Transforming Health Care: Nurses Engaged in Policy

1. Transforming Health Care: Nurses Engaged in Policy Nancy Ridenour, PhD, APRN, BC, FAAN American Academy of Nursing October 13, 2012

2. RWJ Health Policy Fellowship • http://www.healthpolicyfellows.org/home.php • Founded 1973 • 12-18 month residency in DC • 4 month orientation • Work assignments on the Hill traditionally • Administration /Agencies • TRANSFORMATIONAL

3. Twelve Academy Members Who are RWJ Health Policy Fellows

4. Mary Mundinger, RN, DrPH1984-1985 Virginia Trotter Betts, JD, MSN, RN, FAAN 1987-1988

5. Ellen-Marie Whelan, PhD, NP, RN, FAAN2003-2004 Nancy Ridenour, PhD, APRN, BC, FAAN 2007-2008

6. Margaret Moss, PhD, JD, RN, FAAN2008-2009 Margaret Wilmoth, PhD, RN, FAAN 2009-2010

7. Janice Phillips, PhD, RN, FAAN2010-2011 Barbara Damron, PhD, RN,FAAN Current Fellow

8. Hurdis Griffith, PhD, RN, FAAN 1986-1987 Julie Sochalski, PhD, FAAN 1992-1993 Sister Rosemary Donley, PhD, APRN, BC, FAAN 1997-1998

9. Being Inducted into the Academy This Evening! Liana Orsolini-Hain, PhD, RN, CCRN 2011-2012

10. Portfolio While at Ways and Means • PPACA now ACA • Hospice • Hospital acquired infections; conditions • Health care associated conditions • Health Information Technology; meaningful use • E-prescribing • Transparency in ownership of long-term care facilities • Quality outcomes /Value Based Purchasing • Funding for primary care • International comparisons in health outcomes and health systems • Chronic Care Coordination • Clinical Outcomes/Quality • Workforce

12. Health Reform 2007-2008

13. Health Reform 2009-Now

14. Lessons Learned • Need more nurses on the Hill • Nursing professional groups need to speak in “one voice” • Nurses need to make strategic partnerships • We need nurses to get PhDs in Health Economics! • Nursing needs to invest more in government relations • Research focus on issues to inform health policy • Translate profession specific language to stories for general public • Need more nurses in executive, legislative, and judicial branches

15. Characteristics of the Reformed Health System Health Equity Patient/Consumer Centric Focus on Quality and Safety Value Based/Pay for Performance Evidence Based Practice Comparative Effectiveness Prevention and Early Intervention Increased Access

16. Reformed System • Demographics: aging population with increasing chronicity at all age levels • Meaningful use (HIT) • Population based practice • High Functioning Teams • Workforce Issues • Numbers • Distribution • Best Mix

17. Biggest Impact High Priority Health Problem/Issue High Risk High Volume High Cost Closing the Gap between Research and Practice

18. Increase Policy Relevance Gap between clinical practice and research findings Need to show public investment in research leads to benefits for patients Timing Policymakers not interested in theory Cost: usually more short-term than long-term Know goals of agency, lawmaker, etc How are data being used? By Whom?

19. Research Trajectories to Inform Policy Design our research to inform and change policy Design our research to evaluate current policy Translate our current research into policy implications Posit new policy approaches and test them

20. Research Agenda for Policy • Comparative Effectiveness Research ($3 Billion) • Interprofessional: research, education, practice • Team Science • Workforce • Quality; Safety • Innovations in care delivery • Outcomes • Innovations in payment systems • Health Information Technology • Center for Innovation at CMS

21. Think of Your Research, Practice, Teaching • Why would someone be interested in your work? • How can you humanize and personalize what you are doing? • How can you help others see themselves as part of the solution you are proposing? • What “niche” can you fill?

23. Role of AAN Each characteristic of the Reformed Health System suggests a Major role for The Academy to Impact Health Policy and Contribute to the Nation’s Health!

24. Be Part of the Solution • Increase involvement, visibility, and influence in the health policy process • Enhanced advocacy role • Briefings, hearings and testimonies • Fellowship Opportunities: Robert Wood Johnson Health Policy Fellowship; AAN/IOM Scholar • Membership on key boards, committees, task forces • Collect and provide data showing outcomes and comparative effectiveness of nurse driven care

25. Robert Wood Johnson Foundation Nursing and Health Policy Collaborative at UNM The Robert Wood Johnson Foundation Nursing and Health Policy Collaborative at University of New Mexico: Prepares nurses to become leaders in health policy through research and advocacy. Offers generous financial support for full-time study. Offers Web-based course study. Targets those from underrepresented populations. Provides funds to support student and faculty research. Provides resources and support from Robert Wood Johnson Foundation Center for Health Policy. For more information about the Robert Wood Johnson Foundation Nursing and Health Policy Collaborative at University of New Mexico visit our Web site at www.nursinghealthpolicy.org or write to us at CON-RWJF@salud.unm.edu.

26. Things to Do • Develop and practice a 30 second “elevator” speech on your project • Develop one page lay audience description of your research or practice and the impact on healthcare. • Outcomes • Quality and Effectiveness • Cost savings or recovery • Safety

27. AND • Communicate • Disseminate • Synthesize Across Disciplines • Integrate Into Practice • Accelerate the Pace of Policy Development • Provide data to inform and evaluate policy

28. American Academy of Nursingtransforming health care policy and practice through nursing knowledge AAN/IOM Scholars in Residence

29. Nurse Scholars 2012 Marla Salmon ScD, RN, FAAN Project Focus on micro-finance, nursing, and women’s development will impact domestic and global health policy 2010 - Pamela F. CiprianoPhD, RN, FAAN Project Impact, implications of Health IT and identify technologies that reduce errors, waste and promote seamless care coordination 2009 - Julie A. FairmanPhD, RN, FAAN Project Initiative on the Future of Nursing

30. Nurse Scholars 2008 - Mary E. Evans PhD, RN, FAAN 2007- Carolyn Williams PhD, RN, FAAN 2006- Ada Sue HinshawPhD, RN, FAAN 2005 - Jacquelyn C. Campbell PhD, RN, FAAN 2004 - Veronica D. FeegPhD, RN, FAAN 2003 - Angela Barron McBride PhD, RN, FAAN 2002 - Bonnie M. JenningsDNSc, RN FAAN

31. Sampling of Work of Expert Panels • Aging: Commented on proposed regulations regarding RNs in LTC; Expressed concern to House leadership regarding ‘observational status” • Emerging Infectious Diseases: Published policy brief Hepatitis C Screening and Testing: A Call for a National Response; Wide dissemination of policy brief on the need for routine testing for HIV • Global Nursing and Health Care: Policy brief: Leadership needed to address the Global Nursing and Midwifery Workforce Shortage

32. Sampling of Work of Expert Panels • Quality: Preparing 6 positions papers • Measuring Episode of Care Outcomes • Measuring Care Coordination • Measuring the Economic Value of Nursing • Measuring Nurses’ Workload • Measuring Patient Engagement • Harmonizing Performance Measures—Implications for Practice, Education, and Research

33. MedPAC Commissioner: Mary Naylor, PhD, RN, FAAN Transitions of Care Chair National Health Workforce Commission: Peter Buerhaus, PhD, RN, FAAN

34. Initiative on the Future of Nursing The Recommendations

35. Future of Nursing Report: Sue Hassmiller, Donna Shalala, Linda Burnes Bolton, Michael Bleich, Jennie Chin Hansen, Liana Orsolini-Hain Action Coalitions: Multiple Fellows

36. HRSA Administrator: Mary Wakefield CMS Innovation Center: Ellen-Marie Whelan

37. Our Patients, Our Communities, Our Health Care System, Our Nation Need Nurses to Successfully Inform Policy Through Practice and Research Through Engagement of Strategic Partners

38. Activate Strategic Partner Networks

40. Build Bridges with Common Vision

41. Soar to New Heights