Future of Nursing: Campaign for Action Kansas Public Health Association

September 21, 2011

Shirley Orr, MHS, ARNP, NEA-BC

Health Care System Challenges

Fragmentation

Health Care Disparities

Aging and Sicker Population

• Life expectancy rising

• Baby boomers aging

• Chronic diseases increasing

Primary Care Shortage

• Rural and low-income areas particularly affected

• Fewer physicians entering primary care

• 32 million more people to get health insurance in 2014

High Costs

RWJF’s Commitment to Improving Care

• RWJF mission: to improve health and health care for all Americans

• Need to address challenges facing nursing to address challenges facing our health system

IOM Report

• High-quality, patient-centered health care for all will require a transformation of the health care delivery system

Campaign Vision

• All Americans have access to high-quality, patient-centered care in a health care system where nurses contribute as essential partners in achieving success

Campaign for Action

Education

Education

• Evidence

– Significant association between educational level and patient outcomes

– 6 percent of AD grads get advanced degree, enabling them to teach and serve as PCPs, compared to 20 percent of BSN grads

Practice

• All practitioners should practice to full extent of their education and training

• Optimal care

– Physicians, nurses and other health professionals work in team-based model of care delivery

– Models of care maximize time that providers can spend on their respective roles and responsibilities to patients

Practice

• Evidence: More than 10 studies show equivalent patient outcomes when care is provided by APRN or MD for certain services

– Includes two Cochrane reviews

– Randomized clinical trial published in JAMA

– Office of Technology Assessment

• No studies show care is better in states that do not allow APRNs to practice to full extent of education and training

Practice

Collaboration

• Integrated, collaborative, patient-centered health care teams

• Foster interprofessional education, training and practice

Leadership

• Nurses bring important viewpoint to management and policy discussions

• Prepare more nurses to help lead improvements in health care quality, safety, access and value

Leadership

• Gallup survey of 1,500 opinion leaders* said nurses should have more:

– Influence in reducing medical errors, increasing quality of care, promoting wellness

– Input and impact in planning, policy development and management

* RWJF, 2010

Nurse Leaders in the Boardroom

• Survey of 1,000 U.S. hospitals* found:

– Nurses account for only 6 percent of board members

– Physicians are 20 percent of board members

– Other clinicians are 5 percent of board members

* American Hospital Association, 2011

Data

• Improve health care workforce data collection to better assess and project workforce requirements

– Research on health care workforce is fragmented

– Need data on all health professions

Diversity

Campaign Strategies

Strategic Advisory CommitteeMembers

Judy Ann Bigby, MD, Massachusetts Secretary of HHS

Sheila Burke, RN, (Chair), Harvard Kennedy School of Government

Linda Burnes Bolton, RN, CNO, Cedars Sinai Medical Center

Lloyd Dean, CEO, Catholic Healthcare West

Christina Esperat, RN, Associate Dean, Texas Tech University

Chip Kahn, President, Federation of American Hospitals

Darrell Kirch, MD, CEO, American Association of Medical Colleges

Alan Morgan, CEO, National Rural Health Association

Debra Ness, President, National Partnership for Women and Families

Bill Novelli, Professor, Georgetown University School of Business

Jack Rowe, MD, Professor, Columbia University

Antonia Villarruel, RN, Associate Dean, University of Michigan School of Nursing

Phyllis Wise, PhD, Interim President, University of Washington

Campaign for Action

Examples

Organization Commitment

National Hispanic Medical AssociationWorking with members on initiative to improve interdisciplinary education

Consumers Advancing Patient SafetyChallenged nursing members to identify and place a nurse on their board

Convenient Care Association

Working with national members who have community partners to increase Coalition involvement

Leapfrog GroupEncouraging hospitals to achieve magnet status

Target Promised to engage its clinical nurses in leadership positions and opportunities

RWJF Grantmaking Examples

New Investment Area

• The Future of Public Health Nursing 2011-2012

• PHN Workforce Enumeration

• State of Public Health Nursing Summit

• Exploration of New Models for Education--Pilots

• Links—Scope and Standards of PHN Practice; PHN Core Competencies

Campaign for Action

Map Legend

Action Coalition State

State Involvement

Campaign for Action State Involvement

OR

WA

ID

MT

WY

NV

CA

UT

AZ

CO

NM

ND

SD

NE

KS

OK

TX

MN

IA

MO

AR

LA

WI

IL

IN

MI

OH

KY

TN

MS AL

FL

GA

SC

NC

VAWV

PA

MD

DE

NY

DC

CTRI

MA

VT

NH

ME

AK

HI

NJ

UPDATED: 7.14.2011

Campaign Resources

• Visit us on the Web at: www.thefutureofnursing.org

• Follow us on twitter at: www.twitter.com/futureofnursing

• Join us on Facebook at: http://facebook.com/futureofnursing