September 11, 2012
• Share the history and work of the AARP Center to Champion Nursing in America
• Focus on the Campaign for Action Education pillar
• Describe the four models that are the most promising for education transformation
Aging and sicker population High costs Primary care shortage Fragmentation Health care disparities
High-quality,
patient-centered health care for all will require a transformation of the health care delivery system
One of the most-viewed online reports in IOM
Need to address challenges facing nursing to address challenges facing our health system
RWJF MISSION
To improve health and
health care for all
Launched in 2007 Mission
Ensure that all Americans have access to a highly-skilled nurse when and where they need one
Positioning
The Center is a consumer-driven national force for change, working to build a 21st century workforce that positively impacts
• Initiative of AARP, the AARP Foundation and the Robert Wood Johnson Foundation
• Partners from business, consumer advocates, policy-makers, health care communities
All Americans have access to high-quality,
patient-centered care in a health care system where nurses
contribute as essential partners in achieving success.
Diverse Stakeholders Policy-makers Communications Action Coalitions Research, Monitoring, Evaluation Grantmaking RWJF AARP Advisory Committee
Coming soon!
http://championnursing.org
Options to easily link to discussions about education topics, to review data by state, to pose a question to the group,
to share your innovations
February 28 – March 1, 2013
CCNA National Liaisons
Education transformation leader Mary Sue Gorski Nursing education experts
Consultants & staff support
Existing resources at Championnursing.org
Advancing Education
Transformation Removing Barriers to Practice and Care Nursing Leadership
Interprofessional Collaboration
DATA
Implement nurse residency programs Increase the number of nurses
with doctorates
Promote lifelong learning
Increase the proportion of nurses with BSN and higher degrees
Evidence
Some association between educational level and patient outcomes
Twenty percent of BSN graduates get advanced degrees
Six percent of associate-degree graduates get advanced degrees
• We know that more, better educated nurses will help advance the other recommendations in the report.
Scope of practice
Innovative practice sites
Advanced research in many areas, including how better to care for chronically ill patients
Best models in community-based care and the need to further the database around new models of care, and advance the leadership to develop these models
•Webinars and face to face meetings •Listserv facilitated discussions
•Determine and share best practices
Learning
Collaborative
•State sharing; virtual and face to face •Resource guides as result of work •Web archives of all work accomplished
Regional Facilitated
Sharing
•Nursing expertise
•Coordination in region and nationally •Communication
•Facilitation and collaboration
Regional Nurse Experts
Source: Gajda, R. & Koliba, C. (2007). Evaluating the Imperative of Interorganizational Collaboration. American Journal of Evaluation, (28)1,26-44
• Sharing knowledge and creativity
• Spreading innovation and information across states • Disseminating knowledge
• Contributing to ongoing dialogue on education transformation
• Making connections and moving forward together to achieve education transformation
• We are all focused on the same goal: Increasing the supply of BSN and doctorally prepared nurses
• Each state is moving at its own pace
• CCNA wants to provide support as states continue progress toward education transformation
Northeast Region (April 13 2011)
• North Carolina: Polly Johnson
• Massachusetts: Maureen Sroczynski • New York: Maureen Wallace
National: NLN; Elaine Tagliareni, AACN;
Jane Kirschling, NCSBN; Nancy Spector
Western Region (June 29 2011)
• New Mexico: Jean Giddens • California: Liz Close
• Washington: Gerianne Babbo and Sharon Fought
• National: Fran Roberts, Private for Profit
Schools
Mid-western Region (July 7 2011)
• Indiana: Donna Boland
• Michigan: Teresa Wehrwein • Ohio: Susan Taft
• National: Linda Tieman, Workforce data
Southeast Region (July 7 2011)
• Mississippi: Wanda Jones • Florida: Mary Lou Brunell • Texas: Sondra Flemming
Southeast Region (Dec 8 & 9 2011)
•St Petersburg, Florida
•Nine state Action Coalitions participated •Key CCNA staff attended
•Discussed; key partnership, promising
models, and key components of success
• Special focus on BSN at Community
Colleges
Western Region (Feb 23 & 24 2012)
• Sacramento, California
•Ten state Action Coalitions participated •Key CCNA staff attended
• Discussed four promising models •Special focus on shared curricular
components
Midwest Region ( April 16 & 17 2012)
• Minneapolis, Minn.
• Thirteen state Action Coalitions participated
•Key CCNA staff attended
•Discussed online education models and proprietary school programs
•Special focus on accelerated models
Northeast (May 10 & 11 2012)
•Princeton, New Jersey RWJF
•Two participants from each Action Coalition in the Northeast invited
•Key CCNA staff will attend •Continue the discussion
•Special focus on competency based
• Community Colleges Grant RN to BSN Degree • Accelerated Options: RN to MSN Programs
• State or Regional Shared Curriculum
• State or Regional Competency Based Programs
• Partnerships of education and practice
• BSN completed in no more that four academic years • Substantive curriculum transformation
• Strong evaluation plans to provide data and analyze strategies
• Intentional strategies to increase diversity of students and graduates
• Associate degree in nursing (ADN) nurses with an RN advance directly to BSN
• May be more affordable
• The American Association of Colleges of Nursing(AACN) supports provided the Baccalaureate Essentials are utilized and the program is accredited
• Especially beneficial for nurses who are place bound with limited access to other options
• May require legislative changes • Does not include a four year BSN
• Offers a shorter timeline to completion than traditional BSN or MSN
• An accelerated model that values the practice experience of AD nurses and meets BSN criteria
• Is seamless and university based • Emphasizes practice components
• A major challenge of this model is meeting the needs of students with varying clinical expertise
• Educational collaboratives between universities and community colleges to enable automatic and seamless transition from an AD t0 BSN program
• All schools share curriculum, simulation facilities and faculty
• Shared components include pre-requisites and graduation requirements
• Requires formal articulation agreements and buy in from legislative bodies and institutions
• Partners from different education programs develop a shared understanding , common goals and education framework
• Partners universally agree on the outcomes
• The scope of the curriculum reaches beyond core
competencies and across the entire profession focusing on knowledge, attitudes and skills
• The curriculum is not standardized but aims to reach standardized outcomes
All health professionals should be
educated to deliver patient centered care
as members of an interdisciplinary team,
emphasizing evidence-based practice,
quality improvement approaches and
informatics.
The IOM Vision 2003
Core Competency Comparisons
IOM ACGME QSEN MA Nurse of the
Future NY CUNY
Apply Quality
Improvement Practice based Learning & Improvement Systems Based Practice Quality Improvement Safety Quality Improvement Safety
Systems based practice
Quality and Safety Clinical Judgment Provide Patient- Centered Care Patient Care Interpersonal & Communication Skills Patient Centered Care
Patient Centered Care Communication
Leadership
People Centered Care Communication Management of Care Work in Inter- Disciplinary Teams Professionalism Teamwork and Collaboration Teamwork and Collaboration Professionalism Professionalism Collaboration Employ Evidenced- Based Practice Medical
Knowledge Evidence based practice
Evidence based practice Evidenced based practice
Utilize
31 Diploma ADN, BSN Nursing Programs & Practice Partners Gap Analysis Process of Curricula Designing New Models by Addressing the Gaps Implementation of Seamless Progression Curriculum Models Evaluation and Updating of Competencies Agreement on Competencies
Agreement on Competencies
•Engage school administration in plan for curriculum redesign early on in the process
•Can select from various competencies •Develop your own
•QSEN
• Nurse of the Future
•Align all with AACN Essentials for Baccalaureate Education and NLN AC Competencies
Partnerships of Diploma, AD, BS Nursing Programs &
Practice Partners
•Practice partners bring insight into current healthcare environment and clinical learning opportunities
•May begin with “coalition of the willing” Competency Model Process
Gap
Analysis Process
•Technique for determining the steps to be taken in moving from a current state to a desired future state.
• Diploma, AD and BS programs assess curriculum against competencies
•Must demonstrate evidence of the competency in curriculum or clinical experiences
•Practice partners may examine orientation programs Competency Model Process
Competencies
1. Assessment of current status How many opportunities are currently available for your students to learn the K/A/S by graduation?
2. Validation of current status Where are these learning opportunities in your curriculum and how are they taught? Can include course objectives, lecture content , clinical objectives, clinical experiences, written assignments , case studies or other documented evidence and how evaluated
3. Desired outcomes Nursing Program How many opportunities do you (the faculty) believe
should be available for your students to learn the K/A/S by graduation
4. Desired Outcome Practice Partner(s) How many opportunities does your practice partner believe should be available for your students to learn the K/A/S by graduation?
5. GAP between Desired Outcomes and Current Status
6. GAP between Practice Partners Desired outcomes and Nursing Program Desired Outcomes
Designing New Models by
Addressing the Gaps
•May be designed at undergraduate level or within RN to BSN programs
•May involve dual or co-admission
•May involve assessment and/or alignment of prerequisites, general education requirements and credit transfer issues which will necessitate involvement of school administration
Implementation of Seamless Progression
Curriculum Models
•Competency based models provide seamless progression models
•Competency based models can also serve as foundation for shared or common curriculum models
•Some models based on 1 plus 2 plus 1 approach
•Some states have begun with a cohort approach that can be expanded within a system or across the state or region
Evaluation and Updating of Competencies
•Evaluation of student achievement of competencies
•Can be achieved by achievement of course outcomes and/or performance within clinical setting
•With ongoing advances in clinical settings competencies will need to be updated on a regular basis
• This process addresses the fact that education and practice do not always speak the same language
• Practice needs be involved early in the review and development of new curriculum models
• Diploma, AD and BS programs all have gaps in reviewing current competency models
• Divergence and convergence are part of the process • Iterative process of innovation
Dialogue Decision Making Action Evaluation Shared Purpose
The Model Implementation Process: A Cycle of Inquiry
Gajda, R. & Koliba, C. (2007). Evaluating the Imperative of
Interorganizational Collaboration. American Journal of Evaluation, (28)1,26-44
Academic-service partnerships
• Nurse-managed health centers • Preceptor models
• Dedicated education units
Regional school network
partnerships, dual enrollment Support from funders
Nurses can’t do it alone!
For us who nurse, our nursing is a thing which,
unless we are making progress every year,
every month, every week, take my word for
What model or models will work best for you in
Colorado?
• Community Colleges Grant RN to BSN Degree • Accelerated Options: RN to MSN Programs
• State or Regional Shared Curriculum
• State or Regional Competency Based Programs
Managing Complex Change
Vision + Skills + Incentives + Resources + Action Plan =
CHANGE
Skills + Incentives + Resources+ Action Plan =
CONFUSION
Vision + Incentives + Resources + Action Plan =
ANXIETY
X
Managing Complex Change
Vision + Skills + Resources + Action Plan =
GRADUAL CHANGE
Vision + Skills + Incentives + Action Plan =
FRUSTRATION
Vision+ Skills + Incentives +Resources =
FALSE STARTS
X
X
X
Vision + Skills + Incentives + Resources + Action Plan =
Real change does not come from decree, pressure,
permission or persuasion.
Real change comes from people who are
passionately and personally committed to a
decision or direction that they helped to shape.
Visit us on the Web http://thefutureofnursing.org http://championnursing.org Follow us on twitter www.twitter.com/futureofnursing http://twitter.com/#!/championnursing Join us on Facebook http://facebook.com/futureofnursing http://www.facebook.com/championnursing
Education Progression Webinar Series
