Co-chairs
Yvonne Culpepper, DNP RN Cherona J. Hajewski, MSN RN NEA-BC
Indiana Action Coalition: Transforming Healthcare ‐Practice Initiatives
Review the INAC:TH goals specifically related to the Practice Initiatives and Practice Committee
Review the Practice committee’s substructure inclusive of leadership, members, objectives and actions/progress completed
Identify INAC:TH Nursing Practice Committee challenges and priorities to align the Indiana Center of Nursing (ICN) strategic plan and committee structure with INAC:TH
Indiana Action Coalition: Transforming Healthcare ‐Practice Initiatives
Goals were specifically developed for the
Practice Committee
These Goals were derived from the
Institute of Medicine’s report on the Future
of Nursing: Leading Change, Advancing
Health
#1-Identify activities to reflect the full scope of nursing practice
#2-Maximize utilization of clinical experiences for health related programs statewide
#3-Collaborate with partners to review and propose relevant changes to the existing statute and/or rules related to nursing practice
#4-Increase funding to support nurses returning for additional education leading to either an APN role or a doctorate
Indiana Action Coalition: Transforming Healthcare ‐Practice Initiatives
Co-Chairs:
Yvonne Culpepper, DNP, RN, Vice President, Nursing & CNO, Hendricks Regional Health
Cherona Hajewski, MSN, RN, NEA-BC, Vice President, Patient Care & CNO, Deaconess Health System
Members:
Cindy Adams, PhD, ANP-BC, RN, CNO, Community Health Network
Susan Ahrens, PhD, RN, Associate faculty, IUPU-Fort Wayne Bridget Dolohanty-Johnson, MSN, RN, CPNP, Vice President,
Patient Care, Parkview Whitley Hospital
Linda Q. Everett, PhD, RN, NEA-BC, FAAN, Executive Vice President & CNE, Indiana University Health
Kim Harper, MS, RN, Executive Director, Indiana Center for Nursing
Marcia Jackson, MSN, MPA, FNP, Nurse Practitioner, Lifecare HIV/Aids Program, IU Health
Indiana Action Coalition: Transforming Healthcare ‐Practice Initiatives
Members (cont.):
Barbara Kelly, MSN, FNP-BC, RN, President, ISNA, Director, Koval Center, University of Indianapolis
Jan Kirsch, EdD, MSN, RN, Senior Director Performance Improvement VHA Central
Bambi McQuade- Jones, DNPc, FNP-C, MSN, Executive
Director/Provider, Robert Wood Johnson Foundation Fellow
Susan McRoberts, MSN, RN, NEA-BC, Vice President & CNO, Franciscan St. Francis Health
Rachael Moody, MS, CNS, RN, Critical Care CNS, Saint Joseph Regional Medical Center
Diana Sullivan, MSN, RN, CNOR, Adjunct Clinical Lecturer IUSON Lynn Turner, MSN, RN, Nursing Director, Hendricks Regional
Health
Subcommittee Membership: Leader- Barbara Kelly
Members: Marcia Jackson, Rachel Moody, Cornelia Hammerly, Barbara Winningham, Mary Blackburn
Objective A-Develop a white paper on reimbursement issues
with APRN practice groups related to reimbursement of services
Actions Completed or in progress
A 25 page white paper on APRN scope of practice and reimbursement issues was completed
Aim of the white paper was to serve as a resource & education
An Executive summary was developed highlighting main points
The white paper was submitted to the INAC:TH Steering Committee in December for review and approval
Indiana Action Coalition: Transforming Healthcare ‐Practice Initiatives
Action completed or in progress:
The white paper encompassed 4 groups of Advanced Practice Registered Nurses (APRNs):
1) Certified Nurse Midwife (CNM)
2) Certified Registered Nurse Anesthetist (CRNA)
3) Clinical Nurse Specialist (CNS)
4) Nurse Practitioner (NP)
Each APRN group identified issues related to: scope of practice, practice barriers, and reimbursement. All made recommendations to remove these barriers and developed strategies for future recommendations.
Indiana Action Coalition: Transforming Healthcare ‐Practice Initiatives
Actions completed or in progress:
White paper recommendations to Removing APRN Practice Barriers: Support the Consensus Model for APRN Regulation-Independent
practitioners
Negotiate equitable reimbursement for similar services Enforce the “any willing provider laws” that mandate insurance
reimbursement for APRN services
Remove barriers that restrict APRNs’ ability to participate in pay-for-performance/incentive payment
Work to identify APRNs (CNM,CNS,NP) as primary care providers Promote provider neutral language in state/federal laws and regulations Allow APRNs admitting and medical staff privileges
Develop APRN sensitive quality measures (indicators) similar to NDNQI Educate key stakeholders on the quality and economic value of APRNs
Subcommittee Membership: Leader- Bambi McQuade-Jones Members: Diana Sullivan
Objective A: Grow the number of clinical preceptors appropriate to fill
advanced practice health care worker roles especially in rural health designated setting
Action completed or in progress:
A survey for APRN’s was developed requesting information on
precepting barriers
Survey was approved by the INAC:TH Steering Committee was
sent to the Coalition of Advance Practice Nurses in Indiana (CAPNI)
Survey was sent to ISNA for additional APRN responses
Survey results are being returned but need to analyzed for
precepting barriers
Discussed a RWJ grant to trial a precepting model of 1:3 versus 1:1
Indiana Action Coalition: Transforming Healthcare ‐Practice Initiatives
Subcommittee Membership: Leader- Barbara Kelly. Members: Diana Sullivan, Marcia Jackson, & Katherine Wallace
Objective A: Collaborate with partners to propose
language for legislative or regulatory consideration as deemed appropriate for this state
Actions in Progress:
Initially, work on this objective was placed on-hold pending finalization of the APRN white paper
Current focus with completion of the white paper is to identify best approach to identify and organize legislative priorities to move this work forward
Indiana Action Coalition: Transforming Healthcare ‐Practice Initiatives
Subcommittee Membership: Leader - Kim Harper Team members: Bridget Dolohanty Johnson
Objective B: Identify those organizations that can provide
advocacy support and sponsorship
Actions Completed and In-progress:
Submission of a proposal to RWJF “Academic Progression in Nursing: The 21stCentury Challenge” to fund state wide plan to increase BSN to 80% by 2020. Proposal was not selected for funding.
Grant application for $35,000 submitted to IONE’s License Plate Fund requesting financial support for a Summit, INAC:TH work, and data collection. Grant was approved.
IONE has provided significant funding to date for the INAC:TH and ICN with a $37,000 grant approved for 2012 and a grant for $35,000 in 2013.
Subcommittee Members: Leader- Susan Ahrens
Members: Linda Everett, Bridget Dolohanty-Johnson, Katherine Wallace
Objective A: Collaborate with Indiana schools
and health care employers in exploring strategies to increase the number of nurses returning for advanced education
Actions completed: To avoid duplication and
overlap with the work of the Education Committee, this subcommittee was dissolved summer, 2012
Indiana Action Coalition: Transforming Healthcare ‐Practice Initiatives
Subcommittee members: Leader- Cindy Adams
Members: Susan Ahrens, Susan McRoberts, Jan Kirsch, Lynn Turner, Cherona Hajewski, Linda Cason, Dawn Scott, Angela Bratina, Lori Hodges, Abbey Camp, Romma Woodward
Objective B: Host a task force from education and practice to explore interest in nurse residency programming
Actions in Progress:
The subgroup is completing work in 3 areas: define content, define preceptor training identify recommendations for divergent ASN and BSN tracks for transition into practice
Intent is to design a program using a turnkey approach to be web accessed
The model will advocate for seamless education progression
Curriculum framework incorporates 6 domains: Leadership, Patient Outcomes, Professional Role, Informatics, Integration into Practice & Profession of Nursing, QI & Safety Processes
Sources include:
National Council of State Boards of Nursing Transition to Practice Model
University Health System Consortium and AACN Nurse Residency Program
Versant Residency Program at Children’s Hospital, Los Angeles
University of Utah Residency Program
HCPro Nurse Residency Program Builder
CCNE Standards for Accreditation of Nurse Residency Programs
Indiana Action Coalition: Transforming Healthcare ‐Practice Initiatives
INACTH NPC goals:
#1-Identify activities to reflect
the full scope of nursing practice
#2-Maximize utilization of
clinical experiences for health related programs statewide
#3-Collaborate with partners
to review and propose relevant changes to the existing statute and/or rules related to nursing practice
#4-Increase funding to
support nurses returning for additional education leading to either an APN role or a doctorate
INC NPC goals:
Practice to full extent of
education and training
Achieve higher levels of
education and training through systems that provide seamless progression
Achieve full interdisciplinary
partnership in re-designing healthcare delivery
Determine other clinical
education models
Identify other potential
Health care is undergoing a much needed transformation
The work of the INAC:TH Practice Committee is committed to meet the growing health care demands and changes by:
Removing scope of practice barriers
Maximizing clinical experience
Creating partnerships to change policy
Advancing formal and informal nurse education to lead innovative practice at all levels
Indiana Action Coalition: Transforming Healthcare ‐Practice Initiatives