Partnering with Academic Partners to Enhance Student Experiences and Transitions into Practice

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2 Partnering with Academic Partners to Enhance Student Experiences and Transitions into Practice Holly Lorenz, RN, MSN Sandra Rader, DNP, MSA, RN, NEA-BC Melanie Shatzer, DNP, RN Pittsburgh, PA UPMC

3 Objectives Identify key elements of a successful regional academic service partnership council including membership, mission, and operational components Describe essential assessments, programs and replication opportunities to improve the student experience in community, regional and academic medical center settings Examine the relationship between AONE s guiding principles for the newly licensed nurse s transition into practice and a regional academic partnership council s mission and collaborative outcomes 3

4 UPMC Global health enterprise headquartered in Pittsburgh, PA Integrating more than 20 hospitals, 400 doctors offices and outpatient sites, health insurance services division and international & commercial services 4

5 UPMC: Western Pennsylvania 5 UPMC Hospital Facility

6 UPMC International Hospitals Italy ISMETT UPMC has managed and operated since inpatient beds More than 1,000 transplants performed. JCI accredited 6 Ireland Beacon Hospital UPMC oversees the operations, staffing and clinical programs 183 beds JCI accredited

7 Rich Academic Region Academic partners represent doctorate, masters, baccalaureate, associate and hospital-based diploma degree programs Three UPMC Schools of Nursing University of Pittsburgh 9 other academic partners Over 3000 student experiences at UPMC per semester

8 UPMC Schools of Nursing UPMC Shadyside School of Nursing Mercy Hospital School of Nursing St. Margaret School of Nursing Diploma programs RN & LPN preparation 8

9 University of Pittsburgh School of Nursing BSN, MSN, DNP, & PhD programs Loaned faculty program Support for various UPMC nursing initiatives Preceptor Academy Evidence Based Nursing Council Nursing research Statistician 9

10 1 Academic Partners

11 Academic Service Partnership Council (ASPC) History Chief Nurse Executive charged ASPC with enhancing the student experience Initially focused on pre-licensure students Evolution to current model Expanded representation Collaborative partnership Future 1

12 Current ASPC Model Co-chaired by Chief Nursing Officer and the Director, Academic Service Partnerships Academic representation including deans, program directors and faculty Service representation from chief nursing officers, directors of nursing education, program administrators and nurse educators Tied to evidence-based findings 1

13 ASPC Mission The mission of the Academic Service Partnership Council is the create systems which support the finest clinical experiences at UPMC, the highest prepared new graduate prior to hire at UPMC, and focus on hiring and retaining the best and the brightest in new graduates, both locally and nationally. 1

14 Academic-Service Partnership: Models & Literature Findings 1

15 Academic-Service Partnerships 1 Recommended by the Institute of Medicine Robert Wood Johnson Foundation identified partnerships as being needed to address faculty shortages Literature examples report academic-service partnerships have led to: Expanded enrollment Increased capacity Enhanced the nursing workforce

16 Phases of Academic Service Partnerships Systematic review by Nabavi and associates aimed and retrieving and integrating relevant evidence related to the process of forming and implementing an academic-service partnership with the aim of reforming clinical education 4 phases of ASP formation Mutual potential benefits Moving from being competitors to collaborators Joint practice Beneficial outcomes Nabavi, F. H., Vanaki, Z. & Mohammadi, E. (2011). Systematic review: process of forming academic service partnerships to reform clinical education. Western Journal of Nursing Research. Jan,1-24.

17 ASP Developmental Phases Mutual Potential Benefits Implementation of Partnership Program Moving from Competitors to Collaborators Stakeholder collaboration Shared decision making Shared structure Joint Practice Clinical education Staff development EBP Beneficial Outcomes

18 1 Building Bridges

19 Bridging Academic & Service ASPC Member experience 360 feedback 3 Essential Elements National landscape ASPC Strategic Plan & Collaborative Outcomes 1

20 Bridging Academic & Service Partners: National Landscape National Landscape 2

21 National Nursing Landscape Models of excellence IOM Report 2

22 IOM: 4 Key Messages #1) Nurses should be able to practice to full extent of their education and training Need to remove scope-of-practice restrictions for APRNs Need nurse residency program to better manage transition from school to practice

23 IOM: 4 Key Messages #2) Nurses should achieve higher levels of education and training through an improved education system that promotes seamless academic progression More BSN-trained nurses ADN-to-BSN and ADN-to-MSN programs Increase student diversity to create workforce prepared to meet demands of increasingly diverse patient population

24 IOM: 4 Key Messages #3) Nurses should be full partners with physicians and others in redesigning U.S. health care Foster leadership skills and competencies Nurses must see policy as something they shape

25 IOM: 4 Key Messages #4) Effective workforce planning and policy-making require better data collection and an information infrastructure Need balance of skills and perspectives among physicians, nurses and others Need more specific workforce data collection both within and across professions

26 Initiative on the Future of Nursing The Recommendations

27 The 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 proportion of nurses with BSN degree to 80% by 2020

28 The Recommendations 5) 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 to collect and analyze health care workforce data

29 Additional National Landscape Challenges Increasing patient complexity Faculty shortages Legislative changes Quality metrics & reimbursement implications Rapid technological changes Preceptor development 2

30 Bridging Academic & Service Partners: Feedback 360 Feedback 3

31 360 Student Experience Evaluation 3 Critical feedback Create transparency The purpose of the survey is to improve the collaboration between UPMC nurses, students and clinical instructors Students, faculty and UPMC staff nurses provide feedback Content developed by ASPC Five question format

32 Survey Design 3 Demographics School Clinical location Year in school 4-point Likert scale Strongly disagree Disagree Agree Strongly agree

33 Student Content I felt welcomed as a student on unit I was able to apply in practice the knowledge & skills I learned in class I worked collaboratively with nurses on the unit to care for patients I felt that I was included as a member of the health care team I would recommend this unit to other students for their clinical education 3

34 Faculty Content 3 The nursing staff worked collaboratively with me to promote a good learning experience for the students The activity on the unit was appropriate for the number and level of students My students and I were treated as members of the healthcare team The clinical unit was a learning environment that facilitated the achievement of the course objectives I would recommend this unit for continued student clinical rotations

35 Staff Survey The instructor collaborated with the nursing staff to adequately care for patients The instructor was available to the students throughout the rotation The students displayed professional behavior while on the unit The students demonstrated an eagerness to learn I would recommend that students from this school continue to utilize UPMC for their clinical education 3

36 Survey Process Announcement & communication plan Student placement coordinators ASPC members Student Pathways newsletter Distribution: Survey Monkey links 4 week survey collection window Data collation: System Business unit 3 School

37 Stakeholders Chief Nursing Officers Unit Directors Deans Directors of Education ASPC members 3

38 3 Student Feedback Sample

39 Common Themes 3 Overall positive comments Opportunities identified: Documentation Onboarding/communication of rotation objectives Communication of assignment(s) Pivotal role of unit director Preceptor preparation Student-to-instructor ratio

40 Bridging Academic & Service Partners: Experience ASPC Members Experience 4

41 ASPC Member Feedback Clinical affiliation agreements Faculty orientation Student placement process Building trust 4

42 Translating Feedback & Observations into Action ASPC Mission & Strategic Plan 4

43 ASPC Mission Revised Original: To create systems which support the finest clinical experiences at UPMC, the highest prepared new graduate prior to hire at UPMC, and focus on hiring and retaining the best and the brightest in new graduates, both locally and nationally Fall 2011: Serve as an exemplar nursing academic-service partnership to promote best practices within collaborative, working learning environments 4

44 Building Bridges to Move Forward: Opportunities 4 Universal agreement Creative clinical partnership programs Stakeholder relationships Documentation process Annual spring summit Preceptor development Transition to practice residency Faculty orientation

45 Strategic Plan Model Magnet Model Transformational leadership Structural empowerment Exemplary professional practice New knowledge, innovation & improvements Goal-directed Empirical outcomes oriented 4

46 Cultural Values Leadership Excellence Inclusion Generativity Learning Outcome: Pt. outcomes Quality Pt. satisfaction Staff satisfaction Morale Profitability Productivity Outcome: Turnover Overtime Agency Recruitment Organizational Solutions Leadership Development Executive/Managerial Succession planning Nursing Grand Rounds Recruitment New Hire Selection Schools of Nursing Targeted Initiatives Performance Management My Nursing Career Retention Strategies Academic Partnerships Clinical Rotations RN Residency Student Intern Program National Intern Program Operational Imperatives Benchmarking/Dashboards Labor Strategy/Safe Work Hours/ UPMC Care Website and Newsletters Healthy Workforce Health Status of Nurses Inclusion Work-life Balance

47 4 Empirical Outcomes

48 Universal Agreement Academic & UPMC Nursing leaders identified opportunity for a universal agreement Collaborative journey with ASPC members and legal department Students at undergraduate and graduate level Beyond nursing programs to include other healthcare disciplines Standard clearance process 4

49 Faculty Supply Solutions Clinical Education Models/Pilots 4

50 Dedicated Education Unit (DEU) Collaboration between RMU and UPMC Passavant DEU- a clinical unit in the hospital that is dedicated to the education and development of student nurses by using specially trained staff nurses as clinical instructors Enhance student nursing education and prepare the student for working as a future staff nurse on a hospital unit 5

51 Faculty Supply Educational pilot project with Duquesne University, Mercy Hospital School of Nursing and UPMC Mercy Provide an educational opportunity for nursing students from a hospital based program to collaborate in the clinical practicum with baccalaureate nursing students utilizing the clinical teaching associate model (CTA) Improve collaborative professional practice and maximize student clinical learning opportunities 5

52 DEU Model & Collaborative Practice- CTA Model Staff nurses received formalized training from academic partners Educational philosophy Ethical-legal aspects of clinical education Teaching-learning strategies Clinical evaluation 5

53 5 Building Connections

54 Legislative Changes Quarterly updates from federal and state government relations representatives Healthcare reform impact Accountable care organization pilot Role of mid-level providers 5

55 5 Technology & Documentation

56 Rapid Technological Changes School representative erecord account request process Revised account review process erecord weekly update Documentation Optimization Meaningful use 5

57 Spring Summit ASPC members Chief Nursing Officers Networking Chief Nurse Executive Address Year in Review 5

58 Graduate nurse residence Academic partners serve on advisory council Core curriculum Model for mid-level provider residency Transition to Practice 5

59 UPMC Summer Student Nurse Internship Program Highly competitive ten week program National and local models Staff nurse preceptor 5

60 Preceptor Development Preceptor Academy formation Academic & Service representatives The mission of the UPMC Preceptor Academy is to develop, empower and recognize successful preceptors through respectful communication, education and support 6

61 6 Bridging the Future

62 ASPC Subgroups- Planning for the Future Faculty orientation Streamlining orientation process Consistent competencies Improving access to standard orientation materials Capacity Sharing projections Proactive placements 6

63 Additional ASPC Activities Networking subcommittee Instilling IOM recommendations Supporting UPMC Nursing Strategic Plan 6

64 6 Questions

65 References 6 Allen, P., Schumann, R., Collins, C. & Selz, N. (2007). Reinventing practice and education partnerships for capacity expansion. Journal of Nursing Education, 46, American Association of Colleges of Nursing and the University Health System Consortium (2003). Building capacity through university hospital and university school of nursing partnerships. Washington, DC. Institute of Medicine (2010). The future of nursing: leading change, advancing health. Nabavi, F. H., Vanaki, Z. & Mohammadi, E. (2011). Systematic review: process of forming academic service partnerships to reform clinical education. Western Journal of Nursing Research. Jan,1-24. Robert Wood Johnson Foundation. (2010). Putting innovations in nursing education to the test. Retrieved from