Many Southern states mobilized quickly last year in order to begin the process of meeting the goals outlined in the Institute of Medicines and Robert Wood Johnson Foundations report The Future of Nursing: Leading Change, Advancing Health. The effort will entail years of work, until 2020 and perhaps beyond, to meet all eight of the recommendations. Still, laying the groundwork in 2011 was a crucial step that brought together key people who will see efforts through the reform era.
The IOM recommendations were the catalyst last year for Southern states to form action coalitions and launch targeted efforts to improve nursing education and leadership. In fact, mobilizing so quickly after the IOM recommendations were released in October 2010 is something action coalitions say they are particularly proud of especially because they received support from nonclinicians, who understand the impact nursing efficiency will have on reducing healthcare costs.
Most action coalitions are concentrating on the IOM recommendation that will require enormous time and effort increasing the number of nurses with BSNs to 80% by 2020. However, coalitions made significant progress toward other key IOM recommendations.
Leadership, learning promotedMary Lou Brunell, RN
Zeroing in on IOM recommendations No. 3 and No. 6, the North Carolina Action Coalition is promoting lifelong learning, residency programs for nurses and fostering leadership skills.
Although formally slated as an action coalition in September, the states summit earlier in the year was a springboard for decision-making and initiatives to reach IOM goals. Aside from increasing the number of nurses with BSNs, summit participants identified three other priority areas: removing barriers to practice; enhancing leadership opportunities; and building a system to collect and analyze interprofessional state workforce data.
North Carolinas Foundation for Nursing Excellence, the action coalitions co-lead, together with AARP, continued to develop a Transition-to-Practice program. In 2008, work began to develop the model, which emphasizes preparation of preceptors so they can strengthen the competence of newly licensed nurses entering the workforce.
The program ended in 2011 and included evaluation of new nurses in nine acute care settings across the state. Results were very encouraging; analysis of new nurses during their first six months of employment showed continued progress in competence. Using feedback from the preceptors in training and faculty, FFNE produced three online learning modules. It also is creating a webinar presenting simulated scenarios to illustrate the module concepts that will be available early this year.
It is critically important that we find more effective ways of transitioning newly licensed nurses into effective members of the healthcare team if we hope to improve the quality and safety of care and retention of the nursing workforce, said Polly Johnson, RN, MSN, FAAN, president and CEO of FFNE.
The business impact of nursing
In the Lone Star State, BlueCross BlueShield of Texas is the non-nursing lead on the action coalition, and theyve infused a new perspective. Alexia Green, RN, PhD, FAAN, co-leader of the Texas Action Coalition, said members were introduced to the roles nurses with the insurer play to reduce costs and improve patient outcomes. For many who attended a conference in November, it opened their eyes to the possibilities tracking by insurers could bring on a large scale. We were blown away by the things they are doing with population management, Green said.
Among the examples presented was monitoring medication adherence, particularly in groups of patients with chronic disease.
The Texas coalition also gained a powerful advocate when the Texas Association of Business joined the group. A collaborative of 3,000 large and small employers and 200 local chambers of commerce, the association is a major player in policy and legislative development, Green said. Enhancing the business perspective on nursing quality, the coalition attracted M. Ray Perryman, PhD, an internationally influential economist, as co-chair of its Strategic Advisory Council, which met for the first time in October. We want to show the value that nursing brings to healthcare and get peoples attention from an economic standpoint, Green said.
This year, Texas will organize into eight regions to address local strategies to work toward IOM goals. Leaders and teams will form, with opportunities for nursing and non-nursing participants to join.
Key to progress: leadership skills
If we do not build leadership skills in all nurses, we will not succeed, said Mary Lou Brunell, RN, MSN, co-leader of the Florida Action Coalition and executive director of the Florida Center for Nursing. That statement was the consensus after a meeting of the coalitions Steering Committee in October in which leaders prioritized IOM recommendation No. 7 to prepare nurses to lead and ensure leadership roles are filled by nurses.
The Florida Action Coalition was approved in March 2011 as part of the second wave of states to formalize their coalitions. The group is composed of a diverse array of healthcare providers, such as hospitals, skilled nursing facilities, and public and community health systems.
If efforts to reach IOM goals are to succeed, Brunell said it is crucial nurses have the ability to influence policy-makers, financial supporters and employers.
Action teams are forming on improving education, leadership skills and similar areas of emphasis, and nurses are invited to join. Teams are expected to implement plans this year to reach IOM standards, and representatives will include specialized experts from industries such as human resources, education and other relevant disciplines.
Guided by IOM recommendation No. 8, and near the top of the Florida Action Coalitions list is revising the scope of the Florida Center for Nursing. The center is the states source for data, research and strategies to address Floridas nursing workforce needs. It has not received state funding for the past three years and is run through donations and residual funds.
Brunell said the center, a national model for workforce data and analysis, fulfills a critical function and should cover other healthcare professions. Supporters will explore options for funding and expanding the centers work in Florida.
For more details on IOM and RWJF Future of Nursing initiatives and recommendations, go to TheFutureofNursing.org.