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Name of Sponsoring Organization presents  The Future of Nursing: Leading Change, Advancing Health

Name of Sponsoring Organization presents  The Future of Nursing: Leading Change, Advancing Health. Casey R. Shillam, PhD, RN-BC Mary Dickow, MPA Nurse Co-Lead Statewide Director CA Action Coalition CA Action Coalition. Objectives.

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Name of Sponsoring Organization presents  The Future of Nursing: Leading Change, Advancing Health

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  1. Name of Sponsoring Organizationpresents The Future of Nursing: Leading Change, Advancing Health Casey R. Shillam, PhD, RN-BC Mary Dickow, MPA Nurse Co-Lead Statewide Director CA Action Coalition CA Action Coalition

  2. Objectives At the conclusion of the presentation participants will be able to: • Identify the 4 key messages and 8 recommendations of Institute of Medicine (IOM) study on the future of nursing. • Determine how INSERT THE AUDIENCE POPULATION DESCRIPTION in California can contribute to the California Action Coalition (CA AC) workgroups and the statewide effort. • Demonstrate understanding of nursing’s contributions that positively impact the health of the population.

  3. Institute of Medicine

  4. Why Now?

  5. Health System Challenges *World Health Statistics 2009. World Health Organization, 2009. Available at: http:/www.who.int/whosis/whostat/EN_WHS09_Full.pdf

  6. IOM Committee for the RWJF Initiative on the Future of Nursing 18 members with expertise in: • Health information and technology • Health services research • Health policy • Workforce research and policy • Economics • Health care consumer perspective • Public health • Nursing • Federal and state administration • Hospital and health plan administration • Business administration

  7. Our Current Health System

  8. Committee’s Vision

  9. A Transformed Health System

  10. Fostering Inter-professional Collaboration Diversity

  11. Future of Nursing: Campaign for Action Collaboration created by the Robert Wood Johnson and AARP Foundations to ensure that all Americans have access to high quality, person-centered care

  12. Education Leadership High-quality patient centered care Inter-professional Collaboration Access to Care Workforce Data

  13. Key Message #1: Nurses should practice to the full extent of their education and training. Nurse leaders must: • work with state boards of nursing, state policy makers, consumers and other health care professional organizations to remove restrictive scopes of practice. • participate in efforts to assure appropriate use of advanced practice nurses and optimal roles for RNs in chronic disease and transitional care management.

  14. Improve Access to Care

  15. The Evidence Over 10 studies show equivalent patient outcomes when care is provided by APRN or MD: • Two Cochrane reviews (Hatem et al, 2008 and Laurant et al, 2004) • RCT published in JAMA (Mundinger et al., 2000) • No studies suggest care is better in states with tighter scope-of-practice restrictions

  16. Role of the Registered Nurse Refocus the role of the Registered Nurse to provide: • Prevention and wellness care rather than acute care • Community education and wellness • Chronic disease case management • Prevention of functional decline and need for hospitalization / placement in facility

  17. Key Message #2: Nurses should achieve higher levels of education and training through an improved education system that promotes seamless academic progression. Nurse leaders must: • support academic progression of the nursing workforce. • collaborate in developing and implementing transitional programs. • identify, promote and support colleagues in pursuing doctorates.

  18. Improve Education

  19. The Evidence • Lowered patient mortality • Every 10% increase in BSN nurses results in 4% decrease in risk of death • Lower number of medication errors and procedural violations • Stronger critical thinking and leadership skills of BSN nurses • 6% of nurses who graduate with AD get advanced degree, compared to 20% of BSN graduates *Aiken et al., 2003; Aiken et al., 2009; Estabrooks et al., 2005; Friese et al., 2008;Tourangeau et al., 2007; Van den Heede et al., 2009

  20. Key Message #3: Nurses should be full partners, with physicians and other health care professionals, in redesigning health care in the United States • Nurse leaders must: • act as full partners with other health care providers, being accountable for their responsibility to deliver high-quality care. • work collaboratively with leaders from other health professions. • identify and propose solutions to problems in care environments. • devise and implement plans for improvement. • participate in health policy decision-making.

  21. Promote Interprofessional Collaboration

  22. The Evidence Greater levels of collaboration between health professionals, especially between nurses and physicians, improves quality of care and patient outcomes Barr, 2002; Barnsteiner et al, 2007

  23. Prepare and Enable Nurses to Lead

  24. The Evidence Gallup survey of 1,500 opinion leaders: • Predicted nurses will have little influence on health care reform over next 5-10 years • Wanted nurses to have more influence in reducing medical errors, increasing quality of care and promoting wellness • Believed nurses should have more input and impact in planning, policy development and management *RWJF, 2010

  25. Key Message #4: Effective workforce planning and policy making require better data collection and an improved information infrastructure Nurse leaders must: • assist in the collection of data regarding both the workforce and the demand for care from the populations we serve. • determine the type of data to collect to accurately assess the demand for nursing services, particularly the specialties and geographic areas of nursing shortages.

  26. Build Workforce Data

  27. The Evidence Move from evaluating simply “number” of hours to the content and quality of those hours • CA BRN survey • No nursing shortage!?!? • Evaluating hours of nursing care across settings • Can create methods of comparing quantitatively long term care vs. primary care vs. home health care Spetz et al., 2011; Van Cleave et al., 2011

  28. The Evidence Only with the right “mix” of data can we ensure the populations in most need will have the services and health care that they need.

  29. The Evidence

  30. The IOM Recommendations

  31. The IOM Recommendations

  32. How Nursing Will Contribute to Improved Healthcare

  33. Communications Committee engaged nurses and other partners from across the state to develop a brand for the Coalition.

  34. Vision A healthy California through nursing leadership and service

  35. Mission Implement the recommendations of the IOM Future of Nursing report through strategic partnerships for a healthy California

  36. Core Values • Engaging broad and diverse perspectives • Increasing and using influence • Strategic and efficient use of resources • Improving health outcomes

  37. Goals • Develop action steps to achieve the Recommendations • Engage a broad-base of stakeholders in the Campaign • Create statewide structures that support the work • Ensure regional engagement • Influence national-level healthcare policy decisions

  38. Organizational Structure Executive Committee Leadership Council Working Group #1 Working Group #8 Working Group #2 Working Group #7 Working Group #6 Working Group #3 Working Group #4 Working Group #5 Regional Groups Stakeholders

  39. Recommendation #1: Remove scope-of- practice barriers Conduct gap analyses to: • compare California regulatory language with NCSBN Consensus Model for advanced-practice registered nurse regulation • compare for the four advanced-practice registered nurse and RN roles to the IOM Future of Nursing Report with the laws and statues of California Co-Leads: Garrett Chan and Susanne Phillips

  40. Recommendation #2: Lead and diffuse new practice model efforts • Convene a statewide symposium in September 2012 to explore opportunities to transform health care delivery, share innovative models, and assess gaps in current models of care delivery Lead: BJ Bartleson

  41. Recommendation #3: Transition-to-practice through nurse residencies • Promote transition to practice programs and residencies as expectation of nursing education • Expand programs for new graduates to include more community-based opportunities • Create a statewide evaluation of current programs to inform next steps Co-Leads: Dorel Harms and Nikki West

  42. Recommendation #4: Increase number of nurses with BSN • Establish baseline percentage of RN’s with minimum educational level of BSN • Inventory and analyze data from existing ADN-BSN projects to establish best practices • Continue to facilitate progress AB1295 with consultation and support to CCC and CSU Chancellor’s Offices Co-Leads: Liz Close and Stephanie Robinson

  43. Recommendation #5: Double number of nurses with a doctorate by 2020 • Work with Recommendation #8 to establish baseline number of nurse with a doctorate • Establish outcome measures and methods of collecting data for reaching goal of a 10% increase of BSN grads matriculating into Master’s programs within 5 years Co-Leads: HolliDeVon and Robyn Nelson

  44. Recommendation #6: Ensure that nurses engage in life-long learning • Establish priorities and communications plans for messaging the need for culture change to expectations of life long learning in the profession of nursing • Create repository on the Action Coalition website showcasing service and academic partnerships that demonstrate and support lifelong learning Co-Leads: Jan Boller and Martha Dispoto

  45. Recommendation #7: Prepare and enable nurses in leadership positions • Conduct gap analysis of 2011 survey to identify needs for developing new leadership programs for nurses • Expand nursing leadership opportunities for participation by nurses in board rooms, policy discussions and on management teams • Develop a systematic plan for involving students in the Action Coalition work Co-Leads: Pat McFarland and Peggy Hodge

  46. Recommendation #8: Build data infrastructure for workforce planning • Upload all public-access web links and resources for data to Action Coalition website • Disseminate a seamless inventory of CA data for analysis and workforce planning • Work closely with other recommendation groups to assess data needs to implement strategies Co-Leads: Joanne Spetz and Louise Bailey

  47. Regional Approach • Change will happen locally • Regional champions serve on Leadership Council • Hold regional forums to build engagement and deliver the message locally • Ensure regional members serving on work groups and/or coordinate with regional subgroups to link into statewide effort

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