1. Institute of Medicine (IOM) Report & Affect on Nursing Donna Lester, ACNP-BC PCAPNA President

2. Committee Members  Led by Donna Shalala  17 members  IOM provides independent, objective, evidence based advice to policy makers, health professional, the private sector and public.  www.iom.edu

3. Four Key Messages:

4. Eliminate Practice Barriers:  Practice to full extent of their education and training  NP, CNS, CRNA & Midwives  State regulations vary practice  Federal Trade Commission  Residency Programs for new grads  High Turnover Rate among new nurses

5. APN Success Stories:  Veterans Health Administration  Geisinger Health System  Kaiser Permanente  Indian Affairs  CDC  HRSA  Red Cross

6. Research on Practice  Compare cost, quality outcomes and access with a range of primary care models  Examine impact of expanding range of providers to certify patient for Admission, HHC, SNF or Hospice  Capture reimbursement consequences of APN, MD or other

7. Practice (cont.)  Explore payment reform for NP, PA and teams  Residency programs and reallocating funds for training

8. Improve Nursing Education  Competencies to deliver high quality care  Leadership  Policy  System Improvement  Evidence based practice  Teamwork/Collaboration  Public Health/Community

9. Research on Education  Identify combination of salary, benefit and job attributes to recruit and retain highly qualified faculty  Analyze faculty to student ratio and affect on knowledge  Identify if online is beneficial  Identify and evaluate programs

10. Nurses as Partners  Involved in the Redesign efforts as leaders and collaborators.  Take Responsibility  Identify problems  Devise improvement plan  Track progress  Adjust  Professional growth

11. Transitional Care Model  Saw barriers to provide care to the chronically ill

12. Effective Workforce Planning  Better data collection  Affordable Care Act  Create National Health Care Workforce Commission  Gauge the demands and analyze needs  Devise a way to meet the needs in all areas of specialty and in states

13. Conclusion  Nurses play a fundamental role  Power lies with:  Government  Businesses  Health Care Organizations  Insurance companies  Professional organizations