IOM Report: Future of Nursing Massachusetts Action Coalition

Overview, January 2013

Massachusetts Action Coalition

IOM Report: The Future of Nursing

• IOM Report Summary:

Key Messages & Recommendations

• Future of Nursing: Campaign for Action

• MA Action Coalition (MAAC)

• Academic Progression in Nursing (APIN) Grant

• Role of Deans and Directors

• Report released in October of 2010 by the IOM in collaboration with RWJF

• “Blueprint” for transforming the American health system:

– Timely due to recent Affordable Care Act legislation

– Developed Vision for Transformed Health Care System

– Goal to improve access, quality of care and cost control

– Nursing profession must transform to achieve Vision

• Two-year study resulted in 4 key themes and 8 recommendations

IOM Report: The Future of Nursing

• The RWJF/IOM Vision: Transformed Health Care System

– Quality care is accessible to the diverse US populations

– Promotes wellness and disease prevention

– Reliably improves health outcomes

– Provides compassionate care across the lifespan

– Primary care and prevention are central drivers of the health care system

– Inter-professional collaboration and coordination are the norm

– Payment for health care services rewards value, not volume

IOM Report: The Future of Nursing

Nursing’s Potential Wide-Reaching Impact

IOM Report’s 4 Key Messages

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

2. Nurses should achieve higher levels of education and training through an improved education system that promotes seamless academic progression

3. Nurses should be full partners, with physicians and other health care professionals, in redesigning health care in the United States

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

IOM Report’s Recommendations

1. Remove scope-of-practice barriers

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

3. Implement nurse residency programs

4. Increase the proportion of nurses with baccalaureate degree to 80 percent by 2020

IOM Report’s Recommendations

5. Double the number of nurses with a doctorate by 2020

6. Ensure that nurses engage in lifelong learning

7. Prepare and enable nurses to lead change to advance health

8. Build and infrastructure for the collection and analysis of inter-professional health care workforce data

Nurse

Dietician

Athletic Trainer

Diploma/Associate

Bachelor’s Master’s Doctorate

Advance Practice Nurse

Occupational Therapy

Speech Language Pathology

Audiology

Clinical Social Worker

Mental Health Counselor

Physician Assistant

Medicine

Dentistry

Podiatry

Psychology

Pharmacy

Physical Therapy

Select Licensed Health Professions in Massachusetts

OCABR and EOHHS

Current Minimum Entry-Level Education Requirements

IOM Future of Nursing: Campaign for Action

IOM ReportFuture of Nursing

Leading Change, Advancing Health

RWJFSusan Hassmiller, RN

Senior Nursing AdvisorSusan Reinhard, RN

SVP, Public Policy

State Action Coalitions

State Action Coalitions

• Massachusetts Action Coalition (MAAC)

– Applied to RWJF/AARP’s “Center to Champion Nursing in America” (CCNA) to become an AC

– MA designated as an AC - September 2011

– Nurse Lead:

MA Organization of Nurse Leaders

– Non-Nurse Lead:

MA Department of Higher Education (DHE)

– Established Short-term and Long-term Goals

MA Action Coalition: Short Term Goals

Disseminate IOM Report Findings

• Engage/educate stakeholders statewide

Build statewide consensus for academic progression with plan to increase diversity

• Use developed models as framework

• Survey nursing program requirements

Develop plan for statewide adoption of NOFNCC©

• Expand use in academic/practice settings

MA Action Coalition: Long Term Goals

Implement statewide plan for academic progression for all nurses

• Create models for all levels of practice

Remove scope of practice barriers for APRNs

• Strengthen interdisciplinary collaboration within medical community

• Strategies to influence policy changes

Utilize data to understand workforce needs, demographics

• Analyze data and develop action plans to address workforce needs/diversity gaps

MAAC Progress to date

• Created teams and action plans to address goals

• Began fundraising efforts

• Held a 2 day “State Site Visit” featuring Sue Hassmiller during 7 events in March 2012

• Developed and submitted proposal for RWJF Academic Progression in Nursing (APIN) Grant in May 2012

Academic Progression in Nursing Grant Announcement – August 2012

MAAC Highlights (con’t)

• MA was awarded the APIN Grant as one of nine states selected nationwide !

• Grant timeline: Sept 2012 – Aug 2014

• Funding $150,000 per year for 2 years

• Developed 12 Project Teams – Sept 2012

• Team membership recruitment – ongoing

49 Action Coalitions

9Action

Coalitions with APIN Funding

Campaign for Action - RWJF

CCNA (The Center to Champion Nursing

in America at AARP)

MAAC Executive Committee

MA Action Coalition (MAAC) Leadership Structure

MA Action Coalition (MAAC)

MAAC TeamsAPIN Grant

TeamsAPIN Grant

TeamsPIN Grants Other Initiatives

Academic ProgressionAcademic

ProgressionCare Transitions

IP Education NOFNCC© IntegrationNOFNCC© Integration

IncreaseFaculty

IncreaseFaculty

Scope of Practice

Data Use

Communications

Philanthropy

MAAC Stakeholder

Advisory Council

MA Action Coalition (MAAC)Leadership Structure

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APIN Goal # 1

CREATE ACCELERATED PATHWAYS FOR NURSES TO ACHIEVE BACCALAUREATE OR HIGHER DEGREE

Strategy 1: Disseminate existing and new seamless academic progression models throughout the higher education system.

Strategy 2: Develop and implement Nursing Education Transfer Compact.

Strategy 3: Work with nursing programs and employers to increase options for flexible student-centered learning environments that will increase diversity and promote access for educational advancement.

APIN Goal # 2

PROMOTE THE INTEGRATION OF NURSE OF THE FUTURE NURSING CORE COMPETENCIES (NOFNCC©)

Strategy 1: Work with academic institutions to integrate NOFNCC© into curriculum at all levels of education throughout the Commonwealth of Massachusetts.

Strategy 2: Work with practice settings to integrate NOFNCC© into practice programs throughout the Commonwealth of Massachusetts.

APIN Goal # 3

INCREASE FACULTY POOL AVAILABLE TO EDUCATE NURSES FROM BSN THROUGH DOCTORAL DEGREES

Strategy 1: Increase opportunities for retired faculty to return to teaching positions.

Strategy 2: Maximize opportunities for the practicing nursing workforce to obtain faculty positions.

MAAC Project Teams (12)

Scope of Practice - APRN Team

- RN Team

Data Use- Data Team

Communications - Plan Team

Philanthropy- Fundraising Team

Academic Progression- Progression Model Team - Transfer Compact Team - Flexible Options Team

NOFNCC Integration- Academic Institutions Team - Practice Settings Team

Faculty- Faculty Opportunities Team - Faculty Development Team

MAAC Project Team Co-Leads Progression Models

Janet Lusk, Donna Kelly Williams

Education Transfer Compact

Susie Conrad, Eileen Costello

Flexible Options

Kathleen Scoble, Earlene Avalon

NONCC© Academic Settings

Judy Beal, Cecilia McVey

NOFNCC© Practice Settings

Gayle Gravlin, Lorraine Schoen

Faculty Opportunities

Cynthia Bechtel, Nancy Bittner

Faculty Recruitment/Retention

Karen Manning, Paulette Seymour Route

Scope of Practice APRN

Pat Noga, Stephanie Ahmed

Scope of Practice RN

Elaine Bridge, Paul McKinnon

Data Collection and Use

Judie Pelletier, Stephen Cavanagh

Communications Plan

Pat Crombie, Ashley Waddell

Philanthropy

Sharon Gale, Kevin Whitney

Nursing Workforce Development

PatientOutcomes

Quality

Safety

Cost

Nurse of Future Nursing Core Competencies

Education/ Clinical

Orientation

DEU’s

Residency

Competent

Nursing

Practice

Inter-

Professional

Care

Environments

Education ------------------Transition-------Practice

Education/Academic

Technology Enhanced

Curriculum

Lifelong Learning

Precepting

Diploma ADN BSN

PN

MSN Doctorate

24

Nursing by the NumbersMA BORN License Data, February 2012• Total Nurses - 141,773• Registered Nurses – 111,388• Advanced Practice RN – 9,598

Nurse Midwives – 480Nurse Practitioners – 6,962Nurse Specialists – 946Nurse Anesthetists – 1,210

• Licensed Practical Nurses – 20,787

MA BORN Approved Nursing ProgramsTotal of MA Programs – 74

• RN Entry Level Graduate Degree (MSN) – 7• RN Baccalaureate (BSN) – 20• RN Associate Degree (ADN) – 20• RN Diploma – 1• Practical Nursing - 26

Rebalancing the Nursing Workforce

27

The Plan: Key Assumptions• 55% - Nurses with a BSN or Higher Degrees in 2012

• 66% - Target for increase by 2020

• Projections based on:

LPN/Diploma/AD numbers are level or declining

New BSNs include direct entry plus LPN/Diploma/AD graduates progressing to BSN degree

Currently working LPN/Diploma/AD nurses also return to school to obtain a BSN

Higher degrees include new MSNs and AD/BSN/MSN nurses progressing

IOM Report – Role of Community Colleges

• Key role in attracting nurses into pipeline

• Provide access where other access points are limited by capacity, distance or cost

• Provide high quality and affordable pathway for nurses to move to higher education levels

• Predominant education institutions in rural and medically underserved areas

• Greatest opportunities to develop innovations linking to BSN programs and to foster a culture that values academic progression

Role of Deans and Directors

• Promote life long learning and academic progression

• Partner with other Deans and join education collaboratives

• Partner with CNOs to develop strategies for flexible student-centered learning environments

• Promote NOFNCC© integration into curriculum at all levels of education!

• Support the work of the MAAC by participating in requested surveys!!

Next Steps:

Visit our new state page, MAAC website:

http://championnursing.org/state/massachusetts

also: www.mass.edu/nursing

Be part of The Future of Nursing: Campaign for Action

Join MAAC Project Teams