1. April 1, 2015 Peg Daw- MHEC Oscar Ibarra-HSCRC Priscilla Moore-MHEC
Nurse Support Program II Competitive Institutional Grants Technical Assistance Meeting
April 1, 2015
Peg Daw- MHEC
Oscar Ibarra-HSCRC
Priscilla Moore-MHEC

2. Nurse Support Programs NSP I- Hospitals NSP II- Higher Education
Website:
Health Services Cost Review Commission provides stable funding and oversight.
HSCRC administers NSP I
MHEC administers NSP II

3. Nurse Support Programs
NSP- HSCRC began funding Nurses ~~1986
NSP I- On July 1, 2001, HSCRC approved hospital revenue for hospital-based initiatives aimed at addressing the short and long term nursing shortage impacting Maryland hospitals. 
NSP II – On May 4, 2005, HSCRC approved hospital revenue for use in expanding the nursing workforce through increased nursing faculty and nursing program capacity in Maryland.

4. Goals of NSP I and NSP II NURSING FOCUS: Two Aims
1. Increase the number of registered nurses
2. Increase the number of nurse faculty

5. Funded Nursing Programs FY 2006- FY 2015
12 Universities
15 Community
Colleges
27 SON
$7.1 mil 3
$6.3mil 3
$2.3 mil 1
$44 mil 16
$3.8 mil 4
NSP II
Competitive Institutional Grants Awarded ~ $63 mil

6. NSP II Program Evaluation
Types of Program Initiatives (N=41)
Community Colleges
Private University
Public University
Historically Black College or University
TOTALS
Increase pre-licensure RN graduates
2102
180
175
150
2607 New RNs
Increase graduate degrees-MSN, DNP
142
310
632 MSN/DNP
Student Retention and Success
135
135 New RNs
Increase RN to BSN completions
275
302
577 RN-BSNs
Increase statewide resources, faculty, preceptors, simulation
474
177
154
805 Faculty/ Preceptors
Total Graduates
2711
774
941
330
4756

7. Measurement and Evaluation
5800 or 27% total 20,967 pre-licensure graduates attributed to NSP II
In 2013, 1,726 ADNs (58% increase)
In 2006, 1,090 ADNs
In 2013, 1,615 BSNs (43% increase)
In 2006, 1,127 BSNs

8. Measurement and Evaluation
No known impact on PhD graduates
PhDs
PhDs
621 new MS and 203 new DNP degrees directly attributed to NSP II
219 % Increase in MS degrees from 2006 to 2013

9. INPUTS NSP II Evaluation Resources SITUATION OUTPUTS IMPACT
New Faculty- new hires
Project Directors
Instructional supplies
Funding- grant and
In-kind
Clinical Simulation
External Consultants
Professional development
Instructional Technology
Collaborations
SITUATION
Shortage estimates
Associated hospital cost
Faculty shortage
Turned away students
OUTPUTS
New/Expanded Programs
5 + MSNs, 2+ DNPs
2+ BSN, 3+ RN-BSN
Accelerated Programs
3 + ADN cohorts, 2 + WE
Technology/ Development
4+ Simulation labs
5+ Online-
4+ Faculty Development
IMPACT
27% of New RNs
Renewed (5 yrs)
$75 million
5 New Initiatives-
Related to IOM Goals
Evaluation & Dissemination
OUTCOMES
2237 ADNs 621MSNs
505 BSNs 190 DNPs
577 RN-BSNs 245 NNFF
51 NEDG GNF
805 Certificates

10. HRSA Workforce Evaluation
2012
                                        2025 Projected
State
Supply & Demand
Demand
Supply
Difference
Maryland
60,600
72,000
59,900
  -12,100
Virginia
69,900
87,300
106,700
+19,400
Pennsylvania
145,000
152,600
178,400
+25,800
Delaware
10,600
12,500
16,200
+3,700
 West Virginia
  20,600
  21,100
 29,000
  +7,900 US
2,897,000
3,509,000
3,849,000
 + 340,000
Source: HRSA (2014).The Future of the Nursing Workforce: National and State Level Projections, Notes: Projections assume demand and supply are equal in 2012 and nurses remain in their state of training.

11. Nurse Support Program II Evaluation
In 2014, at the conclusion of ten years of funding, the HSCRC and MHEC staff, with the help of a 7 member Advisory Group completed the program evaluation.
Many stakeholders provided letters of support: 15 schools- MHA and MNA
HSCRC renewed NSP II
for 5 more years ~ $75 mil on
1/14/15
NSP II Workgroup provided guidance and new RFA released 3/13/15
Nurse Support Program II Evaluation

12. IOM Goals = NSP II Goals #4- Increase RNs to 80% BSN by 2020
#5- Double the # of RNs with Doctorates 2020
#6- Ensure lifelong learning for RNs
#7- Enable RNs to lead change
The Future of Nursing: Leading Change, Advancing Health (2010)

13. NSP II- New Goals & Metrics
NSP II Workgroup Members:
Dr. Steve Jencks- HSCRC Commissioner
Advisory Group- NSP II Project Directors &
NSP I Nurse Leaders
Chief Nursing Officers at Hospitals
Maryland Board of Nursing
Maryland Hospital Association
MNA, MONE, MDAC, MHEC, HSCRC

14. Workgroup Recommendations
5 New Competitive Institutional Grants Initiatives
Pre-licensure RNs
Advance education RN-BSN, MSN, Doctoral
Doctoral- prepared RN Faculty
Continuum of care- education/practice
Statewide capacity

15. Workgroup Recommendations
Baseline Data
Evaluation Tools
2 New Statewide Initiatives
Leadership Consortium
Clinical Simulation Resource Consortium
Dissemination Requirements

16. Initiative #1 Increase Nursing Pre-licensure enrollments and graduates
Academic Progression-Dual Enrollment
To meet IOM Goal #4, need community colleges nurse educators working alongside university and hospital nurse educators to prepare future RN workforce

17. Initiative #2
Advance the education of students and RNs to BSN , MSN and Doctoral level
Programs approved by MHEC/MBON
RN-BSN & RN-MSN (online-hybrid-onsite)
MSN ( entry level, 2nd degree, MS)
Doctorates (DNP or PhD)
To meet IOM Goals #4, 5, 6 & 7

18. Initiative #3 Increase the number of doctoral prepared nursing faculty
DNP, PhD
Nursing Faculty Careers
MBON and MHEC program approvals
To meet IOM # 5, 6 & 7

19. Initiative #4
Build collaborations between education and practice that develop new models that promote a patient centered continuum of care
Prepare RNs to lead change in hospitals
Utilize NSP I and NSP II
Academic/Practice Leadership
Increase primary care- APRNs, NPs
To meet IOM Goals # 4, 5, 6 & 7

20. Initiative #5 Increase educational capacity statewide
Develop innovations
Standardize
Share
Disseminate
To meet IOM Goals # 4, 5, 6, & 7

21. Equivalents (Total FTEs)
Data Tools- Faculty
Mandatory Data Table for all Proposals and all Future Interim Annual and Final Reports
FACULTY for current AY ( )
Equivalents (Total FTEs) FT PT
Total Number
Nursing faculty with PhD in Nursing
Nursing Faculty with PhD - Other
Nursing Faculty with DNP
Nursing Faculty with EdD
Nursing faculty with MSN
Clinical nursing faculty with BSN
Clinical nursing faculty with MS

22. Data Tools- Students
Academic Year/Session for Indicated Program- Describe Program Type
Program Capacity (new students only)
Number of qualified applicants
Qualified but not admitted
Admitted who registered
Graduation Rate
Retention Rate
# Graduates per academic year (as appropriate)
Graduates
ADN
BSN
Master Entry
RN-BSN
RN-MSN MS
DNP
PhD

23. Data Tools- Diversity Underrepresented Groups in Nursing
Ethnic/Racial Minority
% White
% Non-White
Total Number
Nursing faculty (Full Time)
Clinical or part-time faculty
Nursing students
Underrepresented Groups in Nursing
Gender
Female
Male
Total Number
Nursing faculty (FT)
Clinical or part-time faculty
Nursing students

24. Data Tools- Geographic
Can we answer the question: Where do our RNs ( students/Faculty) work and live?
In-State or Out of State
State of Residence
Maryland
Geographic Neighbors (VA,DE, DC, PA, West VA)
Other States
Total Number
Percent In State
Nursing faculty (FT)
Clinical or part-time faculty
Nursing students

25. Findings- MONE Hospital Survey
Maryland Hospital CNOs reported:
Top 3 hard to fill departments:
ED(71%), ICU(68%) and OR(58%)
Most difficult to fill RN roles:
RN Manager (63%), Director(50%), Educator(47)
In 2015, 53% CNOs creating new RN jobs:
Care navigator(64%), Documentation RN(64%),
Care coordinator(50%), Quality/Safety RN(50%)
Hospital Educator- Professional Development Specialist- often misnamed Clinical Nurse Specialist (8 titles)

26. NSP II Faculty Survey (n=389)
86% of 79 Faculty with Doctorates (PhD, DNP, EdD) are over age 54 (n=68)
Younger Faculty- more diverse/less education/ less opportunity
Preference for Doctorates/Experience
50% all Faculty retiring in 10 yrs.
70% all Faculty retiring in 15 yrs.

27. 5 NSP II Nurse Faculty Resources
Faculty Survey-
7/28-10/31/14
389 Respondents
245 NNFF
Recruit/retain
88% retention
51 NEDG awards for
Doctoral Completions
Leadership Consortium
Simulation Consortium
Hal and Jo Cohen GNF

28. Implications No research has been identified that provides a
direct or indirect relationship between a state’s
investment in Nursing faculty or nurses and the cost or
outcomes of the state’s health care system…….
Without a strategic framework, model of change
and outcomes criteria………….
one solution will appear to be as good as any other ……….
Kowalski & Kelley (2013)

29. NSP II Return on Investment
Research is needed:
Evidence based faculty strategies
Innovative education initiatives
ROI to fund nurse faculty & workforce
Nurse’s impact on patient outcomes/cost
NSP II funded programs need to be evaluated and disseminated through peer-reviewed publications.
REQUIRED: Data Tables ( see pg. 6 & 18)
Dissemination meetings ( see pg. 18 & 20)

30. NSP II Expectations Rigorous Reporting & Accountability
Embed Retention, Simulation & IPE
Collaboration among Project Directors
Curricular Change/ Agreements
Seamless Academic Progression
Well Executed Programs/Innovations
Hospital Leaders and Education Leaders
Program Evaluation and Improvements

31. NSP II Evaluation 2019 Measure Progress and Impact
NSP I and NSP II Goals for RNs INCLUDE:
1. Statewide strategies for the workforce
2. Right RN skills/mix =Triple Aim/Waiver
Next NSP II Evaluation Due 2019

32. References
Institute of Medicine, (IOM) 2010 report, The Future of Nursing: Leading Change, Advancing Health. Washington, DC: The National Academies Press.
Kowalski, K. & Kelley, B.M. (2013). What’s the ROI for resolving the nursing faculty shortage? Nursing Economics, 32(2),
Nurse Support Program II. Accessed at
Nurse Support Program II Faculty Survey, completed October 31, 2014, released at NSP II Advisory Group meeting on November 19, 2014.

33. References
Nurse Support Program II (NSP II) Outcomes Evaluation FY FY 2015 and Recommendations for Future Funding

34. Addendum
During the NSP II Technical Assistance Meeting, many questions arose. The program is essentially the same; however, many participants had specific questions about the new data requirements and items that might be allowed.
Afterwards, some who did not attend requested more assistance, so the following
Q & A Session slides were developed!

35. Q & A Session Can we write more than one grant proposal?
Can we write a grant for more than 1 initiative?
No, please address one major initiative per proposal.
Yes, there is no limit on the number of good proposals that a school can submit.

36. Q & A Session Can we ask for funding for pre-nursing students?
Can we write grants for equipment?
Can we ask for funding for pre-nursing students?
Probably not, we did not have any of these discussions in the Workgroup and are not familiar with how to measure actual RN graduates within a grant’s time frame.
No, there is an option for instructional technology, but it is not the main focus/funding of a proposal that measures progress in nurse graduates.

37. Q & A Session
Do we have to complete the enrollments listed on pg 16?
Is the Cover sheet and data tables part of our 15 page limit?
Yes, that is background information- include in the narrative a snapshot of the program’s enrollments- in addition to the required data set.
No- they are not counted in your narrative section.
Please number all pages!

38. Q & A Session What are Dissemination Activities?
Do we have to include funds for faculty to attend the Maryland Action Coalition meetings?
Yes- the MDAC is our lead organization reporting on movement towards IOM Nursing Goals.
Conferences, meetings, & activities to share best practices and progress on successful programs on IOM Goals – national, state, local- for Maryland’s RNs.

39. Q & A Session Where do I find the data required?
How did you decide on these data?
The Workgroup consulted with Deans/Directors of Nursing Programs.
Consult with yours.
Deans and Directors/ Nursing Programs report standard, readily available data to the MBON and Accreditation Boards.
These data are defined and consistent.

40. Q & A Session What is the deadline for the electronic files?
Do we have to submit the hard copies by 4/24?
The Deadline for submission is 4/24.
All items- electronic proposals and excel budget with hard copies are due in MHEC’s offices- 10th Floor.
Yes
The Receptionist leaves at 4pm, therefore, proposal packages can be hand delivered up until that time.

41. Q & A Session What are Statewide Initiatives?
Can schools apply for the Statewide programs?
Faculty Focused Funded Programs
Not part of the Competitive Institutional Grants
Listed for information
No- these are faculty focused initiatives guided by a Nursing Dean/ Director nomination process- available to faculty in nursing programs.

42. Q & A Session Can hospitals apply for NSP II?
Why did the Workgroup emphasize Hospitals and Higher Education collaboratives? No
Hospitals have NSP I funds. However, nursing schools and hospitals are encouraged to partner and share NSP I and NSP II Funded programs/ initiatives.
It is a natural fit- they share the same end goals- a highly educated RN workforce that meets the needs of Maryland’s Waiver & the Triple Aim- better care & better health/ patient experience at lower cost.

43. Q & A Session What about Nurse Residency Programs?
What about the NSP II Simulation and Leadership Consortiums?
Nurse Residency could be considered as an aspect of an NSP II Education Focused program, i.e.: Academic credits for Residency Courses
Hospital Nurses/ Leaders are eligible, as well as Nurse Faculty. The CNO or designee can nominate participating hospital RNs/ educators and Deans/Directors can nominate faculty.

44. Q & A Session What is the abstract?
What if we need to have more pages to explain our proposal and funds request?
The panel may have 27 proposals to review. They are RNs or hospital professionals and well informed.
Please make sure you deliver a clear, concise proposal.
Answer anything a potential reviewer would question.
State the case in the first 1-2 pages- then build it.
Use addendum for job descriptions, etc.
A well written abstract – 1-2 paragraphs- less than 200 words.
It briefly describes the program- may be included verbatim in future outlines/ or on the

45. Q & A Session Electronic copies- PDF signed budget- with narratives
What about the budget pages?
How do I deliver the budget?
The budget needs to be completed on a single budget sheet for each year.
In addition, all years of the grant proposed should be submitted in Excel.
Electronic copies-
PDF signed budget- with narratives
Excel format by
Send signed hard copy with copies of proposal

46. Q & A Session What about the Evaluation Plan?
HSCRC and MHEC expect the evaluation to be clear, well considered and easy to follow.
Recommended: prepare a Logic Model for your program proposal. Sample templates at

47. NEW Mandatory Requirements
Data Tables
Page 7, 8 & 9
Appendix A behind Cover Sheet
Format & Data required
Dissemination Activities
Part of the Evaluation Plan
Funded in the Budget
Activities reported within Annual and Final Reports

48. Location of MHEC Offices
Maryland Higher Education Commission
6 N. Liberty St., 10th Floor
Baltimore, Maryland
Located in MSDE/ Nancy Grasmick Building
Across from the First Mariner’s -on the corner of W. Baltimore and Liberty St.
Questions: Contact Priscilla Moore at or at