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TCC Site Visit December 18 – 19, 2012 Richmond, VA.

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1 TCC Site Visit December 18 – 19, 2012 Richmond, VA

2  To participate in the RWJF evaluation process  To define the Virginia Action Coalition  To describe the workgroups  To review next steps Objectives

3 IOM Future of Nursing Campaign for Action

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

5 Field strategy to move key nursing issues forward at local, state and national levels In 15 states before moving nationwide Capture best practices, track lessons learned and identify replicable models Short and long term Action Coalition Goals

6  Campaign for Action: Key Messages High-quality patient centered care Leadership Access to Care Workforce Data Education Interprofessional Collaboration

7 1.Remove scope of practice barriers 2.Expand opportunities for interprofessional collaboration 3.Implement nurse residency programs 4.Increase proportion of nurses with BSN to 80% by Double the number of nurses with doctorates 6.Ensure that nurses engage in lifelong learning 7.Prepare and enable nurses to lead change and advance healthcare 8.Build an infrastructure for data collection Future of Nursing Recommendations

8  2010 Landmark IOM Report: Future of Nursing: Leading Change, Advancing Health  November 2010 Campaign for Action Launch Summit  RWJ Foundation and AARP Center to Champion Nursing in America  State Action Coalitions – 5 pilots, New Jersey, New York, Michigan, Mississippi, California How action coalitions got started

9 Virginia Action Coalition Co-Leads AARP Virginia  David Debiasi, RN, Associate State Director – Advocacy  Bill Kallio, State Director VNA  Shirley Gibson, MSHA, RN, FACHE, President

10  Submitted February input from more than sixty stakeholders  Awarded designation in March 2011  Focuses on technical support and exchange of best practices  Catalyst to convene diverse stakeholder around common themes Virginia’s Action Coalition Application

11  Nurses should practice to the full extent of their education and training  Nurses should achieve higher levels of education and training through an improved educational system that promotes academic progress and explore residency programs  Nurses should be full partners, with all members of the healthcare team in redesigning healthcare  Nurses should develop strategies to ensure that nursing is skilled to provide leadership at all levels  Nurses should ensure effective workforce planning and policy making require better data collection and an improved information infrastructure Virginia Action Coalition Goals

12  Wave II – 10 States – Idaho, Utah, Colorado, New Mexico, Illinois, Indiana, Louisiana, Virginia, Florida and Washington Awarded designation in March 2011 Virginia Action Coalition

13  Five workgroups with many volunteers – April 2011  Kickoff : June 16, 2011 Nursing Roundtable  website  Blog and wiki -media training that Chelsea Savage, Lindsey Cardwell-Jones and Linda Ault participated with AARP  Featured articles in the Virginia Nurses Today and media coverage across state Engagement

14  Funding  Virginia Nurses Foundation  Virginia Council of Nurse Practitioners,  Virginia Nurses Association  Virginia Partnership for Nursing  In-kind-engagement of non nursing partners  PIN Synergy grant awarded to Richmond Memorial Health Foundation and partners Partnerships

15  AARP volunteers including 4 state legislative specialists join VAC workgroups  AARP 2012 legislative platform included supervision should be removed from the code of Virginia with regard to Nurse Practitioners  Testimony given “on the record” at Department of Health Professions Town Hall Meeting on supervision of APRNs being a barrier to access to care AARP Partnership

16  AARP 2011 Voter Education Pamphlet Questions anyone running for VA General Assembly should answer :  If elected/re-elected, how would you ensure advanced practice registered nurses can practice to the full extent of their education and expertise?  Do you support or oppose allowing advanced practice registered nurses to practice without physician supervision? AARP Partnership

17 Leadership Lindsey Jones-Cardwell, BSN, RN and Loressa Cole DNP, MBA, RN Co-Leads

18 Develop strategies to ensure nursing is skilled to provide leadership from the bedside to the boardroom Leadership Goal

19  Continue to determine strategic boards to which nurses could be appointed and work with stakeholders to identify, mentor, and recommend individuals for those appointments  Collaborate with schools of nursing to ensure the curriculum focuses on leadership skills necessary for today’s complex healthcare environment  Recognize leaders “from the bedside to the boardroom” at the annual Virginia Nurses Foundation Excellence in Nursing gala Leadership Objectives

20  Continue “Nurse Leaders in the Boardroom” program piloted with Robert Wood Johnson and AARP in September, 2009  Continue to support the current and expanded Nurse Leadership Institute, a program of the Richmond Memorial Health Foundation and a 2007 Partners Investing in Nursing’s Future (PIN) grantee, by participating on committees, providing scholarships, assisting in encouraging employers to nominate fellows and nurses to serve as faculty Leadership Objectives

21  Networking and educational event for the nurses identified as 40 under 40  Recognized at VNF Gala  Mentoring event – May 31, 2012  Collaboration with:  VONEL  VNA  VNF Outcomes

22  Utilizing WikiSpace to facilitate online discussion of objectives  Hosting monthly conference calls to update the team on the background of objectives and develop implementation strategies for each objective  Survey has been completed to determine boards nurses are serving – regional, state and national  Survey also identified those who want to serve on boards  Determining which boards nurses should be serving Outcomes

23 The Survey  Survey was released in January 2012  Closed in March 2012  344 started the survey  282 (82%) completed the survey

24 Do you currently serve on a local board or organization’s board of directors?

25 What type of local board are you serving on?

26 Local Boards  Free Clinics  Crisis Pregnancy Centers  AORN, VNA, Black Nurses & other professional nursing associations  Public Health Advisory Commissions  Red Cross  Alzheimer’s Association  Church Affiliated Boards  Performing Arts Council  Historical Councils  County Board of Supervisors  AARP  University & Community College Councils  YMCA

27 What is your role on the local board you serve?  54.1% of those serving on a local board are board Members  45.9% of those serving on a local board are board Officers

28 Do you currently serve on a state- wide board or organization’s board of directors?

29 What type of state board are you serving on?

30 State Boards  Virginia Partnership for Nursing  Virginia Board of Nursing  Virginia Nurses Association  Virginia Nurses Foundation  Multiple professional nurses associations  Virginia Board of Health  Virginia Association of Counties  VCCS Associates Degree Nursing Program Heads  Virginia Association of Colleges of Nursing  Health Insurance Exchange Governing Body

31  36.2% of those serving on a state board are Members  63.8% of those serving on a state board are Officers What is your role on the state board you serve?

32 Do you currently serve on a national board or organization’s board of directors?

33 What type of national board are you serving on?

34 National Boards  American Nurses Association & Political Action Coalition  National eHealth Collaborative  Nurses Organization of Veterans Affairs  American Midwifery Certification Board  AORN Journal Editorial Board  National Kidney Foundation  American Academy of Nurse Practitioners  American Organization of Nurse Executives  Various National Nursing Organizations

35  72.4% of those serving on national boards are Members  27.6% of those serving on national boards are Officers What is your role on the national board you serve on?

36  64.1 % or 118 Experienced Nurse Board Leaders were willing to mentor other Registered Nurses interested in board leadership Experienced Nursing Board Leaders Willing to Mentor New Board Members

37  Of the Registered Nurses surveyed, 60.3% of those not currently serving on a board, were interested in future board leadership  181 Virginia Registered Nurses are future board leaders! Future Nurse Board Leaders


39  Continue compilation of potential boards for nurse leaders to serve on  Identify key boards that nurses should be present on and facilitate nurse leaders to apply for these positions  Identify a forum to facilitate mentorship of future registered nurse board leaders  Provide resources to current nurse board leaders to advance and mentor new board leaders  Provide resources to future nurse board leaders Next Steps for the Nurses on Boards Initiative

40 2013 Objectives  Provide the CCNA Nurse Leaders in Boardroom DVD to targeted groups; facilitate presentations  Develop a Nurse Leaders in the Boardroom resource toolkit and post this on the VAC and VNA websites  Develop a mentorship support structure  Contact survey participants to enlist involvement and continue to identify interested nurses to serve on boards

41  Provide the VAC Nurse Leader in the Boardroom toolkit and mentorship resources to targeted leaders  Categorize the targeted Boards list and link to VAC and VNA websites  Identify 5 associations to target for nursing membership on Boards  Develop a forum to continue to identify nurses interested in board leadership 2013 Objectives

42 Access to Care Linda Ault, BSN, MSN and Cindy Fagan, RN, MSN, FNP-BC Co-Leads

43  All Nurses should practice to the full extent of their education and training Access to Care Objectives

44  Identified barriers to APRN practice in statutory (code) and each facility determines what the practice parameters will be for their institution.  Published a series of “Myth Busters” in VNT to educate nurses regarding what the various APRNs are actually licensed to do  Collaboration with VCNP and MSV Progress

45  House Bill 346 passed and signed by Governor  Eliminates supervisory language  Emphasized collaboration and consultation between NPs (LNP & CNMs) and physicians to practice in teams  Increased from 4 to 6 number of APRNs physicians can collaborate with  Joint Boards of Nursing and Medicine have 280 days from July 1 to develop regulations  HB 346 may not manifest until early 2013 Progress

46  APRN Video has been completedVideo Progress

47  Collaborating with Center for Championing Nursing Diana Mason PhD, RN, FAAN and Andrea Brassard DNSc, MPH, FNP – scope for other RNs  Broadening focus on scope for other RNs  Linda Ault, RN MSN appointed to national Center for Championing Nursing committee for long term care Progress

48  Call for stories: to demonstrate through real practice stories how APRNs were either able to successfully bridge a gap to care or how the current statutes hindered and negatively impact access to care throughout the state  Developing an APRN video to educate public on new regulations  Plan to conduct focus groups to identify institutional restriction to practice for RNs  Plan to develop tool kit based on results to educate administrative teams, physicians and other stakehoder Next Steps

49  Create a dashboard on the VAC website to track the speakers and organizations that have been addressed. To date we have visited various APRN meetings in Virginia to educate them on the VAC and recruit future speakers.  Secure more support statements for legislative change such as the one obtained by AARP  Culminate results of identified RN/APRN barriers into a qualitative research project  Long term goal: Implement legislative strategies to impact statutory and regulatory barriers that prevent nurses from practicing to the full extent of their education and training. Next Steps

50  Publish results of the survey  Developing a list of potential emerging leaders  Mentoring potential leaders to be selected for boards identified  Targeting boards nurses should be appointed  Developing a list of leadership programs  Collaborate with schools of nursing on curriculum

51 Education Advancement Deb Zimmermann, DNP, RN, NEA-BC, Amy Gillespie, RN, MSN, EdD, Nancy Langston, PhD, RN, FAAN, Lauren Goodloe, PhD, RN, NEA-BC, Linda Dedo, RN, MSN, MHA Co-leads

52 Advances in science and increasing patient complexity have accelerated the need for nurses with the skill and knowledge to manage a challenging and increasingly diverse healthcare environment. Researchers have demonstrated a significant relationship between nursing education and improved patient outcomes A Call to Action: Transformation of Nursing Education BACKGROUND: Aiken et al. 2003, 2008; Benner, Stuphen, Leonard, & Day, 2010; Blegen & Goode, 2009; Estabrooks, et al., 2005; Institute of Medicine, 2011; Tourangeau et al., 2006

53 Institute of Medicine Report High-quality, patient- centered care requires transformation of the health care delivery system

54 Call for Action on Education Achieve 80% BSN workforce by 2020 Double doctorally prepared RNs Transform Curriculum Institute of Medicine The Future of Nursing: Leading Change, Advancing Health. Washington D.C.: The National Academies Press

55  Educate workforce and stakeholders on the importance of education.  Support implementation of strategies to achieve a more educated workforce.  Convene stakeholders on the implementation of seamless education progression.  Consider role of residency programs in the Commonwealth. VA Education Coalition Objectives

56 The Evidence Supporting BS Education

57 As Nurse Education Increases, Patient Mortality Decreases57 Education Percentage of hospital nurses with BS degrees Aiken (2003) Deaths per 1000 patients with complications 90 deaths in 1,000 patients 84 deaths in 1,000 patients 76 death in 1,000 patients

58 Research supporting education and improved patient outcomes  Estabrooks et al. (2005)  Tourangeau et al. (2006)  Blegen &Goode (2009)

59  RNs twice as likely to remain in job with tuition assistance  BS prepared RNs reported higher job satisfaction and lower job stress  BS prepared nurses more than ten years of tenure More Benefits from Education Ingersoll et al., 2002; McGinnis & Martiniano, 2008; Megginson, 2008; Rambur et al., 2005

60  NCLEX tests for competency of new graduates. Does not test content in: Scholarship for evidence based practice Information management Health care policy and finance Inter-professional communication and collaboration Organizational and systems leadership, as well as patient safety Disease prevention and population health NCLEX AD vs BS: Added Value ?

61 Education around the World AustraliaItaly BelgiumNetherlands CanadaNew Zealand DenmarkNorway FinlandPhilippines IrelandSpain Countries Requiring BSN: Nurses per capita increased or remained the same following advances in education standards Organization for Economic Cooperation and Development. (2009)

62 A Growing Profession  2,724,570 RNs employed in the U.S.  Mean U.S. Salary: $69,110  Projected employment 2018: 3,200,200  83% all RNs employed U.S. Department of Health and Human Services, HRSA, 2010 Bureau of Labor Statistics (2011)

63 RN Employment Settings Health and Human Services, 2010

64 Virginia RN Statistics October 2012Virginia Number Registered Nurses100,000 Nurse Practitioners 7,023 Clinical Nurse Specialists433 Licensed Practical Nurses 31,408 Nursing Programs Number Associate Degree 45 Baccalaureate and Accelerated Masters 31 Diploma 6 Total82 Virginia Board of Nursing (2012)

65 Virginia State Board of Nursing (2010). Virginia Graduates

66 66 Education Initial education of graduates in VA Year BSN40%37%38%40%36%35%38% AD48%51%48%45%52%53%54% Diploma12% 13%15%13%12%8% Total2,9122,9093,2653,2283,4923,5483,686 Virginia State Board of Nursing (2012).

67 Projected Need for RNs in VA  Expected growth in VA population 1 million  16% of Virginians will be 65 or older  Need 30,000 RNs over next 20 years (replace retiring nurses and care for growing, aging population) Virginia Board of Nursing (2010)

68 Future of Nursing Education: Challenge  50% of VA RNs BS prepared  Only 32% of AD and 31% of Diploma grads attain BSN

69 Where to Begin?

70  Eastern:  Grace Meyers, RN, MS, Karen Karlowicz, EdD, RN  Central  Lauren Goodloe, PhD, RN, Susan Bodin, EdD, RN  Northwest:  Amy Black, MSN, RN, NEA-BC, Katherine Ganske, PhD, RN  North:  Robin Remsburg, PhD, RN, Maureen Swick, PhD, RN, MSN, NEA-BC, Joyce Hahn, PhD, APRN-CNS, NEA-BC  Southwest:  Carolyn Webster, BSN, MBA, RN, Kimberly Carter, PhD, RN, Ava Porter, DNP, RN, Charlotte Ramsey, RN, MSN Regional Groups

71 Analysis of the Gaps: Interviews with VA Nursing Programs Amy Gillespie, RN, EdD Nancy Langston, PhD, RN, FAAN Partners Investing in Nursing’s Future Inspiration for Aspirations

72 Partners Investing in Nursing’s Future (PIN) is a partnership of the Northwest Health Foundation and the Robert Wood Johnson Foundation to support the capacity, involvement and leadership of local foundations to advance the nursing profession in their own communities. Mission: The Partnerships for Progression: Inspiration for Aspiration project is to help regions in Virginia develop a culture of educational progression, where colleagues in associate and baccalaureate institutions work together, side-by-side, to “pull” students into advanced educational preparation and lifelong learning. Goal: Partnerships for Progression: Inspiration for Aspirations will result in sustainable partnerships between and among local community colleges and universities and their community partners to create seamless educational progression programs starting with ADN to BSN. Partnerships for Progression: Inspiration for Aspirations

73  Interviews with nursing programs in VA  Major findings: Programs are working to create partnerships, procedures in place to make progression more seamless. Barriers for students center on personal and home life issues – family responsibilities, need to work full time for benefits  Completion of RN-BSN Directory  Easy access to information about RN-BSN programs  Response to finding that RN-BSN information is difficult to find and confusing Inspiration for Aspirations Accomplishments

74  Survey of current RN-BSN students  Major findings: personal issues and family responsibilities cited as primary barriers, tuition support and flexible scheduling listed as vital to success  Identified that “information is not inspiration”  Academic Progression Models: What’s Out There, What Works  Statewide conference brought stakeholders together to share partnership and academic progression model information Accomplishments (cont)

75 Inspiration for Aspirations: School Again Video of five nurses who returned to school and successfully completed a Bachelors of Science degree in nursing share their experiences.  What motivated you to go back to school?  What were the challenges?  What kept you going?  What does having a BSN mean to you?  What insights can you offer to other nurses? Accomplishments (cont)

76  Manuscripts to be developed  Creation of Academic Progression Toolkit  Website with tools to facilitate progression  Development of sustainability plan  Identification of agency to maintain, update, and possibly expand the toolkit  Spring Conference  Follow-up to summer conference  Format for networking Future Steps

77 Survey of Chief Nursing Officers 2012 Lauren Goodloe, PhD, RN, NEA-BC

78  Survey sent to all Virginia Hospitals  29 completed surveys were returned from all regions of Commonwealth.  Bed size ranged from 25 to >500.  Goal of the survey was to explore employer RN support of educational progression. About the Survey

79  21 Hospitals found barriers that included:  Financial support. (12)  Distance of schools. (6)  Flexibility of the schools. (3)  Family Obligations (3)  Nurses not receiving additional salary for education progression. (2)  Current HR policy. (1) Barriers for Progression

80 100% responded “YES” to offering tuition assistance for full- time employees. Tuition Assistance for Full-Time Employees

81 At what point do tuition benefits begin?

82  16 of the hospitals offer part-time employees tuition assistance.  Most hospitals prorated their full-time tuition assistance in half for part-time employees.  Tuition assistance varied from $750 to $2,500. Tuition Assistance for Part-Time Employees

83 Does your hospital offer any of the following supports to nurses returning to school?

84 Do you hire new RN’s who graduated from schools that are not NLNAC or CCNE accredited?

85 Do you hire unlicensed assistive personal who are RN students enrolled in schools not accredited by NLNAC or CCNE?

86 Do you allow schools who are not accredited by NLNAC or CCNE to bring students to your organization for clinical or observational experience?

87  21 of the hospitals have a clinical ladder in place.  16 of the 21 require a particular degree in nursing in order to attain a certain level.  Most requiring a BSN at level 4  And a MSN at level 5 Degree requirements with clinical ladder?

88  14 Hospitals answered Yes  11 Hospitals answered No  3 stated plans under development  Common Plans  Forecasting – BSN must be attained within 3 – 5 years of hire (5)  Hiring only BSN (4)  Changing job description to BSN requirement Does your organization have a plan if place to attain an 80% BSN workforce by 2020?

89  YES – 14  NO – 12 Does your health system have a defined relationship with a school of nursing that provide you with innovative solutions for increasing your BSN prepared RN

90 Know where you are to best determine the course you need to follow Analyze Gaps Then Forecast Outcomes with potential policy changes

91  American Association of Colleges of Nursing (September 2009)  Virginia Board of Nursing (January 2010)  Virginia Department of Health Professions, Healthcare Workforce Data Center (November 2010)  U.S. Bureau of Labor Statistics (March 2011)  U.S. Census Bureau (2011)  U.S. Department of Health and Human Services, HRSA (March 2010) Forecasting Model - Background

92 RN Education Cadres Non-BSN # and % BSN or Higher # and % Current Workforce Projected Completions New Graduate New Hires Experienced RN New Hires Terminations Acquisitions

93 What Changes Will Lead to Your Success?  Policy changes:  In hiring  In tuition assistance  In student affiliations  In contracts  Collaboration:  Seamless transition  Onsite education  Elimination of barriers

94 The Decision Don’t make it aloneMake it in Public

95 Example Education Progression Standard  Effective January 1, 2012, ALL New hires without BS(N) sign agreement to:  Enroll in an RN-BS(N) or RN-MS(N) accredited program within 24 months of hire  Graduate from an RN-BS(N) program within 5 years of hire  Failure to meet either term results in separation from organization  Includes employees in school

96  As a [diploma prepared; associated degree prepared] nurse, please be aware that continuation of employment in your position as a registered nurse is contingent upon the following requirements: Enrollment in an accredited RN to BSN program within 24 months of your hire date (i.e., no later than [mm/dd/yyyy]) Successfully obtain your BSN no later than 5 years or 60 months from your hire date (i.e., [mm/dd/yyyy])  Failure to enroll in the RN to BSN program by the date specified or failure to obtain your BSN by [specify date] will result in the termination of your employment as a registered nurse. Employee tuition assistance benefits may be available to assist you in achieving this expectation after you have successfully been employed for twelve months in a continuous benefit-eligible role. Wording in Letter of Hire

97 Example of Governance Decisions  New RNs Hired  Must be a graduate of an NLN-AC or CCNE accredited school of nursing  Student Workers  Must be enrolled in an accredited NLN-AC or CCNE accredited program  Tuition Reimbursement  Restricted to NLN-AC or CCNE accredited programs  Contracts  Only NLN-AC or CCNE accredited schools eligible for clinical experiences in the health system

98 Communication  State Board of Nursing  Schools of Nursing in Region  Community College Presidents  VA Magnet Consortium  VA Nurses Association, VONEL  Healthcare Leaders in Region

99 Progress  Summary of all RN to BSN in VA posted on VNA website  Magnet Consortium CNO’s lead VA Education Action Coalition with academic leaders  Survey of schools, CNO’s & students completed  Testimonial video completed

100  Regional meetings with clinicians, leaders, and academe are underway.  A forecasting & strategy tool was developed, piloted, and available for predictive modeling.  Directory of RN to MS programs almost complete  Virginia’s CNO’s committed to academic progression Progress

101  Second meeting on education progression and innovative models  Completion of Comprehensive Tool kit  Collaboration on curriculum and articulation agreements Future Plans

102  Development of a FAQ page on “What to look for and questions to ask when choosing a Nursing School.” Will be located on the VAC and VNA websites  Development of a list of all Virginia Nursing Schools - displaying all programs and concentrations offered by each school Future Plans

103  Submission of a grant proposal to NCSBN to study level of RN Education and relationship to BON action and type of action taken on a license – Collaborative study between VCU and Va BON Future Plans

104 If not now, then when, if not us, then who? A Profession United In Purpose Can Change the World

105 References 1.Aiken LH, Clarke SP, Cheung RB, Sloane DM, Silber JH. (2003). Educational levels of hospital nurses and surgical patient mortality. JAMA, 290(12), Benner P, Sutphen M, Leonard V, Day L. (2010). Educating nurses: A call for radical transformation.. Stanford, CA: The Carnegie Foundation 3.Bureau of Labor Statistics, U.S. Department of Labor. (2011). Occupational outlook handbook: May-2011 Edition, registered nurses. Retrieved from 4.Estabrooks CA, Midodzi WK, Cummings GG, Ricker KL, Giovannetti P. (2005). The impact of hospital nursing characteristics on 30-day mortality. Nursing Research, (2), Goode CJ, Blegen MA. The link between nurse staffing and patient outcomes. ANCC National Magnet Conference; October 2, 2009; Louisville, KY. Available at 6.Ingersoll GL, Olsan T, Drew-Cates J, DeVinney BC, Davies J. (2002). Nurses job satisfaction, organizational commitment, and career intent. Journal of Nursing Administration. 32(5), Institute of Medicine The Future of Nursing: Leading Change, Advancing Health. Washington D.C.: The National Academies Press 8.Institute of Medicine. (2010, October). The future of nursing focus on education (Report Brief). Washington, DC: National Academy of Sciences. Retrieved from Nursing/Nursing%20Education%202010%20Brief.pdf

106 9.McGinnis S, Martiniano R. (2008). The hospital workforce in New York: Findings from a survey of hospital registered nurses. Rensselaer, NY: Center for Health Workforce Studies, School for Public Health, SUNY Albany. 10.Megginson LA. (2008). RN-BSN education: 21 st century barriers and incentives. Journal of Nursing Management, 15, NetMBA Business Knowledge Center. (2010). Scenario planning. Retrieved from 12.Organization for economic Cooperation and Development. (2009). OECD health data 2009: Statistics and indicators for 30 countries. Retrieved from 13.Rambur B, McIntosh B, Palumbo V, Reiner K. (2005). Education as a determinant of career retention and job satisfaction among registered nurses. Journal of Nursing Scholarship, 37(2), Tourangeau AE, Doran DM, Hall LM, et al. (2007). Impact of hospital nursing care on 30-day mortality in acute medical patients. JAN, August 14, U.S. Census Bureau, Statistical Abstract of the United States: Table 18.Resident Population by Age and State – Projections: 2010 and Washington, D.C.: Author. Retrieved from 16.U.S. Department of Health and Human Services Administration. (2006). The registered nurse population: Findings of the March, 2004 national sample survey of registered nurses. Washington, DC: U.S. Government Printing Office. Retrieved from

107 17.U.S. Department of Health and Human Resources, Health Resources and Services Administration. (2010, September). The registered nurse population. Findings from the 2007 national sample survey of registered nurses. Washington, DC: Author. Retrieved from 18.U.S. Department of Labor, Bureau of Labor Statistics. (2011, March 11). Job openings and labor turnover survey highlights, January Washington, DC: Author. Retrieved from 19.U.S. Department of Labor, Bureau of Labor Statistics. (2011, March 17). Occupational employment and wages, May 2009: registered nurses. Occupational Employment Statistics. Washington, DC: Author. Retrieved from 20.Virginia Department of Health Professions, Healthcare Workforce Center. (2010, January). Forecasting nurse supply and demand in Virginia: Richmond, VA: Author. Retrieved from 21.Virginia Department of Health Professions, Healthcare Workforce Center. (2010, January). The Virginia licensed nursing workforce survey findings and recommendations. Richmond, VA: Author. Retrieved from 22.Zimmermann, D. T. (2011, March). A more highly educated workforce. A model for the future. PowerPoint presentation at meeting of the Virginia Magnet Consortium, Roanoke, VA.

108 Thank You Virginia Magnet Consortium Richmond Memorial Health Foundation Virginia Action Coalition on Education The Partners Investing in Nursing's Future program, a collaborative initiative of the Robert Wood Johnson Foundation and the Northwest Health Foundation

109 VCU Health System Transitional Care Programs Highlighted by the Center for Championing Nursing. Lauren Goodloe, PhD, RN, NEA-BC

110  Virginia University – Geriatric Services Division: Focus on successful transition, prevention of readmissions and management of highly complex patients:  Multiple Programs incorporating extensive use of NPs as equal partners and leaders of the intraprofessional team.  House Calls  Transitional Care  Long Term Care  Ambulatory Care  Independence At HCommonwealth ome (CMS Demonstration Project) Model Program Highlighted By the Center for Championing Nursing/AARP: Pat Polansky & Jen Cooper

111 Workforce Data Nina Beaman, PhD, MS, RN-BC (PMH), RNC-AWHC and Richardean Benjamin, PhD, MSN, MPH, RN Co-Leads

112 Improve data collection and information infrastructure Develop and implement specific geographical demand models for nursing and other health professionals Workforce Data Objective

113 Conducted briefings:  Components of minimum data sets  Results of recent Nurse Licensure Survey  HRSA plans to discontinue RN Sample Survey  Created a matrix of supply and demand data to inform members about available data and sources on the workforce  Discussed advantages and disadvantages of data collection and reporting methods Progress

114 WHITE PAPER  Completed comprehensive white paper- Addressing Nursing Workforce Issues in the Commonwealth of Virginia  Finalized  In distribution Progress

115  Continue participation on DHP Healthcare Workforce Data Center  Participation and dissemination of information from the VA Workforce Development Authority to inform AC workgroups  VHHA Workforce Development Progress

116 Next Steps  Serve as data experts to other workgroups  Assist VAC with compiling necessary statistics for any grant proposals

117 Interdisciplinary/Team Based Care Delivery Sallie Eissler, MSN, CPNP, RN and Patti McCue Sc.D., RN, MSN, NEA-BC Co-Leads

118 Develop and deploy best practices in team/inter professional models that promote nurses and other health care professionals in all settings to practice according to their level of education and licensure to improve and transform health care to patients, families and communities Objective

119  Kickoff session hosted by Centra in Lynchburg – September 2011  Facilitated by Pamela Cipriano, PhD, RN, NEA-BC  Diverse group of participants including nurses, physicians, chaplains, pharmacists & nurse practitioners  Presentations: Centra ED model & NP Single Provider model  Two small workgroups: ambulatory and inpatient services Progress

120  Commitment from MSV, VHHA, VphA and VNA has been solidified to support the development of a curriculum to educate current healthcare professionals on practicing in team based care delivery models  Develop a fundraising strategy to provide on-going financial support for a new leadership institute focused on preparing physician and nurse leaders to engage in and promote inter professional collaboration and team based care delivery models  Grant request submitted to The Physicians Foundation to fund a pilot in 2013 Next Steps

121  Identify 4 models in VA  PACE  Education – interprofessional  Define champions in the models  Ambulatory and inpatient  Identify pilot potentials  Identify transitions for education to practice across settings Next Steps

122 Finance Committee Nina Beaman, Ed.D, MS, RN-BC (PMH), RNC-AWHC and Amy M. Walker, MS, RN, CPHQ, FACHE, NEA-BC Co-Leads

123  The Virginia Action Coalition does not receive funding or financial support through RWJF or AARP.  VNA/VNF must raise at least $50,000 each year for the support of VAC workgroups and volunteers.  Public relations/fundraising campaign conducted May to coincide with Nurses Week 2012 (May 6-12)  Campaign - “Give $5 for Nursing” - Continuing the work of Florence Nightingale and Nancy Vance raised about $8000 in 30 days  Small-scale promotion– , VNA Voice, VNT, website Initial Fundraising Campaign

124  July 30 Strategic Planning Session – Fundraising Workshop  Finance Committee began as a result of this workshop  Developed marketing one-sheet  Conversion foundations –VAC members who have connections will solicit funds  Developing long-term fundraising initiative Finance Committee

125 Planning, Promotion and Outreach

126  Next steps  Workgroups continue work – monthly conference  Co-Lead Meetings face to face February 7, 2012  April 9, 2012  June 1, 2012  July 30, 2012  November 5, 2012  Over 200 volunteers engaged  Funding strategy – RWJF Grants Meeting Dates

127  VNA Education Day – September 29, 2012  The Jefferson  Keynote - Dr. Linda Aiken, PhD, FAAN, FRCN, RN  Collaborative sponsorship  VONEL  VNA  VMC Virginia Action Coalition

128  Gala – September 29, The Jefferson Hotel  Honoring and celebrating the VAC  Honorary Chair – Bill Hazel, M.D., Virginia Secretary of Health & Human Services  Magnet Awards  Nancy Vance  Scholarships  Friend of Nursing VNF Gala

129 Members of the Virginia Action Coalition honored for their contributions to the nursing profession at the 2012 VNF Gala

130 Pat Polansky speaks at the VNF Gala about the importance of the work of the Virginia Action Coalition.

131  Shirley Gibson, Loressa Cole, and Pat Polansky met in November 2011 with Marilyn Tavenner, Acting Administrator Centers for Medicare and Medicaid Services to review the IOM FON recommendations and discuss a role for CMS in facilitating the implementation of recommendations. Advocacy Outreach

132  Shirley Gibson and other nursing leaders met with staff from the office of Governor McDonnell, Secretary of Education Laura Fornash, and Secretary of Health and Human Resources, Bill Hazel, MD, to gain a commitment to collaborate with our statewide nursing community to further education progression.  As a part of this commitment, Secretary Fornash spoke at VNA’s Annual Meeting on September 28, 2012 Advocacy Outreach

133  Sue Hassmiller visited the VAC on July 30, 2012 and facilitated a strategic planning session  Pat Polansky and Jennifer Cooper of the Center to Champion Nursing in America held a planning session with VAC leadership on November 5, 2012 Outreach with CCNA and RWFJ

134  The Leadership Workgroup presented the results of their Nursing Leadership Survey to over 300 attendees at VNA’s Education Day  The poster will also be on display at VNA’s Annual Nurses Day at the General Assembly, attended by nurses and nursing students. Research Presentation

135 RWJF Human Capital Blog

136 Virginia Nurses Today



139  VAC promotion and marketing needs will be a major part of the 2013 Strategic Communications plan.  Social media development  Dedicated VAC sections in quarterly VNT and biweekly VNA Voice,  Development of a stand-alone sister website hosted by VNA for VAC  New long-term fundraising initiative built upon “Give $5” from Promotion and Marketing

140 Advancing Education Transformation Removing Barriers to Practice and Care Nursing Leadership Interprofessional Collaboration DATA Diversity

141 Engage!

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