature articles in the Virginia Nurses Today and media coverage across state for the Forty Under Forty awards

Engagement

Funding from the Virginia Nurses Foundation, VCNP, Virginia Nurses Association, and the Virginia Partnership for Nursing

Engagement of non nursing partners PIN Synergy grant awarded to Richmond

Memorial Health Foundation and partners

Partnerships

AARP volunteers including 4 state legislative specialists join VAC workgroups

AARP 2012 legislative platform includes supervision should be removed from the code of Virginia with regard to Nurse Practitioners

Testimony given “on the record” at Department of Health Professions Town Hall Meeting on supervision of APRNs being a barrier to access to care

AARP Partnership

AARP 2011 Voter Education PamphletQuestions anyone running for VA General

Assembly should answer : If elected/re-elected, how would you ensure

advanced practice registered nurses can practice to the full extent of their education and expertise?

Do you support or oppose allowing advanced practice registered nurses to practice without physician supervision?

AARP Partnership

Volunteer engagement with workgroups AARP public policy platform: Supervision

should be removed from the code of Virginia with regard to Nurse Practitioners

Testimony given “on the record” at Department of Health Professions Town Hall Meeting on barriers to access to care

AARP Partnership

AARP raises awareness In print and on line Bulletin features article,

“Nursing Shortage will Grow as Population Ages”

(Susan Motley quoted)

More to come!

AARP Partnership

Education Advancement

Linda Dedo and Deb ZimmermannCo-leads

Educate nursing workforce and stakeholders on the importance of achieving higher levels of education

Support nursing leaders in the implementation of strategies to employ a more educated workforce

Convene stakeholders for the implementation of seamless education progression

Consider role of residency programs in the Commonwealth

Education Objectives

Regional meetings with clinicians, leaders, and academia have supported objectives

A forecasting & strategy tool was developed and is available for predictive modeling

Stakeholders have agreed to meet Collaborating with recipients of Richmond

Memorial Health Foundation PIN Grant on short and long term goals for seamless education progression

Progress

Next Steps

Create four regions in the Commonwealth for communication, collaboration, and action

Meet with Board of Nursing, Virginia Hospital and Health Care Association leaders, Community College Presidents/Nursing Chairs, Magnet Consortium, VONEL, etc.

Develop a webinar on forecasting tool Support grant holders with identification of

best practice for seamless education progression

Access to Care

Linda Ault and Cindy FaganCo-Leads

Nurses should practice to the full extent of their education and training

Nurses should achieve higher levels of education and training through an improved educational system that promotes academic progress and explore residency programs

Access to Care Objectives

One of the barriers to APRN practice was not just statutory (code) but that each facility determines what the practice parameters will be for their institution.

This has resulted in many “myths” regarding what the various APRNs are actually licensed to do

We are in the process of publishing a series of “Myth Busters” in VNT to educate nurses regarding what the various APRNs are actually licensed to do

Progress

Identifying individuals to take the Campaign for Action on the road to educate not only nursing professional groups but also non-nursing groups such as the League for Women Voters, service groups such as Rotary Clubs, legislators, business groups, health care institutions, the Virginia Chamber, and other consumers of health care on how nursing can fill the access to care gap 

Call for stories: to demonstrate through real practice stories how APRNs were either able to successfully bridge a gap to care or how the current statutes hindered and negatively impact access to care throughout the state

Outreach

elimination of “physician supervision” new language will provide for NPs to work in collaboration and

consultation with a physician in a “patient care team” model  the practice agreement describes guidelines for the collaborative and

consultative process in the work setting and prescriptive practices the credentialing process in hospitals and health systems may serve in

lieu of a practice agreement the patient care team physician actively provides management and

leadership to patients or groups of patients on the patient care  team the requirement that the physician "regularly practice" at the same

location as the NP has been eliminated collaboration and consultation may be through telemedicine ratios have been retained but are increased to 6:1 from 4:1

Outcomes:Consensus Bill Salient Features

Create a dashboard on the VAC website to track the speakers and organizations that have been addressed. To date we have visited various APRN meetings in Virginia to educate them on the VAC and recruit future speakers.

Secure more support statements for legislative change such as the one obtained by AARP 

Long term goal: Implement legislative strategies to impact statutory and regulatory barriers that prevent nurses from practicing to the full extent of their education and training.

This can be done through the development of a white paper in addition to education of professional and consumer groups.

Outcomes

Leadership

Lindsey Cardwell-Jones and Loressa ColeCo-Leads

Develop strategies to ensure nursing is skilled to provide

leadership from the bedside to the boardroom

Leadership Goal

Continue to determine strategic boards to which nurses could be appointed and work with stakeholders to identify, mentor, and recommend individuals for those appointments

Collaborate with schools of nursing to ensure the curriculum focuses on leadership skills necessary for today’s complex healthcare environment

Recognize leaders “from the bedside to the board room” at the annual Virginia Nurses Foundation Excellence in Nursing gala

Leadership Objectives

Continue “Nurse Leaders in the Boardroom” program piloted with Robert Wood Johnson and AARP in September, 2009

Continue to support the current and expanded Nurse Leadership Institute, a program of the Richmond Memorial Health Foundation and a 2007 Partners Investing in Nursing’s Future (PIN) grantee, by participating on committees, providing scholarships, assisting in encouraging employers to nominate fellows and nurses to serve as faculty

Leadership Objectives

The Team: Over 30 Registered Nurses from diverse backgrounds and geographic locations as well as a VA AARP Volunteer

2011 Meetings:June 11, 2011- Orientation Conference CallAugust 8, 2011- Strategy Overview & Review of Objective 1 via Conference CallSeptember 23, 2011- Implementation Strategy Session for Objective 1 and Overview of current Nurse Leadership InstituteFocus groups and engagement with the 40 under 40

The Strategy: The Leadership workgroup is utilizing WikiSpace to facilitate online discussion of objectives and hosting monthly conference calls to update the team on the background of objectives and develop implementation strategies for each objective. The team is focusing on one objective each month.

Outcomes

Workforce Data

Nina Beaman and Richardean BenjaminCo-Leads

Improve data collection and information infrastructure

Workforce Data Objective

Continue participation on DHP Healthcare Workforce Data Center

Conduct APRNs survey (in progress) Participation and dissemination of

information from the VA Workforce Development Authority to inform RAC workgroups

Participate in the Forum of State Nursing Workforce Centers (annual conference)

Progress

Support NCSBN’s efforts to standardize data collection

Achieve consensus around the minimum data sets

Develop and implement specific geographical demand models for nursing and other health professionals

Progress

Conducting briefings: Results of recent Nurse Licensure Survey HRSA plans to discontinue RSS Compiling current resources to inform

subgroup members about workforce data group issues

Drafting talking points presentation Drafting framework for subgroup white paper

Progress

Interdisciplinary /Team Based Care Delivery

Sallie Eissler and Patti McCueCo-Leads

Develop and deploy best practices in team/interprofessional models that promote

nurses and other health care professional in all settings to practice according to their level of

education and licensure to improve and transform health care to patients, families and

communities

Objective

Sept. 9th; Hosted by Centra in Lynchburg Facilitated by Pamela Cipriano, PhD, RN, NEA-BC

Diverse group of participants including nurses, physicians, chaplains, pharmacists & nurse practitioners

Presentations: Centra ED model & NP Single Provider model

Two small workgroups: ambulatory and inpatient services

Organizational Meeting

Next Steps

Meet quarterly in person (January 2012) Add new and diverse participants Identify best practices: ambulatory and

inpatient Implement pilots of interdisciplinary team

based care delivery models Develop a plan to market results Link back to the other workgroups

VNA Education Day – September 24, 2011 Linda Burnes-Bolton, Vice – Chair, CNO Cedasr-

Sinai Valentina Brashers, MD, Professor of Nursing

UVA Co-leads update

Next steps Co-Lead Meeting to determine next steps

Virginia Action Coalition

Virginia Action CoalitionEngage!

VNA Legislative Day27th Annual Nurses Day at the General Assembly

February 8, 2012