1. Washington State Association for Healthcare Recruitment July Meeting
Sofia Aragon, JD, BSN, RN
Executive Director
July 2015
Introduction to the Center for Nursing
Introductory remarks and preliminary questions of the audience
Note: WA State Association for Health Care Recruitment used to be focused on nursing. Member organizations are mainly health care facilities.
My background as a nurse
The WA Center for Nursing—What Are We?
Who is in the audience? Who do they recruit for? What professionals do they recruit? What do they want to learn from me today? (from the nursing perspective?)
RWJF survey of industry leaders about where nursing makes the most difference

2. Objectives Major challenges and opportunities in health care
The role of nursing to meet challenges and opportunities
Strategies to determine what employers demand from health care professionals
Challenges and opportunities for nursing to meet the demand

3. What healthcare leaders say about nursing
Robert Wood Johnson Foundation survey from January 20th, 2010 found:
From opinion leaders in insurance, corporate health services, government and industry
Nursing could have the most influence on: reducing medical errors (51%), improving quality of care (50%), and coordinating patient care in the health system (40%)

4. Institute of Medicine Future of Nursing Report
RNs should practice to the full extent of their education and training
RNs should achieve higher levels of education and training through an improved education system that promotes seemless academic progression
RNs should be full partners with physicians and other health care professionals in redesigning healthcare in the US
Effective workforce planning and policy making require better data collection and an improved information infrastructure
Nursing is about patient safety
The Value of Nursing
IOM Report To Err is Human, preventable medical errors 98,000 lives per year
Some recent studies show it is actually higher—injury or death from preventable medical errors: 3rd leading cause of death in the United States.
Link between nursing and improved patient outcomes in the literature (fewer complications, shorter lengths of stay)
ARNPs and delivery of primary care—WA at the forefront. Full practice authority

5. What’s behind nursing’s potential
Largest health care workforce in the state and in the nation with over 80,000 registered nurses in WA and 3 million nationwide
Nurses are instrumental in realizing health reform, to transform its health care system
Nurses are at the front lines
Nurses practice in many settings, including hospitals, schools, homes, retail health clinics, long-term care facilities, battlefields, and community and public health centers
There are barriers: regulatory, business, organizational conditions

7. Too many patients are having to return to the hospital in Washington state within a month of discharge.
That's according to a new report from the Washington Health Alliance, which found that the state's overall readmission rate for the commercially insured is 8.7 percent, slightly worse than the national 50th percentile rate of 8.3 percent.
Washington state's readmission rate amounts to $446 million in additional hospital and health system costs, according to the report.
Readmissions are when a patient returns to the hospital within 30 days of an initial visit, usually because of communication problems in following instructions for follow-up care when they are discharged.
Three years ago, the federal Centers for Medicare and Medicaid Services started fining hospitals in order to encourage better follow-up care and discharge instructions to patients so they wouldn't end up back in the hospital.The higher a hospital's readmission rate, the more it has to pay in fines. Those fines can result in a hospital losing up to 3 percent of its Medicare payments.

8. Health Reform Implementation
Quality—penalized for unnecessary readmission

9. Major Challenges and Opportunities
Full ACA implementation: increased access to health insurance
Persistent health workforce shortage
Economic incentives towards increased safety and quality
Use of technology in health care delivery
Demographic shift implications on the patient population and workforce
Increased access to health insurance: record 1 million people uninsured or underinsured. Now 700,000+ insured through Medicaid expansion and individual market through health benefit exchange
Persistent health workforce shortage
Economic incentives on health systems—hospital readmission policy
Health IT requirements
Consolidation of systems: primary care, acute care, long term care; Accountable Care Organizations (WA Accountable Communities of Health). Hospital consolidation: 98 hospitals, 5 major systems: 98 hospitals, 5 systems: Providence, Franciscan, Peace Health, UW, Community Health Systems (Deaconness, Topennish, Yakima, Valley)
Increased use of technology—major hospital systems are looking to Amazon: Uber you to the hospital; skype with a provider as you’re sitting in a ski lodge with a possible broken arm; use of and text to communicate with providers
Demographic shifts

10. Matt Thornhill of Generations Matter—presenter at the NW Organization of Nurse Executives Conference
Median ages:
Boomers are 60 (Me generation)
Gen X are 42
Millenials are 23 (We generation)
Changing workplace AND patient population:
Workers ages will be an additional 12 million
Over 55: an additional 25 million. In Washington, those over 65 will double by 2030
Average age of RNs (2014) was 48. Nursing faculty are older
Implications for the Boomers
Develop a 50+ strategy for the marketplace and workplace
Plan for more older workers and more competition for new hires
Require generational diversity
Enable rule of women (52% professional workforce; 61% accountants; 50% law firm associates, 54% pharmacists; 91% RNs)
Implications for Millenials
Strategy to attract, manage, and retain millennials (discussion with UWB students)
Embrace culture of collaboration and compromise
Leverage your community position

11. Role of Nursing to Meet Demands
Hearing from Employers
Caring for Patients
Human experience
Patient education
Preventative approach
Care coordination
Approach means generational considerations and others, including cultural
Educational needs (community vs. acute care)
Increase baccalaureate preparation
Influence the system to increase quality and decrease risks (e.g. culture of safety)

12. Strategies to Determine Employer Demand
Workforce Industry Sentinel Network
under development
Goal is to provide real time information on demands of the workforce.
Funded by the Healthier Washington, a federal grant administered by the Health Care Authority

13. Contact Information
Sofia Aragon, JD, BSN, RN
Executive Director
Cell: