Emerging Challenges for Nursing & Healthcare. Judith Hansen, MS, BSN, RN Executive Director Wisconsin Center for Nursing, Inc.

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1 Emerging Challenges for Nursing & Healthcare Judith Hansen, MS, BSN, RN Executive Director Wisconsin Center for Nursing, Inc.

2 Goal Describe the work of Wisconsin Center for Nursing Identify funding priorities to support nursing in Northeast Wisconsin through partnerships & collaboration Develop a regional funding network

3 Mission Assure an adequate, wellprepared & diverse nurse workforce for the people of Wisconsin

4 WCN Partnerships Administrators of Nursing Education of Wisconsin AARP Wisconsin Faye McBeath Foundation Healthier Wisconsin Partnership Program Medical College of Wisconsin Milwaukee Chapter National Black Nurses Association Nurses Foundation of Wisconsin Oscar Rennebohm Foundation Rural Wisconsin Health Cooperative SEIU Healthcare Wisconsin Wisconsin Associate Degree Nursing Educators & Administrators Wisconsin Association of Colleges & Schools of Nursing Wisconsin Association of Licensed Practical Nurses Wisconsin Association of School Nurses Wisconsin Area Health Education Centers WI Chapter-American Assembly of Men in Nursing Wisconsin Department of Economic Advisors Wisconsin Department of Health Services Wisconsin Department of Safety & Professional Services Wisconsin Department of Workforce Development Wisconsin Division of Public Health Wisconsin Healthcare Workforce Data Collaborative Wisconsin Hispanic Nurses Association Wisconsin Hospital Association Wisconsin League for Nursing Wisconsin Nurses Association Wisconsin Nursing Coalition Wisconsin Organization of Nurse Executives Wisconsin Public Health Association Wisconsin State Board of Nursing

5 Strategic Priorities Critically analyzing & disseminating nursing workforce data Strengthening our capacity to bring together nursing interests into coherent platform for nursing workforce issues Advancing Wisconsin response to 2011 Institute of Medicine (IOM) report, The Future of Nursing

6 Data Driven Process Three surveys RN, LPN, and Education National Minimum Dataset: Supply, Demand & Education from Forum of State Nursing Workforce Centers DSPS - Distribution of surveys DWD Workforce forecasting model WCN Analysis & dissemination with recommendations

7 WCN Data Model RN and LPN Diversity Education DWD Forecasting Model IOM Future of Nursing Report Evidence-Based Workforce Reports

8 Wisconsin Population Growth Table 1. Wisconsin Projected Population by Age Group, Age Group Census 2000 Projected 2015 Projected 2035 Percent Change ,368,756 1,349,090 1,448, ,292,406 3,739,160 3,720, , , , ,581,724 1,547,380 1,570, ,190,053 1,638,250 1,572, & over 702, ,170 1,485, , ,710 1,263, & over 95, , , Source: Egan-Robertson, D., Harrier, D. & Wells, P. (2008).

9 Workforce Projections by Setting 2010 Wisconsin RNs and Projected Demand Change by Work Setting 2010 RNs % Change Nursing 7, Home/Extended Care Home Health 3, Inpatient 21, Emergency 3, Surgery 5, Ambulatory 8, Public Health 2, Other 8, Nurse Educators 1, Total 62, Source: 2010 OEA RN Forecasting Model

10 DWD Workforce Projections Source: WI Registered Nurse Supply and Demand Forecasting Update: Wisconsin Department of Workforce Development Office of Economic Advisors Feb 2014

11 RNs - Plans to Leave Direct Patient Care

12 LPNs Plan to Leave Direct Patient Care Source: 2013 Wisconsin LPN Survey

13 Wisconsin Challenges 53.4% BSN (nurses currently in workforce) Time lag to earn degrees degree a decade 67% RNs have no immediate plans to return to school Mean age of faculty = 58 years; 33% plan to retire in < 4 years. 59.9% % nurses plan to leave workforce within 10 years Only 6% of nurses in Wisconsin come from minority populations; only 7% male APRNs not completely independent, 3% less than national average

14 Wisconsin Regional Differences WI RNs South SE NE West North Median age % Female % White % Unemployed % ADN % BSN

15 IOM Report Recommendations 1. Remove scope of practice barriers 2. Expand opportunities for nurses to lead & diffuse collaborative improvement efforts 3. Implement nurse residency programs 4. Increase proportion of BSN s to 80% by Double number of doctorates by Ensure that nurses engage in lifelong learning 7. Prepare & enable nurse to lead change to advance health 8. Build infrastructure for collection & analysis of interprofessional healthcare workforce data Provides framework to guide activities to address unique nursing workforce needs

16 WHY more education for nurses? Research links education to better patient outcomes Lower mortality rates, fewer adverse outcomes, decreases in readmissions Every 10% increase in BSN decreases risk of death & failure to rescue by 5%- Aiken 2003 Support from IOM, Tri-Council, AONE, NLN, ACCA Alignment w/ other healthcare professions

17 Wisconsin Action Coalition Co-Leads: WCN & Rural Wisconsin Health Cooperative Future of Nursing Campaign for Action national partners: Center to Champion Nursing in America Robert Wood Johnson Foundation AARP Activities: Engage & mobilize nurses, stakeholders around state Regional meetings Inventory Survey of IOM activities Report in process RWJF State Implementation Program (SIP) grant: Taking the LEAD for Nursing in Wisconsin: Leadership, Educational Advancement & Diversity.

18 Taking the LEAD for Nursing in WI First RWJF State Implementation Program (SiP) 2 year award; statewide academic-practice collaboratives Leadership: Increase leadership trainings, nurses on boards surveys, board service training, curricular review Educational Advancement: Increase # enrolled in RN to BSN programs, Rural-Urban models, 2012 & 2013 WI Education Surveys Diversity: Statewide conference, engagement of minority associations, WI Diversity Assessment Tool Funders Network development

19 Academic Progression Goal: 80% BSN by 2020 (53.4%) Triple # of ADN returning for BSN or higher (n=28,402) Hiring practices Flex time for school Academic partnerships Access in rural areas Increase scholarships, loan forgiveness Innovative pilot programs

20 Next Round 2 - RWJF SIP Grants Proposals due 10/1/14 Match funding $50-75,000 = 2:1 match by RWJF (up to $150K) Build on success of first grant: leadership, academic progression & diversity Add: partnerships to develop community-based interprofessional approaches to care Title: Wisconsin Nursing LEADs the PACC (Partnerships in Action for Community Care)

21 Multi-prong approach GOALS: 1. Triple #ADNs to BSN degree 2. Double #doctorate degrees to prepare more faculty 3. Double #APRNs to improve primary care access 4. Increase nursing leadership in healthcare transitions With models that: Retain exiting workforce w/in new models of care Recruit & retain new grads Facilitate educational advancement Increase capacity for education, healthcare redesign using innovative partnerships

22 Health of Wisconsin An adequate, competent & diverse workforce is essential to assure quality care and access Vacancy rates currently are low, calm before the storm Workforce projections: 38% vacancy rate of nurses by 2035 if no increase in graduates First time in history: multiple shortages of healthcare providers in tandem w/ massive demands on healthcare system Collaborative planning NOW can address demands of FUTURE

23 Looking to the future I can't change the direction of the wind, but I can adjust my sails to reach my destination. ~James Dean The time to act is now.

Strategize, Optimize, Innovate Using Data to Drive Delivery of IOM Outcomes

Strategize, Optimize, Innovate Using Data to Drive Delivery of IOM Outcomes Barb Pinekenstein MSN, RN-BC, CPHIMS Wisconsin Center for Nursing Long View Conference-Hartford, Connecticut June 13, 2014 Objectives