Nebraska Hospital AssociationMay 15, 2013

Linda Lazure

Rosanna Morris

Marilyn Valerio

Victoria Vinton

Committee Charge: To examine the capacity of the nursing workforce to meet the demands of a reformed health care and public health system

Institute of Medicine Report

IOM Recommendations:A Blue Print for Action

• Recommendation 1: Remove scope-of-practice barriers. Advanced practice registered nurses should be able to practice to the full extent of their education and training.

• Recommendation 2: Expand opportunities for nurses to lead and diffuse collaborative improvement efforts.

• Recommendation 3: Implement nurse residency programs.

• Recommendation 4: Increase the proportion of nurses with a baccalaureate degree to 80 percent by 2020.

IOM Recommendations (cont.)

• Recommendation 5: Double the number of nurses with a doctorate by 2020

• Recommendation 6: Ensure that nurses engage in lifelong learning

• Recommendation 7: Prepare and enable nurses to lead change to advance health.

• Recommendation 8: Build an infrastructure for the collection and analysis of interprofessional health care workforce data.

• Action Coalitions (ACs) are the driving force of the Future of Nursing: Campaign for Action (CFA), national effort to implement the Institute of Medicine’s (IOM) recommendations.

• The Campaign is a collaboration created by the Robert Wood Johnson Foundation (RWJF) and the AARP Foundation.

• The Campaign is building action at the local, state, and regional levels, to support a transformed health care workforce in which nurses contribute as essential partners in system-wide transformation.

• ACs will capture best practices, determine research needs, track lessons learned and identify replicable models. With assistance from the Center to Champion Nursing in America (CCNA) and RWJF, RACs are developing and implementing unique sets of regional goals and campaigns within the framework of the IOM recommendations.

Campaign for Action Pillars

Advancing Education

Transformation

Removing Barriers to Practice and Care

Nursing Leadership

DATA

INTERPROFESSIONAL COLLABORATION

DIVERSITY

Nebraska Action CoalitionLeading Change, Advancing Health

Visiting Nurse Association, Lead Nurse Partner HDR Architecture, Inc., Lead Non-Nurse Partner

• Steering Committee formed November 2010

• Identified lead partners: VNA/HDR• Formal application submitted to the

RWJF/ AARP to become a Regional Action Coalition

• Solicited up to $90,000.00 in funding• Hired Director to coordinate &

facilitate action plans

NAC Formation

Executive Committee (1) J. Summerfelt, B. Cernech,

C. McCullough, L. Lazure, M. Cramer, M. Valerio, R. Morris, J. Lazure,

N. Gondringer, D. Kozeny, A. Orduna, L. Walline, D. Straub

NAC Director (2)V.Vinton (1FTE)

Strategic Advisory Committee (3)

D. Frey MD VP Creighton Health Sciences; C. Benjamin AARP-NE; P. Lopez MSN, PHAN; K. Moore

MSN-RWJF Fellow CEO St. Elizabeth Hosp,

J. Ulrich CEO Community Hosp-McCook

Non-Nursing Organization Lead (4)

HDR Architecture, Inc.

Nursing Organization Lead (5)Visiting Nurse Association

Advancing Nursing Education Statewide Team (6)

M. Valerio & A. Orduna, Co-LeadsL. Connelly & K. Weidner, North Co-ChairsS. Hayek, S. Pitkin, C. Quadhamer, South V. Hess & T. Delahoyde, East Co-Chairs

S. Wilhelm & M. Thomas, West Co-Chairs

Advancing Nursing Leadership Statewide Team (7)

L. Walline & D. Straub Co-LeadsS. Fleming & T. Brown, North Co-Chair

C. Wahl & M. Wolf, South Co-ChairP. Agee-.Lowrey, D.Ernesti, M.Paradis East

West Co-Chair (need 2)Consultant: R. Morris

Advancing Nursing Practice Statewide Team (8)

N. Gondringer & D. Kozeny Co-LeadsNorth Chair (need 2)

S.Borden, South Chair (need 1)T. Spohn, and T, Baker, East Chair

R. Bowman & M.Zimmerman West Chairs Acute Care Consultant: J. LazureLegislative Consultant: L. Lazure

See NAC Organizational Chart Description (1-8)

Financial Support Staff part of in-kind from VNA

Diversity

Interprofessional Collaboration

DATA

Nebraska Action Coalition

NAC Strategic Focus• Preparation of nurses for the future• Manage Care Transitions• Improve access to care• Improve patient outcomes• Operationalize interdisciplinary

team approach to care

Formed three state-wide teams using IOM framework to develop tactics to achieve outcomes: Education, Practice, and Leadership

Prepare nurses to meet new challenges in health & health care.• Increase the proportion of nurses

with BSN and higher degrees.

• Increase the number of nurses with doctorates.

• Implement nurse residency programs.

Advancing Education

Advancing Education Increase BSN to 80% by 2020

IOM Action Steps NAC Update….

1.Define academic pathways, promote seamless access for nurses to higher education.

2.Enable ADN and diploma RNs to obtain BSN by removing barriers.

3.Encourage health care organizations to identify and support incentives for advancing education.

Data collected from all 20 Nebraska schools of nursing in collaboration with NANDD.

Developing competency –based approach for seamless articulation – pilot fall 2013

SIP Grant awarded for $150K – focuses on seamless articulation, leadership development, & diversity.

Education Evidence

Studies show association between higher nurse education level and improved health care outcomes.

• Evidence that higher proportions of BSN-prepared nurses associated with lower rates of medication errors, mortality, and failure to rescue.

• Research also shows that BSN-prepared nurses have stronger diagnostic skills and are better at evaluating interventions.

• A growing body of research shows a connection between baccalaureate education and lower mortality rates.

Advancing Education

• Enhance access to care through use of RNs, APRNs in primary, chronic & transitional care

• Utilize nurses to practice to full education & training

• Redesign the role of nursing specific to care coordination

Advancing Nursing Practice

• Build a diverse workforce to better reflect population served

• Utilize nurses in education and leadership to participate in healthcare redesign

• Prepare and enable nurses to lead

change

• Coach and mentor nurses at all levels

• Prepare nurses to be active decision

makers

Advancing Leadership

• Visiting Nurses Association

• HDR Architecture, Inc.

• Immanuel Communities

• Saint Elizabeth Regional Medical

Center

• Nebraska Medical Center

• Alegent Health

• Great Plains Med Center – North

Platte

• Good Samaritan Hospital – Kearney

• St. Francis Med Center – Grand Island

• Executive Committee of NAC

• NE Assembly of Nursing Deans &

Directors

• Creighton University School of

Nursing

• University of Nebraska College of

Nursing

• Donor-members of NAC

• Nebraska Association of Nurse

Anesthetists

• Nebraska Emergency Nurses

Association

• Nebraska Nurses Association

• Nebraska Nurse Midwives

• Nebraska Nurse Practitioners

• NONL

• Community Hospital - McCook

• Methodist Hospital

• AWHONN

• NNA District 2

• Nebraska Methodist College

• Clarkson College

• AARP-Nebraska Chapter

• Equitable Bank Foundation –Grand

Island

• Five Points State Bank – Grand Island

• Heartland Gerontological Nurse

Association

• NE School Nurse Association

• NE American Psychiatric Nurse

Association

Contributors

Endorsement– Partner with you and others to redesign

healthcare in the state of Nebraska– Focus on access to care– Facilitate Care Transitions– Improve patient outcomes & the health

of the public

Financial Support

The NAC- Future of Nursing Requests your Support

http://www.neactioncoalition.org

Please join us in this important work!For more information, contact:Victoria Vinton, MSN, RNDirector, Nebraska Action CoalitionCall: 402-830-7769Email: vvinton@neactioncoalition.org

ReferencesAiken, L. et al., (2011). Effects of nurse staffing and nurse education on patient deaths in hospitals with different nurse work environments. Medical Care 49: 1047-53. Benner, P. et al. 2010. Educating Nurses: A Call for Radical

Transformation. Jossey-Bass.Blegen, M., Good, C., Park, S., Vaughn, T., & Spetz, J. (2013).

Baccalaureate Education in Nursing and Patient Outcomes. Journal of Nursing Administration, 43(2): 89-94.Chen, L., Nguyen, A., Shaw-Sutherland, K. The Economic

Impact of the Health Care Sector on Nebraska’s Economy, 2009. UNMC NE Center for Rural Health Research & NE Office of Rural Health, March, 2012.Cramer, M., Jones, K. J.(2011). Nurse Staffing in Critical Access Hospitals. Journal of Nursing Quality Care, DOI:10.1097/NCQ.0b013e318219d30a.IOM (Institute of Medicine). 2011 The Future of Nursing: Leading Change, Advancing Health. Washington D.C. The National Academies Press.

References

Kutney-Lee, A., Sloane, D., & Aiken, L. H. An Increase in the Number of Nurses with Baccalaureate Degrees is Linked to Lower Rates of Postsurgery Mortality. Health Affairs. 2013; 32 (3): 579-586.

Joynt, K., Orav, E.J., & Jha, A. Mortality Rates for Medicare Beneficiaries Admitted to Critical Access and Non-Critical Access Hospitals, 2002-2010. JAMA. 2013; 309(13):1379-1387.

Newhouse, R.P., et al. A Phased Cluster-randomized Trial of Rural Hospitals Testing a Quality Collaborative to Improve Heart Failure Care: Organizational Context Matters. (2013). Medical Care, 51(5): 396-403.

Pew Research Center The Data Bank, retrieved September 3 http://pewresearch.org/pubs/1834/baby-boomers-old-age-downbeat-pessimism