September 11, 2012 Maureen Sroczynski, DNP, RN

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1 September 11, 2012 Maureen Sroczynski, DNP, RN

2 Share the history and work of the AARP Center to Champion Nursing in America Focus on the Campaign for Action Education pillar Describe the four models that are the most promising for education transformation Answer questions you may have

3 High costs Fragmentation Primary care shortage Health care disparities Aging and sicker population

4 High-quality, patientcentered health care for all will require a transformation of the health care delivery system One of the most-viewed online reports in IOM history

5 RWJF MISSION To improve health and health care for all Americans Need to address challenges facing nursing to address challenges facing our health system

6 Launched in 2007 Mission Ensure that all Americans have access to a highly-skilled nurse when and where they need one Positioning The Center is a consumer-driven national force for change, working to build a 21 st century workforce that positively impacts health care quality, access, and costs.

7 Initiative of AARP, the AARP Foundation and the Robert Wood Johnson Foundation Partners from business, consumer advocates, policymakers, health care communities

8 All Americans have access to high-quality, patientcentered care in a health care system where nurses contribute as essential partners in achieving success.

9 Diverse Stakeholders Action Coalitions Research, Monitoring, Evaluation RWJF AARP Advisory Committee Policy-makers Communications Grantmaking

10 Coming soon! Options to easily link to discussions about education topics, to review data by state, to pose a question to the group, to share your innovations 10

11 February 28 March 1,

12 CCNA National Liaisons Education transformation leader Mary Sue Gorski Nursing education experts Consultants & staff support Existing resources at Championnursing.org 12

13 Advancing Education Transformation Removing Barriers to Practice and Care Nursing Leadership Interprofessional Collaboration Diversity DATA

14 Increase the proportion of nurses with BSN and higher degrees Increase the number of nurses with doctorates Implement nurse residency programs Promote lifelong learning

15 Evidence Some association between educational level and patient outcomes Twenty percent of BSN graduates get advanced degrees Six percent of associate-degree graduates get advanced degrees

16 We know that more, better educated nurses will help advance the other recommendations in the report. Scope of practice Innovative practice sites Advanced research in many areas, including how better to care for chronically ill patients Best models in community-based care and the need to further the database around new models of care, and advance the leadership to develop these models

17 Learning Collaborative Webinars and face to face meetings Listserv facilitated discussions Determine and share best practices Regional Facilitated Sharing State sharing; virtual and face to face Resource guides as result of work Web archives of all work accomplished Regional Nurse Experts Nursing expertise Coordination in region and nationally Communication Facilitation and collaboration

18 Source: Gajda, R. & Koliba, C. (2007). Evaluating the Imperative of Interorganizational Collaboration. American Journal of Evaluation, (28)1,

19 Sharing knowledge and creativity Spreading innovation and information across states Disseminating knowledge Contributing to ongoing dialogue on education transformation Making connections and moving forward together to achieve education transformation

20 We are all focused on the same goal: Increasing the supply of BSN and doctorally prepared nurses Each state is moving at its own pace CCNA wants to provide support as states continue progress toward education transformation This is a marathon, not a sprint

21 Northeast Region (April ) North Carolina: Polly Johnson Massachusetts: Maureen Sroczynski New York: Maureen Wallace National: NLN; Elaine Tagliareni, AACN; Jane Kirschling, NCSBN; Nancy Spector Western Region (June ) New Mexico: Jean Giddens California: Liz Close Washington: Gerianne Babbo and Sharon Fought National: Fran Roberts, Private for Profit Schools Mid-western Region (July ) Indiana: Donna Boland Michigan: Teresa Wehrwein Ohio: Susan Taft National: Linda Tieman, Workforce data Southeast Region (July ) Mississippi: Wanda Jones Florida: Mary Lou Brunell Texas: Sondra Flemming National: Deana L. Molinari, Rural Health

22 Southeast Region (Dec 8 & ) St Petersburg, Florida Nine state Action Coalitions participated Key CCNA staff attended Discussed; key partnership, promising models, and key components of success Special focus on BSN at Community Colleges Midwest Region ( April 16 & ) Minneapolis, Minn. Thirteen state Action Coalitions participated Key CCNA staff attended Discussed online education models and proprietary school programs Special focus on accelerated models Western Region (Feb 23 & ) Sacramento, California Ten state Action Coalitions participated Key CCNA staff attended Discussed four promising models Special focus on shared curricular components Northeast (May 10 & ) Princeton, New Jersey RWJF Two participants from each Action Coalition in the Northeast invited Key CCNA staff will attend Continue the discussion Special focus on competency based curriculum

23 Community Colleges Grant RN to BSN Degree Accelerated Options: RN to MSN Programs State or Regional Shared Curriculum State or Regional Competency Based Programs 35

24 Partnerships of education and practice BSN completed in no more that four academic years Substantive curriculum transformation Strong evaluation plans to provide data and analyze strategies Intentional strategies to increase diversity of students and graduates

25 Associate degree in nursing (ADN) nurses with an RN advance directly to BSN May be more affordable The American Association of Colleges of Nursing(AACN) supports provided the Baccalaureate Essentials are utilized and the program is accredited Especially beneficial for nurses who are place bound with limited access to other options May require legislative changes Does not include a four year BSN

26 Offers a shorter timeline to completion than traditional BSN or MSN An accelerated model that values the practice experience of AD nurses and meets BSN criteria Is seamless and university based Emphasizes practice components A major challenge of this model is meeting the needs of students with varying clinical expertise Models meet AACN/CCNE Accreditation standards

27 Educational collaboratives between universities and community colleges to enable automatic and seamless transition from an AD t0 BSN program All schools share curriculum, simulation facilities and faculty Shared components include pre-requisites and graduation requirements Requires formal articulation agreements and buy in from legislative bodies and institutions

28 Partners from different education programs develop a shared understanding, common goals and education framework Partners universally agree on the outcomes The scope of the curriculum reaches beyond core competencies and across the entire profession focusing on knowledge, attitudes and skills The curriculum is not standardized but aims to reach standardized outcomes

29 The IOM Vision 2003 Health Professions Education All health professionals should be educated to deliver patient centered care as members of an interdisciplinary team, emphasizing evidence-based practice, quality improvement approaches and informatics.

30 Core Competency Comparisons IOM ACGME QSEN MA Nurse of the Future NY CUNY Apply Quality Improvement Practice based Learning & Improvement Systems Based Practice Quality Improvement Safety Quality Improvement Safety Systems based practice Quality and Safety Clinical Judgment Provide Patient- Centered Care Patient Care Interpersonal & Communication Skills Patient Centered Care Patient Centered Care Communication Leadership People Centered Care Communication Management of Care Work in Inter- Disciplinary Teams Professionalism Teamwork and Collaboration Teamwork and Collaboration Professionalism Professionalism Collaboration Employ Evidenced- Based Practice Medical Knowledge Evidence based practice Evidence based practice Evidenced based practice Utilize Informatics Informatics Informatics Informatics

31 Agreement on Competencies Evaluation and Updating of Competencies Diploma ADN, BSN Nursing Programs & Practice Partners Implementation of Seamless Progression Curriculum Models Designing New Models by Addressing the Gaps Gap Analysis Process of Curricula 31

32 Agreement on Competencies Engage school administration in plan for curriculum redesign early on in the process Can select from various competencies Develop your own QSEN Nurse of the Future Align all with AACN Essentials for Baccalaureate Education and NLN AC Competencies 32

33 Competency Model Process Partnerships of Diploma, AD, BS Nursing Programs & Practice Partners Practice partners bring insight into current healthcare environment and clinical learning opportunities May begin with coalition of the willing 33

34 Competency Model Process Gap Analysis Process Technique for determining the steps to be taken in moving from a current state to a desired future state. Diploma, AD and BS programs assess curriculum against competencies Must demonstrate evidence of the competency in curriculum or clinical experiences Practice partners may examine orientation programs 34

35 Gap Analysis Process Sample Competencies 1. Assessment of current status How many opportunities are currently available for your students to learn the K/A/S by graduation? 2. Validation of current status Where are these learning opportunities in your curriculum and how are they taught? Can include course objectives, lecture content, clinical objectives, clinical experiences, written assignments, case studies or other documented evidence and how evaluated 3. Desired outcomes Nursing Program How many opportunities do you (the faculty) believe should be available for your students to learn the K/A/S by graduation 4. Desired Outcome Practice Partner(s) How many opportunities does your practice partner believe should be available for your students to learn the K/A/S by graduation? 5. GAP between Desired Outcomes and Current Status 6. GAP between Practice Partners Desired outcomes and Nursing Program Desired Outcomes

36 Designing New Models by Addressing the Gaps May be designed at undergraduate level or within RN to BSN programs May involve dual or co-admission May involve assessment and/or alignment of prerequisites, general education requirements and credit transfer issues which will necessitate involvement of school administration 36

37 Implementation of Seamless Progression Curriculum Models Competency based models provide seamless progression models Competency based models can also serve as foundation for shared or common curriculum models Some models based on 1 plus 2 plus 1 approach Some states have begun with a cohort approach that can be expanded within a system or across the state or region 37

38 Evaluation and Updating of Competencies Evaluation of student achievement of competencies Can be achieved by achievement of course outcomes and/or performance within clinical setting With ongoing advances in clinical settings competencies will need to be updated on a regular basis 38

39 This process addresses the fact that education and practice do not always speak the same language Practice needs be involved early in the review and development of new curriculum models Diploma, AD and BS programs all have gaps in reviewing current competency models Divergence and convergence are part of the process Iterative process of innovation 39

40 Available at

41

42 The Model Implementation Process: A Cycle of Inquiry Dialogue Evaluation Shared Purpose Decision Making Action Gajda, R. & Koliba, C. (2007). Evaluating the Imperative of Interorganizational Collaboration. American Journal of Evaluation, (28)1,26-44

43

44 A New Perspective

45 Academic-service partnerships Nurse-managed health centers Preceptor models Dedicated education units Regional school network partnerships, dual enrollment Support from funders Nurses can t do it alone!

46 For us who nurse, our nursing is a thing which, unless we are making progress every year, every month, every week, take my word for it, we are going back.".

47 What model or models will work best for you in Colorado? How do you want to proceed?

48 Community Colleges Grant RN to BSN Degree Accelerated Options: RN to MSN Programs State or Regional Shared Curriculum State or Regional Competency Based Programs 35

49 Managing Complex Change Vision + Skills + Incentives + Resources + Action Plan = CHANGE X Skills + Incentives + Resources+ Action Plan = CONFUSION Vision X + Incentives + Resources + Action Plan = ANXIETY

50 Managing Complex Change Vision + Skills + Incentives + Resources + Action Plan = CHANGE Vision + Skills + Resources + Action Plan = X GRADUAL CHANGE Vision + Skills + Incentives X + Action Plan = FRUSTRATION Vision+ Skills + Incentives +Resources = FALSE STARTS X

51 Real change does not come from decree, pressure, permission or persuasion. Real change comes from people who are passionately and personally committed to a decision or direction that they helped to shape. Margaret Wheatley

52 Visit us on the Web Follow us on twitter Join us on Facebook Education Progression Webinar Series

53 Maureen Sroczynski, DNP, RN or 53

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