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C O R E Commitment to On-going Regulatory Excellence.

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Presentation on theme: "C O R E Commitment to On-going Regulatory Excellence."— Presentation transcript:

1 C O R E Commitment to On-going Regulatory Excellence

2 CORE Performance Measures

3 Establishes measurable (but reasonable) goals CORE IS A PERFORMANCE MEASUREMENT SYSTEM THAT:

4 Provides feedback on whether boards of nursing in the U.S. are doing what they think they are doing

5 Creates a roadmap that others can follow for success CORE IS A PERFORMANCE MEASUREMENT SYSTEM THAT: Best Practices

6 Performance measurement is not just a tool. It is an essential element in aligning resources with priorities

7 Source: The 8th Habit by Stephen R. Covey Only 37% of employed people said they have a clear understanding of what their organization is trying to achieve and why. Only 1 in 5 workers said they have a clear line of sight between their tasks and their teams and organizations goals. If these results were applied to a soccer team, only 4 of the 11 players would know which goal is theirs.

8 Directing organizations is like flying an aircraft What are the Key Indicators? Am I going in the right direction at the right speed?

9 Rather than perception and anecdotal information CORE uses accurate measurements. Are these lines the same length?

10 Purpose To help Boards of Nursing improve their management and service delivery

11 Board of Nursing Roles Licensure Discipline Practice Education Governance

12 Stages in Model INPUTS PROCESS/ ACTIVITIES OUTPUTS INTERMEDIATE OUTCOME OUTCOMESBOARD ROLEIMPACT Definition What resources we invest Actions taken to achieve the desired outcomes Measurable products of a programs activities An outcome that is expected to lead to a desired end but is not an end in itself Benefits to stakeholders, communities, systems, or organizations Functions of the Board of Nursing Are we achieving the right results? Examples Time Staff Money Partners Equipment Space Materials Technology Train Facilitate Meetings Workshops Plans Policy Training Skills Awareness Knowledge Attitudes Opinions Motivations Behavior Practice Decision Making Policies Social Action Licensure Discipline Education Practice Governance Improved well- being for people Sample Money Staff Partners Technology Train investigators Investigate complaints Negotiate consequences Process reports of misconduct or incompetent practice in a timely manner Guidelines for conduct and practice Nurses are held accountable for safe and competent practice Discipline To safeguard the publics health and well-being by providing guidance for and regulation of, entry into the profession, nursing education, and continuing safe practice Metrics Number of monitors Number of investigators Time from receipt of complaint to disposition of complaint Length of time to complete a case Recidivism Logic Model

13 CORE Data collected from boards of nursing and multiple stakeholder groups 1.Boards of Nursing 2.Nurses 3.Educational programs 4.Employers

14 1.9 Nurses and Employers Perception of the Boards Effectiveness in Protecting the Public Very Effective Ineffective Very Ineffective Very Effective Ineffective Effective Very Ineffective 4 3 2 1 4 3 2 1

15 Nurses and Employers Knowledge of How to Report a Suspected Violation of Nursing Statute and Rules 2007 NursesEmployers Percent who say they know how to report violation 64.5%95.2%

16 Nurses Satisfaction with the Licensure Process 2.35 Dissatisfied Very Dissatisfied Satisfied Very Satisfied

17 Nurses Satisfaction with the Renewal Process 2.36 Dissatisfied Very Dissatisfied Satisfied Very Satisfied

18 Method Last Used to Obtain/Renew License 2007 Mail39.2% On-line for entire process36.4% Printed application from Board Web site and mailed/faxed in 10.3% Other9.8% Walk-in4.3%

19 Method Used by Employers to Verify Licenses 2007 Web-based verification system79% Phone – automated system15% Call-in13% E-mail12% Nursys11% Letter5% Fax3%

20 Ratings of Existing Statutes and Administrative Rules and Regulations


22 Using Information from CORE Used the information to support purchasing a new $240,000 phone system - the prior number one dissatisfier/challenge from those surveyed in the state

23 Comparisons Aggregate State Size (Number of Licensees) Umbrella and Independent

24 YearAggregate A Board of Nursing Variance 2007$48.80$38.91 20% Below Avg. Estimated Cost Per Licensee Board vs. Aggregate

25 Variable 200220052007 Value Expenses per licensee (total budget divided by number of nurse licensees) $36.42$37.89$38.91 Estimated Cost Per Licensee Board Results Across Time

26 Year Independent Boards Avg. A Board of Nursing Variance 2007$48.30$38.91 20% Below Avg. Estimated Cost Per Licensee Board vs. Other Independent Boards

27 Year Boards with Between 50,000 to 99,999 Licensees A Board of Nursing Variance 2007$48.89$38.91 20% Below Avg. Estimated Cost Per Licensee Board vs. Boards of Similar Size

28 PERCENTAGE OF EXPENDITURES BY FUNCTIONAL AREA AggregateA Board of Nursing Investigations/discipline 33%51% Licensure 19% 5% Educational Programs 7% 12% Other Indirect Expenses 36%

29 2007 Aggregate Average A Board of Nursing Variance Days Months 228 7.6 months 218 7.3 months About 10 days below avg. Estimated Days & Months to Resolve A Case

30 Percentage of Cases Completed in the Last Year AggregateA Board of Nursing 66%61%

31 Employers Perceptions of New Graduates Preparedness by Function Scale: 4 = very well prepared; 3 = well prepared; 2 = poorly prepared; 1 = very poorly prepared Aggregate A Board of Nursing Administer medication by common routes2.882.97 Recognize abnormal physical findings2.752.56 Communicate relevant information2.752.59 Assess the effectiveness of treatments2.692.54 Teach patients2.692.61 Work with machinery used for patient care2.672.56 Work effectively within a health care team2.672.69 Respond to emergency situations2.632.32 Do math necessary for medication administration2.632.65 Perform thorough physical assessments2.562.61 Create a plan of care for patients2.52.64 Perform psychomotor skills2.472.43 Recognize abnormal diagnostic lab findings2.442.47 Supervise care provided by others2.362.15

32 RN Perception of Education Program Preparation

33 RN Perceived Preparation for Practice by Years of Licensure

34 Perception of Board Functions by Nursing Education Programs Scale: 4 = adequate; 3 = somewhat adequate; 2 = somewhat inadequate; 1 = inadequate 200220052007 Time spent on site during visit3.91 3.70 3.95 Time given to correct deficiencies3.90 3.80 3.94 Preparation time for Board visits3.82 3.80 3.94 Interval between Board visits3.67 3.90 3.89 Overall benefit of approval process3.90 3.80 3.84 Communication with Board staff3.92 3.60 3.84 Timeliness of providing feedback3.91 3.80 3.79 Feedback/evaluation provided by Board3.91 3.70 3.79 Due process for disagreements re. findings3.89 3.56 3.75 Comprehensiveness of feedback provided3.91 4.00 3.74 Fairness in monitoring compliance3.89 3.90 3.72 Fairness/objectivity of Board findings3.91 3.90 3.63

35 2007 Aggregate A Board of Nursing Received Sanctions or Faced Closure 11.3%12.6% Percentage of nursing programs that received sanctions, faced closure, or been the subject of additional monitoring in the last 2 years

36 Education Program Investigation How well Board kept them informed 20052007Improvement Nationally3.413.470.06 State2.503.801.30 Assistance provided by Board staff 20052007Improvement Nationally3.85 0 State3.853.880.03 Scale: 4 = very well informed; 3 = well informed; 2 = minimally informed; 1 = not informed at all) (Scale: 4 = consistently helpful; 3 = occasionally helpful; 2 = rarely;1 = not helpful at all)

37 Education Program Investigation Process Fairness of Investigation Process 20052007Change Nationally3.543.620.08 State3.003.800.8 Appropriateness of Outcome 20052007Change Nationally95% 0 State100% 0 Timeliness of Investigation Process 20052007Change Nationally93.8%92.3%-0.015 State100% 0 (Scale: 4 = very fair;3 = fair; 2 = unfair; 1 = very unfair)

38 Education unit has improved on most parameters Need to ascertain why fairness/objectivity perception decreased Continue to communicate frequently and timely with programs Explore ways to assist programs achieve excellence Conclusions/Future Actions

39 Action Plan Administration, Curricula, and Program Evaluation Plan

40 Please rate your Board of Nursings review process in the following program areas. (Scale: 4 = very effective; 3 = somewhat effective; 2 = ineffective; 1 = not effective at all) 2005 2007 Program AreanRatingn Administration5413.701,2223.79 Curricula5423.671,2243.76 Clinical facilities5263.581,1923.74 Classroom/lab5193.481,1873.75 Student/faculty policy5343.601,2003.76 Program Evaluation Plan 4973.461,2093.74 Please rate your Board of Nursings review process in the following program areas. (Scale: 4 = very effective; 3 = somewhat effective; 2 = ineffective; 1 = not effective at all) 2005 2007 Program AreaRating Administration 2.99 2.43 Curricula 3.21 2.86 Clinical facilities3.00 Classroom/lab2.86 Student/faculty policy 2.86 Program Evaluation Plan 3.11 2.41 +0.4 +.86 +.83 Goal: Be within 0.5 of the aggregate rating

41 Ineffective Somewhat Very Effective Effective 20072009

42 Compare 2007 and 2009 data (from the 2010 report) to determine if goals were met 1.Did response rate for education programs increase by 34%? 2.Did the ratings for administration and curricular requirements increase to within 0.5 of the aggregate results? 3.Did the rating for program evaluation plan requirements increase to with 0.5 of the aggregate results?

43 Were Your Goals Met? NoDiscuss results with stakeholders and get ideas for improvement and revise action plan YesMove on to other results of concern, but continue to monitor these results

44 STRATEGIC GOAL: TO FACILITATE INFORMATION EXCHANGE BETWEEN THE BOARD AND ITS CONSTITUENTS Objective: Effective communication with the public, including licensees, employers, policy makers, consumers Performance Measure: If CORE findings indicate positive communications with constituents Incorporate into Strategic Plan

45 Interview boards in the upper 10% of respondents to determine what it is they do to get better results


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