1. Nursing Education and Nursing Services: Best Partners for Best Practice SCCEN Annual Meeting November 11-13, 2012 Lauren R. Goodloe, PhD, RN, NEA-BC, Director Medical and Geriatric Nursing, Administrative Director for Nursing Research of VCU Health System & Assistant Dean for Clinical Operations VCU School of Nursing, Richmond, VA Nancy F. Langston, PhD, RN, FAAN, Dean VCU School of Nursing & Executive Director for Academic Nursing VCU Health System, Richmond, VA

2. Richmond on the James

4. Experiment in Progress

5. Vision For The Partnership Best Partners for Best Practices A formal structural partnership will create a synergy for continuous quality improvement in both the education and practice of nursing. Furthermore, it will advance an organizational model consistent with the underlying philosophy of operation of an academic Health Sciences Center as a component of a university.

6. Living Next Door to one another or within the same university does not a partnership make!

7. Academic-Service Partnerships are not simply Hospital-School Affiliations

8. Academic-Service Partnerships Many Models Academic Medical Center Models Hospital-Community Partners Models Blended Models

9. Academic-Service Partnerships There are as many possible ways to formulate academic-service partnerships as there are potential partners Partnerships are about trusting, open relationships and ongoing communication, joint planning and day to day operations Recognize what your individual strengths are and what you can do better as partners Beware of “Power Struggles”

10. Story of One Partnership Model Early meetings and Discussions Start with a small very committed group of people Must include the Dean and CNO Must include people who will work through the details and day to day operations Must have committed leaders/cheerleaders who will carry the vision into ACTION

11. Create Preferred Futures

12. Nursing is Knowledge Work

13. Nurses are not DOERS who happen to think But are THINKERS who also do

14. 10/19/08 Environment that EMBRACES AND LIVES LIFE LONG LEARNING

15. Position Titles For The Partnership Nursing ServicesPrimary – School of Nursing AND Associate Dean for Clinical Programs, SON VP Patient Care services & CNO of VCU Health Systems (VCUHS) AND Associate Dean for Clinical Programs, SON AND Assistant Dean for Clinical Operations, SON Director of Medical and Geriatric Nursing AND Assistant Dean for Clinical Operations, SON AND Assistant Dean of Continuing Education, SON Director of Education and Professional Development AND Assistant Dean of Continuing Education, SON AND Executive Director for Academic Nursing, VCUHS Dean of VCU School of Nursing AND Executive Director for Academic Nursing, VCUHS AND Director of Academic Nursing, VCUHS Associate Dean for Academic Programs AND Director of Academic Nursing, VCUHS AND Director of Clinical Research and Evidence based Practice, VCUHS Associate Dean for Doctoral Program and Research AND Director of Clinical Research and Evidence based Practice, VCUHS

16. Extension Of Appointments Within The Partnership Nursing Services School of Nursing All nurses who advance to Clinical Nurse V are automatically appointed as Affiliate Faculty of the School of Nursing PhD prepare nurses Affiliate AND Adjunct faculty appointments Approximately 40 VCUHS nurses a semester serve as adjunct faculty of the School Nursing Faculty who desire are provided practice appointments equivalent of up to a day a week – appointments range from Critical Care through Geriatric Ambulatory Clinic FOUR Joint Appointments between Service and Education created

17. Outcomes of our Partnership WORKFORCE DEVELOPMENT EDUCATIONAL INITIATIVES AND CURRICULUM DEVELOPMENT SHARED RESOURCES ENHANCED COMMUNICATION AND MUTUALITY REGARDING SHARED GOALS, ISSUES AND CONCERNS –internal and external to our system TRANSFORMATION OF AN ORGANIZATION’S CLIMATE

18. Outcomes of our Partnership WORKFORCE DEVELOPMENT Expanded number of BS graduates – both entry level and RN to BS – received financial support from VCU Health System for 6 faculty positions for support of expansion of the entry level track and has continued to support 3 positions

19. 10/12/12 8/99,12/99,5/008/04,12/04,5/058/11,12/11,5/12 BS traditional 76 122 141 RN to BS 90 109 155 MS & post MS 80 72 82 PhD 3 5 14 Total 249 308 392 NUMBER OF GRADUATES

20. Outcomes of our Partnership WORKFORCE DEVELOPMENT Expanded number of BS graduates – both entry level and RN to BS – received financial support from VCU Health System for 6 faculty position for support of expansion of the entry level track and has continued to support 3 positions. Developed systems of personnel support from nursing students as care partners through PhD graduates as nurse scientists

21. Nursing Students as VCUHS Care Partners Spring, 2012 Of the 170 care partners 85 were VCU Nursing Students

22. 16 PhD Nurse Scientists at the Health System

23. Outcomes of our Partnership WORKFORCE DEVELOPMENT Expanded number of BS graduates – both entry level and RN to BS – received financial support from VCU Health System for 6 faculty positions for support of expansion and has continued to support 3 positions Developed systems of personnel support from nursing students as care partners through PhD graduates as nurse scientists Implemented the UHC/AACN nurse residency program for new baccalaureate graduates and currently working toward CCNE accreditation of the program.

24. Number of new Nurse UHC/AACN Residents 2006-2010 and Number who were VCU Graduates ResidentsVCU SON Graduates 20066043 20075132 20087769 20098665 20109475 201112595 201213684 Total629463

25. Outcomes of our Partnership WORKFORCE DEVELOPMENT Expanded number of BS graduates – both entry level and RN to BS – received financial support from VCU Health System for 6 faculty positions for support of expansion and has continued to support 3 positions Developed systems of personnel support from nursing students as care partners through PhD graduates as nurse scientists Implemented the UHC/AACN nurse residency program for new baccalaureate graduates and currently working toward CCNE national accreditation of the program; Created a climate that inspires nurses to continue their formal educational preparation and recently adopted a policy that requires all new AD prepared employees to become enrolled in an accredited BS nursing program within 2 years and obtain the BS degree within 5 years of initial employment;

26. Number of VCUHS Staff Enrolled in School at VCU SON

27. Outcomes of our Partnership WORKFORCE DEVELOPMENT Developed systems of personnel support from nursing students as care partners through PhD graduates as nurse scientists Expanded number of BS graduates – both entry level and RN to BS – received financial support from VCU Health System for 6 faculty positions for support of expansion and has continued to support 3 positions Implemented the UHC/AACN nurse residency program for new baccalaureate graduates and work toward national accreditation of the program; Created a climate that inspires nurses to continue their formal educational preparation and recently adopted a policy that requires all new AD prepared employees to become enrolled in an accredited BS nursing program within 2 years and obtain the BS degree within 5 years of initial employment; Added new rung on Clinical Ladder (Clinical Nurse V) for nurses in direct clinical care built upon competencies of graduate education

28. Creation of Clinical Nurse V Level on The Clinical Ladder Keeping MS Prepared Nurses At The Bedside

29. Clinical Nurse V Criteria Years of practice – 5+ Certification status – Must be certified Education level: MS in Nursing Involvement in professional organization Focus on EBP Strong “leadership” roles Submit for publication of article/poster/podium presentation Affiliate faculty for VCU SON

30. Outcomes of our Partnership EDUCATIONAL INITIATIVES AND CURRICULUM DEVELOPMENT Developed a Nursing Administration and Leadership clinical concentration within the master’s program. Created a perioperative internship in response to request from and work with colleagues in perioperative nursing – extended to add upper division electives AND use of the perioperative area as one of the clinical placements for students in the senior level acute care course. Created a Nursing Research Fellowship Program Developed an evidence-based practice internship and fellowship

32. Outcomes of our Partnership EDUCATIONAL INITIATIVES AND CURRICULUM DEVELOPMENT Developed a Nursing Administration and Leadership clinical concentration within the master’s program. Created a perioperative internship in response to request from and work with colleagues in perioperative nursing – extended to add upper division electives AND use of the perioperative area as one of the clinical placements for students in the senior level acute care course. Created a nursing research fellowship program Developed an evidence-based practice internship and fellowship Co-sponsor an annual summer camp for diversity pipeline development

34. Outcomes of our Partnership SHARED RESOURCES VCU Health System supported faculty positions for enrollment increase Joint Council and Committee Membership Use of Clinical Learning Center for staff orientation and continuing competence Joint Capital Campaign for new building – hospital created payroll deduction for contributions

35. Nursing Education Building

36. School of Nursing Building Photo: Alain Jaramillo

37. Outcomes of our Partnership ENHANCED COMMUNICATION and MUTUALITY REGARDING SHARED GOALS, ISSUES, AND CONCERNS internal and external to our system. Student, staff and faculty concerns addressed immediately – not waiting until...... end of semester Political, legislative and regulatory “ONE VOICE” from VCU

38. Outcomes of our Partnership TRANSFORMATION OF AN ORGANIZATION’S CLIMATE Nursing and nurses as knowledge workers has been made visible and valued within the structures of the organizations Creation of a climate that has at its essence life long learning – for all parties at all times The climate on the hospital units embraces all nurses responsibility for creating a positive learning environment and experiences for the nursing students. We actually talk about “a dedicated educational hospital” among ourselves and with others. There is no us/them, we/they - it is ONLY US

39. Validation of our Partnership Magnet recognition citation of the partnership as a major strength – initial and re-certification VCU School of Nursing and VCUHS Nursing Services X2 The relationship between the School and Nursing Services was cited by the site visitors as a significant strength of the application for Magnet status

40. Validation of our Partnership NLNAC 2009 reaccreditation site visit report cited the partnership and the depth and breadth of adjunct faculty as a strength of the School Virginia Board of Nursing 2011 site visit report cited the strength of the partnership and the adjunct faculty relationship

41. Validation of our Partnership $1,250,000 gift from the VCU Health System to the School of Nursing to establish a Center for Quality Patient Outcomes housed in the School of Nursing - building upon this partnership to expand across other academic units.