COMON UPDATE 2012

1. COMON UPDATE2012 • RN-AIM • 7th Annual Conference & Assembly • September 21, 2012 Linda Taft, RN Chair, COMON www.micomon.org

2. Objectives • Discuss COMON’s structure, mission and purpose. • Identify ways COMON gives an organized, collaborative voice to issues of concern to nursing or impacting nursing practice. • Review COMON’s current and ongoing goals, including plans for sustainability moving forward.

3. What is COMON? • Coalition of Michigan Organizations of Nursing • Represents more than 22,000 nurses in 40 member organizations • Associate members include the Board of Nursing, Office of the Chief Nurse Executive and the Michigan Center for Nursing for a total of 43 organizations

4. Mission of COMON • Our mission is to serve as a vehicle that gives all nurses the opportunity to collectively work toward achieving mutually agreed upon goals for nursing in Michigan

5. Purpose of COMON • To provide for the exchange of appropriate information among those interested in nursing • To provide an organized collaborative voice for nursing on issues of common concern or on issues which impact the practice of nursing • To promote understanding, cooperation and communication among nursing organizations

6. Principles of Collaboration for AdvancingA Legislative Agenda for Nursing • Coalition select(s) issue(s) through a process of consensus building. Possible issues are discussed which are issues all the coalition organizations can support and which meet the criteria established for issue selection. • Coalition organizations work collaboratively using established criteria to advance the issue. • Any organization with concerns about the direction an issue takes or strategy makes a commitment to bring that concern to the Coalition in a timely manner. • In order for Nursing to move its Agenda, any member organization opposing an issue will not speak publicly against that issue once the provisions of the issue have been agreed upon and ratified by a majority of members of the Coalition. • As issues are played out in the legislature, there will be issue-specific coalition task forces which will provide ongoing review of legislation. • (Principles Adopted 4/90, Revised 12/98)

7. COMON Officers 2011-12 • Chair: Linda Taft • Chair-Elect: Sue Idczak • Secretary: Carole Stacy • Treasurer: Cordelia Tucker • Past Chair: Dee Tyler

8. COMON has 3 types of Membership • Regular: Open to all nursing organizations in Michigan • Provisional: Open to newly formed (<2 years) nursing organizations in Michigan • Associate: For those entities interested in nursing issues in Michigan

9. COMON membership represents nursing executives, professional societies, educators and nursing programs, ethnic-based organizations, practice-specific associations, advanced practice groups as well as the Center for Nursing, the Board of Nursing and the Office of the Chief Nurse Executive among others • COMON members participate with many external health related groups as well.

10. MI-AHEC • Federally funded starting grant to WSU in 2010 to create a state-wide Area Health Education Center (AHEC) program. In 2011, Southeast Regional Center was opened in partnership with Detroit-Wayne County Health Authority (DWCHA) in Metro Detroit with plans for Mid Central and Upper Peninsula Regional sites as well. • In August 2012, The Michigan Area Health Education Center (MI-AHEC) was awarded a five-year grant from the Health Resources and Services Administration (HRSA) to continue developing the infrastructure for our MI-AHEC program. Funds will be used to strengthen existing regional centers and establish new ones; they will also be used to enhance the ability of all five regional centers to promote and provide pipeline initiatives, clinical experiences, and continuing education programs in communities throughout Michigan. • Project is multi-disciplinary to include medicine, nursing, dentistry, pharmacology and social work at entry levels as well as degree-prepared.

11. Purpose and Focus of COMON • For most of the past decade, COMON’s primary focus has been to assist in the formation, implementation and advancement of Michigan’s Agenda for Nursing (2006-2010 version). Recently completed updated Agenda for 2011-2015 • In addition, COMON annually selects an Initiative Topic that is significant to nurses and nursing on which to focus it’s education and outreach efforts. • For 2012, COMON voted to support the Michigan Primary Care Consortium Adult Immunization Initiative. The Michigan Primary Care Consortium is an important resource for Michigan nurses as our healthcare system evolves under the pressure of economic, demographic, technological, and legislative forces. As more emphasis is placed on the benefits of preventative services at both State and National levels, COMON urges all Michigan nurses to support the Michigan Primary Care Consortium Initiative of improving immunization and primary care access for all Michigan residents.For more information on the COMON 2012 Initiative, please go to www.mipcc.org. • The 2011 Annual Initiative, endorsed by a strong majority of COMON members, was to promote and disseminate the Institute of Medicine’s report on The Future of Nursing: Leading Change, Advancing Health. For more information on the 2011 Initiative, go to www.micomon.org/events.

12. Nursing Agenda for Michigan: 2011-2015 • Updated Priorities for Nursing in Michigan • Many of the issues articulated in the 2006 Nursing Agenda for Michigan have been addressed and action plans implemented. This updated version of the Nursing Agenda is based on the concerns of member organizations of the Coalition of Michigan Organizations of Nursing (COMON), working collaboratively with the Office of the Chief Nurse Executive (OCNE) at the Michigan Department of Community Health (MDCH). • Over the past two years, COMON workgroups have met to identify issues and prioritize recommendations, keeping in mind the context of healthcare modifications and the changing economy and demographics of the state. This report states the prioritized issues and recommendations, and proposes action steps for implementation. Groups other than COMON are charged to implement action steps, just as they were in the Nursing Agenda. References are made to the work of the 2007 MDCH-Task Force on Nursing Regulation (MDCH-TFNR), 2008 Task Force on Nursing Education (MDCH-TFNE), 2011 Task Force on Nursing Practice (MDCH-TFNP), and the Michigan Future of Nursing initiatives (Michigan Action Coalition and Partners In Nursing) where appropriate. • The work of further refining and implementing these recommendations will be informed by: the strategic priorities of MDCH; the 2010 Report of the Institute of Medicine Future of Nursing Initiative and related Michigan projects (above); the 2010 Carnegie Report, Educating Nurses; and the 2003 report, Health Professions Education: A Bridge to Quality from the Institute of Medicine. [Go to www.micomon.org for information about COMON.]

13. Priority 1 • Issue--The statutes and regulations concerning nursing in Michigan are badly out of date and will not meet the needs of Michigan residents under conditions of healthcare system changes and an aging population, both of which will escalate demand for healthcare services. • Recommendation--Modernize the regulatory environment for nurses in Michigan through changes in the Public Health Code (PHC) and the corresponding Administrative Rules of the Michigan Board of Nursing (MBON). [Recommendation 4 of the MDCH-TFNE] • Action Steps • Enact PHC and Rules changes to authorize Advanced Practice Registered Nurses (APRNs) to practice to the full extent of their education, including prescriptive authority, practice autonomy, and appropriate direct reimbursement for healthcare services provided. [Draft legislation and legislative process steps are referred to the Michigan Legislature. The MDCH-Task Force on Nursing Practice 2011-2012 is charged to monitor legislation and action steps.] • 1. Identify needs for nursing scope of practice changes to maximize appropriate use of healthcare professionals as demand for healthcare services increases. [Refer to MDCH-TFNP.] • 2. Support legislation stipulating national nursing accreditation for all nursing education programs in Michigan. This is needed to align nursing with all other licensed health professions in the state. [COMON and its member organizations will support appropriate legislation.]

14. Priority 2 • Issue--Recruitment and retention of nurses have been facilitated by the economic recession of the past four years. As the economy improves, healthcare system changes occur, and the elderly population expands, a serious nursing shortage will reappear. Stressful and dangerous work environments decrease nurse recruitment and retention. • Recommendation--Modernize the various work environments for nurses to improve nurse recruitment and retention and the quality and safety of patient care. [Refer to MDCH-TFNP.] • Action Steps • 1. Facilitate the introduction, adoption, and implementation of “best-practice” systems to determine safe working hours and staffing levels for nurses. [Refer to MDCH-TFNP; see Colorado example.] • 2. Facilitate the introduction, adoption, and implementation of “best-practice” nursing work design to increase the efficiency and quality of nursing tasks. Build into work design the ergonomics of nursing tasks and patient movement. Make the quality and safety case for all of these steps. [Refer to MDCH-TFNP.] • 3. Increase the respect and support for nurses in the workplace by: • • Developing collaborative, inter-professional teams to manage and deliver patient care using best-practice models. • • Changing organizational culture to improve nurse retention and quality of care, using models drawn from the Keystone Initiative, Service Excellence, 6-Sigma, Magnet Hospitals, the Malcolm Baldridge Award & philosophy, and industrial engineering. [Refer to MDCH-TFNP.]

15. Priority 3 • Issue--Nursing education capacity constrains the number of new nurses graduated to provide healthcare services for Michigan’s people. Major capacity factors are the insufficient availability of nursing faculty and clinical nursing education experiences in nursing practice environments. • Recommendation A--Increase nursing faculty through the Michigan Nursing Corps, which has successfully prepared nearly 200 additional nursing classroom and clinical faculty from 2007-2010. • Action Step • 1. Seek State and federal funding, as well as foundation funding to support completion of accelerated MSN programs, nursing PhD programs, and nursing DNP programs, with Michigan teaching agreements in exchange for tuition and subsidy support. [Refer to Michigan Nursing Education Council (MNEC), OCNE, Michigan Legislature, and Governor.] • Recommendation B--Follow the example of other states (i.e., Florida) in authorizing a percentage of required clinical experience as fulfilled through clinical simulation technology; expand simulation technology and its use in Michigan nursing education programs. • Action Steps • 1. Inventory current simulation technology tools and their integration into nursing education curricula in Michigan. [OCNE Simulation Survey implemented September 2010; findings to be reported in 2011.] • 2. Identify funding sources, establish regional consortia, and seek funding for collaborative development of shared clinical simulation resources, using fixed base, mobile, and broadband delivery systems. [Refer to MNEC and OCNE for implementation.]

16. Priority 4 • Issue--Retention of newly licensed nurses and transition into practice have been problematic for both newly licensed nurses and their employers. As demand for healthcare services increases due to healthcare system changes and an aging population, this factor will become more important. • Recommendation--Require a system of nurse residency (transition to practice) programs in Michigan for all newly licensed graduates of nursing education programs. (MDCH-TFNE Recommendation 3) • Action Steps • 1. Inventory current use and design of nurse residency programs in Michigan. [Refer to MNEC.] • 2. Work with the National Council of State Boards of Nursing to monitor the progress of the accredited NCSBN Residency Model. [Refer to MNEC.] • 3. Facilitate adoption and implementation of model residency programs in collaborating partnerships of nursing facilities and nursing education institutions. [Refer to MNEC for implementation.] • 4. Prepare nursing students and new nursing graduates (at all levels of nursing licensure and certification) to meet the organizational needs of future and current healthcare delivery systems in Michigan through participation in model residency programs. [Refer to MNEC.]

17. Priority 5 • Issue--Nurses often leave nursing due to insufficient career support and lack of opportunities for career redefinition due to age and experience. This lowers nursing retention at a time when demand for nursing services is expected to grow due to healthcare system changes and our aging population. • Recommendation--Improve nurse retention through improved workplace and nursing career supports, including mentoring, oversight, and institutional supports for all stages of nursing careers. • Action Steps • 1. Recruit and support qualified retired nurses in a variety of mentoring roles. [Refer to MDCH-TFNP.] • 2. Leverage healthcare system changes to enhance inter-professional healthcare teams, improve communication, and improve the quality and safety of patient care. [See Priority 2, above; also see Carnegie Report Educating Nurses and IOM Health Professions Education.] • 3. Increase the engagement of nurses in health policy, the Governor’s Michigan 3.0 vision, and the strategic priorities of MDCH on a continuing basis to assure their input to both issues and policy solutions for nursing practice and provision of safe, high-quality healthcare services in a changing environment. Provide opportunities for nurses at all career stages to improve the public’s health through access to care, better care, and lower costs. [Refer to COMON.] • Go to www.micnwp.org for information on MDCH-TFNP and MNEC. Go to www.micomon.org for information on COMON, and for information on the OCNE go to www.michigan.gov/mdch/ocne.

18. COMON Goals • Goal 1: Serve as a vehicle for communication among nurses and nursing organizations that focus on and promote education, collaboration and advocacy • Goal 2: Revise, support, and disseminate the Nursing Agenda for Michigan • Goal 3: Promote membership for all nurses in a professional nursing organization and promote COMON membership for all professional nursing organizations • Goal 4: Develop organizational infrastructure that supports the mission, vision, and goals of COMON, including updated Bylaws and operational resources

19. COMON Committee Charges • Promoting Nursing Professionalism Committee • Encourage and promote membership in COMON and carry out actions to support COMON and its mission and goals. • Encourage membership in State or National nursing professional organizations. • Highlights: Developed and produced bookmarks, publicizing COMON’s purpose and membership, for distribution to member organizations to utilize in their outreach efforts • 2011-2012: At each meeting we will highlight 2-3 member groups per meeting to do a short, 2-3 minute, update on their organization in order to give us all a better understanding of their membership, purpose, focus, etc.

20. Nursing Policy Committee • Monitor, evaluate and recommend policy related to the nursing profession in Michigan, including supporting and disseminating the Nursing Agenda for Michigan. • Highlights:Revised and updated the Agenda for Nursing 2011-2014, focusing on key priorities. • 2011-12: Will be developing guidelines and recommendations for advocacy outreach in the nursing community. • Bylaws Committee • Periodically review the current COMON Bylaws to determine needed changes , but no less than once every 2 years. • Highlights: Bylaws reviewed and supported amendment to align terms of officers and formalization of committee structures and functions. • Sustainability Committee • Identify opportunities and recommend actions to improve the sustainability of COMON as an organization through organizational changes or through funding changes.

21. Meetings are held quarterly at MPHI-ILC, 2436 Woodlake Circle, Ste 380, Okemos, MI. Observers are welcome to attend • 2012 meetings are to be held on Thursdays: March 15 (10 am-1 pm), June 21 (10 am-12 pm), September 20 (Annual Meeting 10 am-3 pm), and December 20 (10 am-12 pm), 2012. • For questions or more information please contact: Emily Forrest at (517) 324-8371 or eforrest@mphi.org