1. Nurse Support Program II
Technical Assistance Meeting
December 5, 2016
Peg Daw, DNP, RN-BC, CNE
Oscar Ibarra, MS, BS

2. Nurse Support Program Nurse Support Program I- CNO’s -hospitals
Next Evaluation Due: 2017
Nurse Support Program II-
Deans/Directors- schools of nursing
Next Evaluation Due: 2020
Common Goals
Common Funding Mechanism
Common Focus on Registered Nurses

3. Modernization of the Waiver
State’s Unique All-Payer Approach & National ACA Challenges:
Align payment incentives across multiple payers. Maryland’s all payer system can be a laboratory for rapid innovation in delivery system reform.
Implementing this model in a State with 5.8 million people living in urban, suburban, and rural settings will test these reforms in many different environments
CMS and Maryland have a strong shared interest in the success of this model. If it proves successful, everyone benefits from improved health at lower cost and the experience will offer important proof of concept for other states.
If it’s unsuccessful, Maryland will transition to the national Medicare hospital-payment system over the course of 2 years- abandoning an approach to hospital financing that has served the state well for more than 3 decades (Rajkumar, et al., 2014)

4. HSCRC Incentives
Designed to support the waiver goal of reducing Medicare READMISSIONS, but applied to all-payers.
Revised payment adjustment structure to recognize the better of improvement or attainment
9.5% minimum improvement target
Scaled penalties up to 2% and rewards up to 1%.
CMS expects to save $300 Million over 5 year test period.
HSCRC-$251 Million cumulative saved to date.
27 hospitals on track to meet 9.5% reduction
(Performance Measurement Workgroup, HSCRC, Oct, 2016)

5. SB 108-”bedside”deleted
Introduced during the 2016 Maryland legislative session with the purpose of deleting the term “bedside” from the descriptor of nurses in the statutory provision establishing the NSP II
Instead of focusing on “bedside” nurses, SB 108 allows the NSP II to improve the pipeline of nurses with the skills necessary to keep pace with the rapidly changing health care delivery system. It was passed by both the Maryland Senate and the House and approved by the Governor on April 26, 2016.
RFA pg. 5
We are currently reviewing and revising websites, webpages, and related information that uses “bedside” nurse to remove the descriptor.

6. RN-Shortages by 2025 STATE 2012 Supply and Demand 2025 Projected
Difference
Maryland
60,600
72,000
59,900
-12,000
West Virginia
20,600
21,100
29,000
+7,900
Delaware
10,600
12,500
16,200
+3,700
Virginia
69,900
87,300
106,700
+19,400
Pennsylvania
145,000
152,600
178,400
+25,800 US
2,897,000
3,509,000
3,849,000
+340,000
(HRSA, 2014)
Consider how we may capture geographic RN movements. Do the RNs we educate in Maryland remain in MD? How can we validate the %?

7. The Shift
The nation’s nursing workforce has reached a critical tipping point. By 2012, more nurses (53 percent) were earning four-year baccalaureate than two-year associate degrees (47 percent). The percentages were mirror images of each other a decade earlier; in 2002, 55 percent of nurses earned an ADN and 45 percent earned a BSN. A strong driver of the change is an explosion of accelerated Registered Nurse (RN)-to-BSN nurse education programs, which enable RNs and nursing students to earn bachelor’s degrees in shorter time periods than do traditional four-year BSN programs. ( Aurbach, Buerhaus, Staiger, 2016)

8. Workforce Study- 2016
After an unprecedented increase in nursing school enrollment and graduates in the past 10 years, projected shortages of nurses have been erased at a national level. However, nursing markets are local, and an uneven distribution of health care providers of all types is a longstanding feature of health care in the United States.
The study was written by Peter Buerhaus, David I. Auerbach, and Douglas O. Staiger. Researchers obtained data from the Integrated Postsecondary Education Data System (IPEDS), a system of surveys conducted annually by the U.S. Department of Education. It does not distinguish between BSNs earned as initial degrees from BSNs earned as second degrees. (*****critical information for nursing leadership & workforce plans)

9. Geographical Differences
Buerhaus and colleagues project greatest need for RNs in East South Central & West South Central. He projects zero growth on New England and Pacific regions between 2015 and Population varies- 15 mil for New England to 63 mil in South Atlantic. Forecast -0- growth in Pacific & New England, to 2.9% in South Atlantic, to 40% growth RNs in East and West South Central. Is 2.9% enough for MD? 2262/ yr……x 4 yrs = 9048 and we need 23,707 by 2020 or at least 1200 more per year to meet the projected HRSA shortage.

10. FY 2018 RFA NSP II Competitive Institutional Grants
RFA Released October 11, 2016
Technical Assistance October 31, 2016
Project Director’s TA Mtg. December 5, 2016
PROPOSALS DUE January 27, 2017
HSCRC Draft April 12, 2017
HSCRC Final Approvals May 10, 2017
FY 2018 Projects Begin July 1, 2017

11. Registered Nurses 78,174 active RN’s in Maryland
38,188 active RN’s with BSN 
Percent of active RNs with BSN = 48.85%  
Compared to nationwide= 51%
GOAL: 80% by 2020
RNs with Doctoral degrees in Maryland
   
796  employed in nursing, 9 employed outside of nursing=
805 total  (represents 1% of all active RN licenses in state)
Is our GOAL: 2% by 2020
(MBON, MDAC, June, 2016)

12. MHEC Data-BSNs-needed: 23,707 by 2020
To get to 80% BSN by yrs- 78,174 (total)- 805 (doctoral) = 77,369 / 80%= 61, ,188 (current BSN ) = 23,707 BSN Target/GOAL by 2020 Right at 1100 are NEW BSNs, and 500 are RN-BSN completions. We need to TRIPLE our efforts.

13. NCLEX-RN BSN 1158 957 82.64% MSN Entry 44 37 84.09%
First Time Testers Number Passing Pass Rate
BSN %
MSN Entry %
ADN 1, , %
All MD RN 2, , %
All U.S. RN 161, , %
Required Passing Rate Maryland RN SON 75.55%
Notice from MBON of 4 nursing programs at risk of closing if pass rates do not improve- one program has already closed in last year. Within this framework, the NSP II recommends schools operating with “conditional approval” consider submitting focused resource grants for agreed upon action plans between their program and the MBON.

14. MHEC Data- Doctorates- needed: 700 by 2020
2016 to 2020= 4 yrs At 71/ yr, we will make half our goal. How can we double the graduates in MD? NSP II supports faculty completing degrees in out of state schools- with NEDG or NNFF funds. We project funding support for 80 over the next 4 yrs, but that leaves us a 3 yr gap- or need for~~~ 200 additional PHD/DNP grads

15. APIN beyond the BSN BSN to PhD MSN to PhD DNP to PhD
Idea for NSP II proposal: Academic progression in nursing from DNP to PhD
Example in another state---required DNP to PhD coursework is as follows:
NURSING CORE COURSES (6 SEMESTER HOURS) Curriculum Evaluation in Nursing Education Evaluation in Nursing
RESEARCH CORE COURSES (15 SEMESTER HOURS) Statistical Methods II Quantitative Research Qualitative Research Research Seminar I Research Seminar II
DISSERTATION (12 SEMESTER HOURS)
Dissertation Seminar Dissertation

16. MONL Workforce Survey Survey of CNOs representing 32 MD hospitals:
Top 3 RN needs: Emergency (71%), ▫ Critical Care (68%) and ▫ Operating Room/Perioperative ( 58%)
Most difficult nursing roles to fill were:
▫ Nurse Manager (63%)
▫ Director ( 50%)
▫ Nursing Professional Development Specialist (hospital based nurse educator) (47%)
▫ Experienced clinical bedside nurses (34% )
(Warren,2014)

17. Initiatives FY 2015-2020 Type of Competitive Grant Initiative:
☐1. Initiative to Increase Nursing Pre-Licensure Enrollments and Graduates
☐2. Initiative to Advance the Education of Students and RNs to BSN, MSN, and Doctoral Level
☐3. Initiative to Increase the Number of Doctoral prepared Nursing Faculty
☐4. Initiative to Build Collaborations between Education and Practice (new nursing roles-pt. care continuum)
☐5. Initiative to Increase Capacity Statewide
RFA Pg. 25

18. American Academy of Nurses

19. Maryland RNs in US model
Care Coordination and Transition Management
Reductions in Hospital Readmissions
Creation of Practice Transformation Networks
State Innovation Models ( Modernization of Waiver)
Focus on Quality
Savings, Risk and Quality Incentives ( Global Budgets- Reducing Agency RN costs)
Social Impact Bonds- Population Health

20. Care Coordination
Facilitate collaborative relationships among providers, patient advocates, public health agencies, faith-based initiatives and others with a particular focus on resource planning, resource coordination, and training
Opportunities for Maryland to invest in Care Coordination Opportunities

21. Faith Community RNs
Faith Communities are more readily becoming partners in health care. Faith Community Nursing is a specialty practice in nursing, recognized by the ANA, with a specific focus on health education, care coordination, referral to community resources, care navigation, and integration of faith and health. ANCC Certification in 2014
1. Meritus Medical Center, Hagerstown
2. Holy Cross Hospital, Silver Spring
3. Adventist Healthcare, Gaithersburg
4. Good Samaritan Hospital, Baltimore
5. Western Maryland Health System, Cumberland

22. Care Coordination & FCNs
THINK OUTSIDE THE BOX for Nursing Solutions to meet identified hospital needs
RNs
Are familiar with motivational and empowering techniques to encourage lifestyle change
yes
Routinely train and utilize volunteers
Are muti-disciplinary and interdisciplinary team members
Understand the concept of holistic health functioning
Are familiar with, and able to implement, community and public health nursing concepts and practices
Are accessible (long-term), approachable, professional, good communicators, and culturally sensitive
Coordinate, implement, and sustain ongoing care activities
Are available to consult and train additional FCNs in Maryland

23. Scope/Standards/Certs
The standards include the first statement of the scope and standards of practice for professional nurses in a relatively new role, care coordination and/or transition management (CCTM).
Ambulatory Care Nursing (ANCC cert)
CCTM ( AAACN cert)
CCTMC ( Med Surg cert)
While the activities of these roles in current times have been evolving over the past twenty five years, there has never been formal identification, specification and/or publication of the scope and standards of practice.  (AAACN, 2016)

24. Chronically ill but under control
Core Approach= Hospitals + SONs
Patient Characteristics
Caregiver Characteristics
High system use—frequent hospitalizations and ED use
Frail elderly, poly-chronic, urban poor
Psychosocial and socioeconomic barriers
Care coordinators (RNs)
Address psychosocial and non-clinical barriers
Community resource navigation
Intensive transition planning
Frequent one-on-one interaction
Chronically ill but under control
Healthy
High need/
complex
Chronically ill but at high risk to be high need
More limited stable chronic conditions
At risk for procedures
Reduce practice variation
Systematic outcomes- oriented care
Scalable team-based coordinated care
Chronic care management
Healthy
Minor health issues
Focused coordination and prevention
Movement toward virtual, mobile, anytime access
Convenience/access is critical
(Modified, Warren, NSP I, 2016)

25. Understanding the Mission
Only 799 of more than 3,400 IPPS hospitals across the US performed well enough in 2015 to avoid reimbursement penalties in 2016.
( Waiver= maintain % below Medicare cost reporting)
We have ~50 acute care hospitals funding NSP
Their mission- Triple AIM
Quadruple Aim- add provider’s experience

26. Leadership- Practice and Academia

27. Collaboration at Conferences

28. Diversity – our strength lies in our differences- not our similarities ( Stephen Covey)
NLI TEAM:
Morgan State University
Bowie State University
Montgomery College
University of Maryland
Presented 9/14/16:
Improving Diversity in
Education and Practice
National Association of
Minority Medical
Educators Conference

29. Clinical Simulation
Provides context to situation, clinical judgment, communication, resource management, “thinking on your feet,” teaching skills, management of emotional situations
Simulation use and identified needs are guided by Dean/Directors and Nursing faculty and educators in nursing programs
Research needed on:
Impact on competence Impact on patient care
Impact on patient safety Impact on clinical time
Utilize as clinical hours? Reduce cost at clinical sites?

30. Directions in Nursing Education
Providing more experiential learning opportunity than instruction
Academic progression models*****
Increased use of learning technology
Emphasis on outcome-based rather than process-based education
Evidence-based education strategies and curriculum

31. APIN- RWJF- Nov. 2016
Academic Progression In Nursing “We have not found a perfect model- one size does NOT fit all”

32. Faculty Directions Double the number of RNs with Doctoral Degrees
( PhD in Nursing, Doctor of Nursing Practice, EdD)
Barriers- Money and Time ( NSP II- tuition, loans,fellowships)
Certified Nurse Educators ( CNE) symbolizes excellence in education
Early career guidance- Mentorship
Dual Roles- Academia and Practice
Research on Nursing Education & Workforce Shortages

33. NSP II Grant Funds Faculty and Personnel ******
Mandatory Dissemination
Professional Development
Instructional Delivery
Curriculum Redesign
Materials and Teaching Supplies
Consultants
Technology
Evaluation

34. NSP II Project Director Presentations
10:30 am Associate to Bachelors (ATB) Model Karen Wons, CCBC
10:45 am New Care Coordination Directions Eun-Shim Nahm, UMSON
11:00 am Partnership Model for Clinical Instructors Mary Etta Mills, UMSON
Linda Hickman, UMSON
11:15 am Online APRN Preceptor Modules
Shannon Idzik, UMSON
11:30 am Cecil-Harford Academic Progression Laura Preston, Harford
Laura Schenk, Harford

35. NSP I Program Evaluation
Update- Evaluation Process
HSCRC Consultant-Joan Warren, HSCRC
Comprehensive evaluation due June 2017 for
5 year renewal of NSP I funding for hospitals
Data interpretation- outcomes evaluation underway
For more information- contact Oscar Ibarra at HSCRC

36. NSP II Project Director Presentations
12:45 pm Leadership Institute for Practice/Academia Patricia Franklin, UMSON
1:00 pm Maryland Articulation Model Revisions
Rebecca Wiseman, UMSON
1:30 pm Minority Student Success Initiatives Maija Anderson, Morgan
1:45 pm Online Inter-professional Modules/Simulations
Ibby Tanner, JHU
2:00 pm Military to ADN & ADN to BSN & Clinical Simulation Resources (MCSRC)
Monique Davis, Montgomery
Sabrina Beroz, Montgomery
2:30 pm Nursing Faculty Mentorship Louise Jenkins, UMSON

37. We need Nurse Faculty

38. We need Nurses
2. “Nurses should achieve higher levels….through an improved education system that promotes seamless academic progression….”
Education should include opportunities for seamless transition into higher degree programs—
From licensed practical nurse (LPN)/ licensed vocational nurse (LVN) diplomas;
To the associate’s (ADN) and bachelor’s (BSN) degrees;
To master’s, PhD, and doctor of nursing practice (DNP) degrees (IOM, FON, 2010)

39. LPNs- NCLEX-PN
FY 2016: July 1, 2015-June 30, 2016 *Updated* Schools of Practical Nursing First Time Testers Number Passing Passing Rate Allegany College %
Anne Arundel Community College %
Baltimore City Community College %
Carroll Community College %
Cecil Community College %
College of Southern Maryland %
Community College of Baltimore County Dundalk %
Frederick Community College %
Hagerstown Community College %
Harford Community College %
Howard Community College %
Prince Georges Community College %
Sojourner-Douglass College (closed) %
Wor-Wic Community College %
All Maryland PN Programs %
All U.S. Candidates 49, , %
Required pass rate for Maryland practical nursing schools %
Practical nurses are listed in the articulation agreement and in the IOM- they are part of the nursing workforce.

40. NSP II Faculty and Hospital Educator Programs
Hal and Jo Cohen Graduate Nurse Scholarships
(Full Tuition and Fees- Faculty or Hospital PDS)
New Nurse Faculty Fellowships
($20,000= over three years- recruit and retain faculty)
Nurse Educator Doctoral Grants for Practice and Dissertation Research ( up to $30,000 )
Maryland Clinical Simulation Resource Consortium
Leadership Institute

41. FY 2017 New Nurse Faculty 15 Nursing Programs
Nominated 53 New Nurse Faculty
All were eligible and All were funded
NNFF 89% retention
Successful program
Open to all SON Deans/ Directors

42. UHC/AACN Nurse Residency Model in IOM 2010 report
Reports reduced rates of turnover and cites cost savings to its participants. According to the UHC (2009) and AACN,28 since 2002 the program:
Saved participating organizations over $6 million per year on the costs of turnover for a first-year nurse (the cost to recruit and retain a replacement nurse was estimated at $88,000);
Increased retention rate from 87 percent in 2004 to 94 percent in 2009;
Increased stability in staffing levels, thereby reducing stress, improving morale, increasing efficiency, and promoting safety;
Achieved a return on investment of up to 14:1; and helped first-year nurses in the program achieve the following:
develop their ability in clinical decision making,
develop clinical autonomy in providing patient care,
incorporate research-based evidence into their practices, and
increase commitment to nursing as a career. ( IOM, FON, 2010)

43. Membership: 20 hospitals June 2016
Anne Arundel Medical Center
Calvert Memorial Hospital
Franklin Square Medical Center
Greater Baltimore Medical Center
Holy Cross Hospital
Johns Hopkins Bayview Medical Center
Johns Hopkins Hospital
Laurel Hospital
Mercy Medical Center
Meritus Medical Center
Northwest Hospital
Prince Georges
Shady Grove Adventist
St Agnes Hospital
Suburban Hospital
Union Hospital
University of Maryland Medical Center
University of Maryland Baltimore Washington Medical Center
University of Maryland Midtown
Washington Adventist Hospital
Washington Adventist Behavioral Health Hospital
Includes both Associate and Bachelors RN Grads
*MRNC, 2016)

44. Needed: Data and Research
Nursesupport.org - website enhancements
Documentation of project results
Dissemination of publications
Shared resources for nurses
Annual and Final Reports- Mandatory Data
Results =Met or Did Not Meet proposed outcomes
Highlighting Faculty Awards
Annual Updates on NSP II to HSCRC
Nursing Education and Workforce Research

45. MDAC- Save the Date Keynote Speaker: Susan Hassmiller, PhD, RN, FAAN
Robert Wood Johnson Foundation Senior Advisor for Nursing and
Director, Future of Nursing: Campaign for Action
Date:                           Monday, May 22, 2017
Location:                    University of Maryland School of Nursing
                                    655 W. Lombard Street
                                    Baltimore, MD  21201
Time:                          8:15 – 9:00      Registration
                                    9:00 – 4:00      Event
Theme:                       Culture of Health
Cost:                           Approximately $30/pp-includes continental breakfast & lunch

46. Grant Outcomes Final Outcomes Projected Increase
(# of Additional Graduates)
Describe Degrees/Results
Nursing Pre-Licensure Graduates __________
Nursing Higher Degrees Completed __________
Nursing Faculty at Doctoral Level __________
Collaborative or Statewide Results __________
Pg. 25 Cover Sheet

47. Types of Grants-Funds Funding Requested: _______
Value of Match (Funds, In-Kind, Etc.): _____ ***
Type of Grant:
☐Planning ( 1 yr)
☐Implementation (1-5 years)
☐Continuation (Invitation only)
☐Statewide Resources ( Share final products-pg.43)
☐New Resource Grant ( Up to $100, yr.)

48. Planning Grants
Planning projects are limited to one (1) year of funding. Special requests for no-cost extensions will be considered on a case by case basis. Planning grants award up to $150,000 for planning projects that align with the goals of the NSP II. The outcome of the planning grant will be a detailed proposal to increase the enrollment and graduation of nurses who will then practice in Maryland and/or (2) increase the supply of qualified nursing faculty required to expand the capacity of Maryland’s nursing programs.

49. Implementation Grants
NSP II Implementation grants are available for projects that will (1) increase the enrollment and graduation of nurses who will then practice in Maryland hospitals and/or (2) increase the supply of qualified nursing faculty required to expand the capacity of Maryland’s nursing programs. Implementation grants have no maximum grant award amounts. However, the budget must be justified by the scope and outcomes of the project. Grants will be funded for a period of one (1) to five (5) years. Produce graduates and fit initiatives
RFA pg. 7

50. Continuation Grants
NSP II Continuation Grants are available for successful grant projects that are recommended for funding beyond the initial grant period to expand on models or programs that have potential for greater impact with additional funding. Continuation grants are only available for projects invited to apply.
Invitations to continue will be sent out in the last year of the grant. If a continuation is not recommended, you may still reapply for similar programs if desired.

51. New 1 yr.-Resource Grants
Statewide resource grants award up to $100,000 for small projects that align with the goals of the NSP II but would not qualify as implementation or planning grants. Initiatives that qualify under this program are short-term (up to 12 months) in nature. These grants support a wide-range of eligible expenditures. Proposed expenditures that (1) add overall value to the nursing program, (2) lack alternative funding sources, and (3) are not considered ineligible expenses
RFA pg. 8

52. Statewide Capacity
The NSP II policy is to ensure intellectual property developed in the course of or under this grant to increase statewide capacity furthers the goals of the NSP II and benefits the nursing profession in Maryland. This policy applies to all grants awarded funding under Initiative 5, Initiatives to Increase Capacity Statewide as identified on the cover sheet of the grant proposal. The NSP II Intellectual Property Policy is as follows:
By accepting these grant funds, the grantee agrees that:
a. The grantee shall deliver a complete, functioning version or copy of the final products developed under the Grant to the Health Services Cost Review Commission (HSCRC) and Maryland Higher Education Commission (MHEC).

53. What should you think about first?
Future funding is determined by program outcomes.
Insert Initiatives
Insert Outcomes Table
FOCUS- address nursing program needs and intended outcomes in the first two pages of the proposal.
*** MBON NCLEX-RN pass rates below state levels or CCNE/ACEN Accreditation review concerns come first.

54. Grant Title and Requestors
Lead Applicant Institution/Organization:
School of Nursing at____________
Project Title:
Brief & Descriptive
Partnership Members: ****
This is an important aspect of a fully funded proposal.

55. Evaluation Criteria Criteria Maximum Points Abstract 5 Overview 10
Project Goals and Objectives 15
Scope of Proposed Initiative 15
Management Plan 15
Evaluation Plan 15
Sustainability Plan 5
Budget and Cost Effectiveness 20
Total

56. Application Budget Summary
Budget Guidance
Application Budget Summary
Budget Pointers
Accuracy: Check and Double Check Figures
Fringe Benefits: Ensure the Cost Allocated for Fringe Benefits is Reasonable
Budget Narrative: Ensure Budget and Budget Narrative Match

57. Projected Outcomes Table from Cover Sheet
Annual Reporting
Changes
Projected Outcomes Table from Cover Sheet
Due Date: August 31st
Budget Summary: Actual Expenditures
Annual Report: Projected Outcomes & Dissemination Sections
Carryover: Linked to Performance

58. FY 2018- Proposals ALL PROPOSALS ARE DUE: January 27, 2017
Friday by 4 pm
Maryland Higher Education Commission
6 N. Liberty Street
Baltimore, Maryland

60. References
American Academy of Nurses, Annual Conference - New FAAN Inductees from Maryland. October , American Academy of Ambulatory Care Nursing, Scope and Standards of Practice for Registered Nurses in Care Coordination and Transition Management, Medical Surgical Nursing Certification Board,

61. References
Auerbach, D.I., Buerhaus, P.I., and Staiger, D.O. (2016). How fast will the registered nurse workforce grow through 2030? Nursing Outlook; 0,1-7.
Competitive Institutional Grants FY 2018 RFA
Cooper, J. & Zimmerman, W. The evaluation of a regional faith community network’s million heart’s program, Public Health Nursing, 33(1),
Institute of Medicine (2010) Future of Nursing Report, ch.3, pg

62. References
Performance Measurement Workgroup Meeting, October, 2016,
Opportunities for Maryland to invest in Care Coordination Opportunities
Health Services Cost Review Commission (HSCRC)
Institute of Medicine, Future of Nursing report
Maryland Higher Education Commission (MHEC)
Nurse Support Program,

63. References
Schroepfer, E. (2016). A renewed look at faith community nursing. MedSurg Nursing, 25(1),62-66.
Rajkumar, A., Murphy, K. Colmers,J., Blum, J., Conway, P. & Sharfstein, J. (2014). Maryland’s all-payer approach to delivery-system reform. New England Journal of Medicine, 370,
U.S. Department of Health and Human Services, Health Resources and Services Administration, National Center for Health Workforce Analysis.  (HRSA) The Future of the Nursing Workforce: National- and State-Level Projections, , Rockville, Maryland; 2014. 

64. Workforce Resources
Auerbach, D.I., Buerhaus, P.I., and Staiger, D.O. (2015). Will the RN workforce weather the retirement of the baby boomers?Medical Care; 53: 850–856.
Auerbach, D.I., Buerhaus, P.I., and Staiger, D.O. (2014) Registered nurses are delaying retirement, a shift that has contributed to recent growth in the nurse workforce. Health Affairs; 33: 1474–1480.
Auerbach, D.I., Buerhaus, P.I., and Staiger, D.O. (2007)Better late than never: Workforce supply implications of later entry into nursing. Health Affairs; 26: 178–185.
Auerbach, D.I., Staiger, D.O., Muench, U., and Buerhaus, P.I. (2013)The nursing workforce in an era of health care reform. New England Journal of Medicine; 368: 1470–1472.
Buerhaus, P.I., Auerbach, D.I., Staiger, D.O., and Muench, U. (2013)Projections of the long-term growth of the registered nurse workforce: A regional analysis. Nursing Economics; 31: 13–17.

65. Workforce Resources
Buerhaus, P., Staiger, D., and Auerbach, D. (2009). The future of the nursing workforce in the United States: Data, trends and implications. Jones & Bartlett Publishers, Boston, MA.
Petterson, S.M., Liaw, W.R., Phillips, R.L. Jr., Rabin, D.L., Meyers, D.S., and Bazemore, A.W.  (2012).Projecting US primary care physician workforce needs:  The Annals of Family Medicine; 10:503–509.
Siow, E. and Ng, J. (2013). Internal migration of nurses in the United States: Migratory prompts and difference in job satisfaction between migrants and non-migrants. Nursing Economics. 2013; 31: 128.
Spetz, J. Too many, too few, or just right? Making sense of conflicting RN supply and demand forecasts. (2015). Nursing Economics; 33: 176.

66. Presentations
Associate to Bachelors (ATB) Model (1-2-3) NSP II Karen Wons Community College of Baltimore County Expanding Clinical Instructor, Faculty and Preceptor Resources and Roles to Increase Nursing Clinical Access NSP II Mary Etta Mills & Linda Hickman University of Maryland &

67. Presentations
Development and Implementation of a Statewide Preceptor Program NSP II Shannon Idzik University of Maryland Cecil-Harford Academic Progression in Nursing Initiative NSP II Laura Preston & Laura Schenk Harford Community College &

68. Presentations Military to ADN (M2ADN) & ADN to BSN &
Clinical Simulation Resources Consortium (MCSRC)
NSP II & NSP II & NSP II
Monique Davis & Sabrina Beroz
Montgomery College
Leadership Institute for Practice and Academia
NSP II Patricia Franklin
University of Maryland

69. Presentations
Update on Maryland Articulation Model Revisions NSP II Rebecca Wiseman University of Maryland Nurse Faculty Mentorship & Credit for Nurse Residency NSP II & NSP II Louise Jenkins

70. Presentations
Online Interprofessional Modules & Simulations for Student Instruction and Faculty Development NSP II Ibby Tanner Johns Hopkins University Minority Student Success and Enrichment Initiatives NSP II , NSP II , NSP II Maija Anderson Morgan State University

71. Presentations
Nursing Workforce with Expertise in Care Coordination Supported by Health Information Technology and Analytics
NSP II Eun-Shim Nahm
University of Maryland
Nurse Support Program I, Program Evaluation Update, Joan Warren, HSCRC consultant.