April 25, 2013 Southwest Regional Action Coalition

SWPA Action Coalition Inaugural Meeting Hosted at the Jewish Healthcare Foundation Reviewed mission statement, IOM report, PA top priorities, and immediate goals Group brainstorming related to immediate goals

CENTER TO CHAMPION NURSING IN AMERICA CAMPAIGN VISION All Americans have access to high-quality, patient-centered care in a health care system where nurses contribute as essential partners in achieving success

Mission Statement To bring together a diverse group of health care organizations, businesses, and academic institutions to develop an action plan to improve the health care of Pennsylvania Citizens by increasing access to, value and quality of care. Steering Committee – Strategic Plan

IOM Recommendations 1.Remove scope of practice barriers. 2. Expand opportunities for nurses to lead and diffuse collaborative improvement efforts. 3. Implement nurse residency programs. 4. Increase the proportion of nurses with a baccalaureate degree to 80% by Double the number of nurses with a doctorate by Ensure that nurses engage in lifelong learning. 7. Prepare and enable nurses to lead change to advance health. 8. Build an infrastructure for the collection and analysis of inter-professional health care workforce data.

Top Priority IOM Recommendations in Pennsylvania 1.Increase the proportion of nurses with a baccalaureate degree to 80% by Double the number of nurses with a doctorate by Prepare and enable nurses to lead change to advance health. 4. Build an infrastructure for the collection and analysis of inter-professional health care workforce data. 5. Implement nurse residency programs.

Increase the number of nurses with a baccalaureate degree to 80% by 2020 Double the number of nurses with doctorates by 2020 Build an infrastructure for the collection and analysis of inter-professional health care workforce data Immediate Goals Grant Submitted 2012

5 Common Themes Accessibility of RN- BSN and Doctoral Programs Residency Programs The Need for Workforce Data Importance of Leadership & Professional Image The Value of the BSN & Different Models

BSN Predictive Model

Forecast the Future State Set the Standard to Meet the Goal Policy Changes Outreach to support collaborative decision making. Communicate often and listen to stakeholders. Adapted from Deborah T. Zimmermann, DNP, RN, NEA-BC Chief Nursing Officer and Vice President, Patient Care Services VCU Health System, Richmond, VA Office: Summary of Virginia Commonwealth University Health System (VCUHS) Recommendations :

1.Measure recruitment of BSN nurses and non- BSN Experienced and Newly Licensed 2.Measure turnover of BSN nurses and non-BSN Retirement, Voluntary and Involuntary 3.Identify nurses with anticipated graduation with BSN annually 4.Project planned growth in nursing (BSN/non-BSN) 5. Analyze the gaps See simulation model STRATEGY 1 – VCUHS Forecast the Future State 11

EXAMPLE: Virginia Commonwealth University Medical Center Forecasting Results 12

Strategy 2 – VCUHS Education Progression Standard 13 Effective January, 2012, ALL new hires without BSN sign an agreement to: 1.Enroll in an RN-BSN or RN- MSN accredited program within 24 months of hire. 2.Graduate from an RN-BSN program within 5 years of hire Letter of Hire: “ As a [Diploma prepared nurse; Associate 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-BSN program within 24 months of your hire date (no later than mm/dd/yyyy); and successfully obtain your BSN no later than 5 years or 60 months from your hire date (mm/dd/yyyy)). Employee tuition assistance benefits may be available to assist you in achieving this expectation after you have successfully been employed for 12-months in a continuous benefit-eligible role. Failure to enroll in the RN-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 at VCUHS.

New RNs Hired: Must be a graduate of an accredited school of nursing. Nursing Workforce: Nurses hired before January 1, 2012 are grandfathered and encouraged but not required to achieve RN-BSN credential. Tuition Reimbursement: Only accredited programs. Contracts: Only accredited schools eligible for clinical experiences in the health system. Strategy 3 – VCUHS Policy Changes 14

Survey of schools, CNO’s, nurses and students conducted Magnet Consortium CNO’s leading Virginia Commonwealth Education Action Coalition and collaboration with academia Analyze input from regional stakeholders including the state board of nursing Strategy 4 – VCUHS Collaboration in Decision Making 15

Strategy 5 – VCUHS Communicate and Listen Often Nursing leadership team open discussions with staff Open blog for comments among consortium members Shared information, education and support for decision making Leveraged support – leverage support of CEOs, University Presidents and Deans, and others

Current State Implementation Grant Initiatives and Nursing Education Survey Initial Report Christine Alichnie PhD, RN President, PSNA ( Nurse Co-Lead Organization) April 25, 2013

Current Coalition Initiatives: State Implementation Program RWJF Award Establishment of a Nursing Diversity Council Collection of data on Academic Progression Mechanisms in place for seamless progression from diploma or associate degree programs to baccalaureate degree programs Collection of data on Nursing Workforce, including diversity indicators Advisors to promote Best Practices on Articulation Mechanisms Get the Message Out! Campaign

Nursing Diversity Council Guidance and Advice on Matters Related to Identification of barriers faced by racial/ethnic and male students to enrollment in pre-licensure baccalaureate nursing programs; Identification of barriers faced by racial/ethnic and male registered nurses to enrollment in baccalaureate nursing programs; Short- and long-term strategies to increase enrollment of racial/ethnic and male students in pre-licensure baccalaureate nursing programs; Short- and long-term strategies to increase enrollment of racial/ethnic and male registered nurses in baccalaureate nursing programs; and

Nursing Education Survey: Cooperative Venture with PCANE Current status of nursing education programs in Pennsylvania – need for faculty—Preliminary Report of Survey Findings to be submitted to PCANE on Current status of articulation mechanisms in place in Pennsylvania’s nursing programs: – Articulation Agreements – Dual Admission Agreements Current status of doctoral programs in Pennsylvania, both PhD in Nursing and Doctorate of Nursing Practice

Nursing Education Survey: Initial Report April 19, 2013 Respondents: – 66.66% of Practical Nursing Programs (N = 46)* – 100% Diploma Schools of Nursing (N = 19) – 96.15% Associate Degree Nursing Programs (N = 25) – 100% Baccalaureate and Higher Degree Nursing Programs (N = 41) Findings: – The majority of diploma, associate degree, and baccalaureate degree programs reported an adequate number of nursing faculty to support their anticipated enrollments in AY – The majority of diploma, associate degree, and baccalaureate degree programs reported that they do not currently reject qualified applicants due to an inadequate number of nursing faculty *PN Program data currently being coded and analyzed.

Nursing Education Survey: Initial Report April 19, 2013 Findings: – 84.21% (16) of all diploma programs report Articulation Agreements with a total of 14 baccalaureate programs – 47.37% (9) of all diploma programs report Dual Admission Agreements with a total of 10 baccalaureate programs – 26.32% (5) of all diploma programs report RN-to-MSN Agreements with four baccalaureate programs – 96% (24) of ADN programs report Articulation Agreements with a total of 32 baccalaureate programs – 48% (12) of ADN programs report Dual Admission Agreements with a total of 9 baccalaureate programs

Nursing Education Survey: Initial Report April 19, 2013 Seven PhD in Nursing Programs and 14 Clinical Doctoral Programs (DNP) More FT students in PhD programs than in DNP programs; more grant funding available to PhD than to DNP students All PhD and DNP programs accept PT students; all programs have students who pay tuition Majority (387; 75.88%) of DNP students attend PT; 155 (55.55%) of PhD students attend PT PhD programs offer teaching assistantships and grant funding for tuition and stipend

Nursing Education Survey: Initial Report April 19, 2013 Reasons for limitation to expansion of PhD programs include: lack of qualified faculty; lack of institutional resources; inadequate pool of both qualified faculty and qualified applicants Reasons for limitation to expansion of DNP programs include: poor faculty salaries, lack of faculty practice plans, competition among programs in the region for faculty, inadequate clinical preceptors, and high workload Note: Findings reported are based on responses from six PhD programs and fourteen DNP programs.

Nurse Residency Programs Pennsylvania Action Coalition and the Pennsylvania Coalition for the Advancement of Nursing Education Pre-Licensure Residency Advanced Practice Nurse Residency PACNP Partnership

Diversity in Nursing Workforce Collection of data on nursing workforce, including diversity indicators Advisors to promote Best Practices on Articulation Mechanisms Get the Message Out! Campaign

Thank you!

Breakout Sessions

Questions and Comments Thank you!