Envisioning The Future: Accelerated RN To BSN Programs. Creating Innovative Programs Where High Volume & High Quality Are Not Mutually Exclusive Terms



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Envisioning The Future: Accelerated RN To BSN Programs Creating Innovative Programs Where High Volume & High Quality Are Not Mutually Exclusive Terms Mary E. Mancini, RN, PhD, NE-BC, FAHA, ANEF, FAAN Associate Dean and Chair Undergraduate Nursing Programs Baylor Professor for Healthcare Research

Nursing in Texas: + - What s The Target? In 2005, the Texas Center for Nursing Workforce Studies projected Texas would need 293,000 RNs in order to meet its needs in 2020. That s 51% more than we have today (194k RNs). Current Assumption in 2012: Texas will need this number of RNs by 2020, if not more.

History of Collaborative Efforts in Texas Texas Deans and Directors ALL nursing programs, BON, THECB, TONE Texas Coalition for Nursing - Last 2 legislative sessions TNA, THA, TAB, TOBGNE, TOADN, Employers, et al agreeing to a common legislative ask CCNA Efforts Team Texas Texas Team Regional Efforts Across The State Local Focus Examples: Common Application and Clinical Placement Programs, Shared Faculty, Retention Program..

Specific To Educational Progression in Texas - History of Articulation Efforts Written Articulation Agreements Between Individual Schools Workforce Education Course Manual (WECM) Community College Transferability Texas Nurses Association s Efforts Identification of Partnership Models Recent Texas Team Efforts CBC and common Gen Ed requirements Encourage TOBGNE & TOADN synergy

And The Numbers Are..

+ Nursing in Texas - Achieving 80% BSN + by 2020 As of 9/2011, there were 194k RNs in Texas Currently 50% Diploma/ADN; 50% BSN or higher Current production is at 60% ADN; 40% BSN Currently only ~16% ADN and BSN continue their education Meeting the 80% goal will require 234,000 BSN + RNs (80% of 293k) We currently have ~92,500.

MANCINI S MENTAL MODEL: THREE PRIMARY STRATEGIES TO ACHIEVE 2020 TARGET BSN Grads 2011-3,840 2012-4,334 2013-4,646 2014-5,111 2015-5,622 2016-6,184 2017-6,803 2018-7,783 2019-8,231 2020-9,055 New Grad BSNs 57,359*** "New" BSNs 145,157 Total BSNs Target = 234,000* ADN to BSNs 87,798**** Existing BSNs Practicing in '20 88,843** Capacity needed for combined Programs^ 55,233 x.5 = 27,616 by 2020 (Current = 16%) Increase Capacity in RN-BSN Programs by 3 to 4-fold (2011 = 1,826) Licensed Dip/ADNs in 2011 = 74,876 (Not age adjusted) "CABNET" CBC Model^ Other Articulation Programs^ New Grad ADNs From 2012-2020 55,233^^ UTA Pathways Model^ *80% of Target Set By CNWF estimated need of 293,000 RNs in 2020 **Currently licensed BSN+ registered nurses < 60 years old in 2012 ***Presumes 10% Year/Year growth from 2011 actual of 3,840 = STRATEGY #1: EXPAND DIRECT BSN PRODUCTION ****Calculated as Total BSNs needed Existing in 2020 New BSN Production ^Programs with early acceptance during ADN program & seamless transition = STRATEGY #2: CONCURRENT ADN:BSN ENROLLMENT ^^10,228 new grads in 2011 @ 60% ADN = 6,137/year X 9 years = 55,233 Assumptions to produce 87,798 RN-BSN graduates by 2020: o New ADNs over 9 years = 55, 233. Convert 50% through combination of seamless articulation programs = 27,616 BSNs. o We d need to advance 60,182 (80%) of existing Dip/ADNs to BSNs over 9 years an average of 6,687/year; a 366% increase over 2011 level of 1,826/year. = STRATEGY #3: EXPAND CURRENT RN-BSN PROGRAMS & ADD NEW ONES

Even If We re Off By Some Multiple. IT S A BIG NUMBER!!! So we better get serious about scalable, high volume programs.

UT Arlington College of Nursing 25+ year history of distance education efforts Multiple sites at CCs - ~100-150 graduates/year 2008 We Decided We Had To Do More

Disruptive Innovations in Education The Challenge Isn t Getting New Ideas Into Our Heads... It s Getting The Old Ideas Out! Disruptive Innovation makes it possible for simple, affordable, and accessible products to replace products that are complex, expensive and inaccessible. Clayton Christensen et al in Disrupting Class: How Disruptive Innovation Will Change the Way the World Learns McGraw Hill. 2008

UTACON Academic Partnership RN to BSN Program Program designed to overcome known barriers to student enrollment and success Partnerships that allowed us to leverage our core skills -Partnered with other best in breed companies to create a best in show product. Courses specifically designed for the content delivery system -Instructional design experts working with expert faculty Media-enriched, modular format -Courses given in 5-week modules -Eight start dates a year Use of MSN-Prepared Academic Coaches

+ Since Inception of AP: RN-to-BSN # of Students In N3645 First Professional Nursing Course Start Date #1 (November 17, 2008) = 27 students Start Date #26 (January 16, 2012) = 549 students Total Enrolled In N3645 in 38 Months = 6,689

UT Arlington College of Nursing Graduations Over Time By Program Type BSN RN-To-BSN Fall 2009 TRAD 104 LEARN 0 TOTAL 104 TRAD 48 AP 13 TOTAL 61 Spring 2010 92 0 92 45 91 136 Summer 2010 2 15 17 15 88 103 TOTAL 09-10 513 Yr/Yr Increase = 59.81% 213 300 Fall 2010 TRAD 103 LEARN 2 TOTAL 105 TRAD 50 AP 264 TOTAL 314 Spring 2011 100 LEARN/AP 132 39 343 382 1/31 Summer 2011 0 AP 60 10 228 241 60 TOTAL 10-11 1234 Yr/Yr Increase = 140.5% 297 934* Fall 2011 GRAND TOTALS FOR AP GRADS SINCE INCEPTION TRAD 98 AP 39 TOTAL 137 TRAD 21 AP 536 130 1563 Spring 2012 (Est) ~650** * 934/1,826 = 51.2% of all RN-BSN graduates from Texas Schools. ** An 89.5% increase over Spring 2011. TOTAL 557

+ Quality I know it when I see it! What Are The Measures of Quality For RN-to- BSN Programs? Accreditation Regional and Specialty Progression To Graduation Rates Satisfaction Surveys

+ Quality Not Just Quantity "Discontinued = not actively enrolled for two semesters Cohorts' progression to graduation rates for enrollment cohorts Fall 2008 to Spring 2010. AP RN-to-BSN = 87.1% to 100% On Campus RN-to-BSN = 90% to 94.5% Average Time to Graduation in Months For RN-to-BSN Programs AP -- Minimum program length = 13 months Cohort Averages = 17 to 20 months (would average 2 "steps off the carousel which we see as a selling feature.) On Campus -- Minimum program length = two semesters (9 to 12 mos). Cohort Averages = 12 to 19 months.

+ Quality Not Just Quantity Student feedback Very positive; continuing to MSN Employer feedback Asked for AP-BSN and AP-MSN Faculty feedback Waiting list; Reinvest revenue in them

In 2011, Building On Our Success, UTACON Decided To Do Something Different...Again. Why? Commitment to Creating Lifelong Learners IOM Future of Nursing Recommendations Developing Employment Opportunities Emerging Technology What? The Professional Nursing Pathways Program

UT Arlington College of Nursing Professional Nursing Pathways Program - Shift From Post-Graduate Recruitment To Recruiting In ADN Program - Push-me/Pull-me Notion for Student Progression to The BSN

UT Arlington College of Nursing Professional Nursing Pathways Program Key Components: Intentionality of Partnerships Create model degree plans for each CC Creating & Maintaining The Student s Vision of BSN and Higher Acceptance into UTACON early Student must maintain minimum requirements Routine contacts at Community College and through email/social media Leverage Technology Build on existing Academic Partnership RN-to-BSN program Applications and data submitted with Common App and SPEEDE Virtual Community (Planned)

Responsibilities as a Pathways Partner UT Arlington College of Nursing Provide program at a competitive price with multiple start dates per year Work with CC to develop a model degree plan that maximizes efforts towards BSN while at CC Provide informational sessions and support to students interested in the program. Inform CC of changes in our degree requirements or admissions criteria that might impact students ability to enter UTACON.

Responsibilities as a Pathways Partner Community College Identify a Program Coordinator Develop a Model Degree Plan to maximize efforts towards BSN while at CC Develop and maintain SPEEDE protocols to assure timely electronic transmission of academic transcripts Provide information/access to students Inform UTACON of any changes in courses that may require revision of the Model Degree Plan

Program Information for ADN Students

Student Feedback Practical -- Students want to make a seamless transition from ADN to BSN with no duplication of course work. Convenient Students do not have to go through the extra steps of reapplying for admission and worrying about acceptance into the BSN program. Value Students maximize the number of courses taken in the community college system. Accessible There s no wait. Upon graduation the start date for their first BSN course is within 8 weeks

+ Professional Nursing Pathways Program Partnerships with 14 Community Colleges on 18 Campuses Trinity Valley Brookhaven Grayson Lee College Mountain View Navarro Tarrant County College Lone Star College System (5 campuses) Alvin Community College Brazosport College of the Mainland Baptist Health San Antonio El Centro College Weatherford

Community College Feedback Pathway Students October 2011 January 2012 449 individual ADN students have made contact regards beginning the process. Complements the developing CABNET program which requires schools to have common prerequisites and, for some, a common curriculum.

Moving Forward ---- Lessons to share with you..

Sometimes it s hard to keep your eye on the ball. Secrets: Establishing Partnerships, Clarity of Intent, Setting Metrics, Flexibility

How faculty feel preparing all of these new approaches Only kidding!! Faculty Concerns: Control, Impact on the On-Campus Program, Quality, Dis-ease, Compensation

Working Through The Summer Moving From 9-Month to 12-Month Operations 12-Month Personnel Administrative Structure Assuring Comparability (TRAD:AP)

Keep Scanning The Environment What s coming up next?

Two of the greatest qualities in life are 1. Patience 2. Wisdom SECRET: No single right or best way to get to the goal increased production and increased educational progression. The key is flexibility being contextually relevant.

A Word Of Caution: Differentiating Between Expediency And Outcomes Don t Lose Sight Of The Value Of Liberal Arts And Masters Level Education

Learn To Embrace Partnerships & Competition You will be partnering with schools/organizations that have assets that complement yours OR You will be competing with those that do.

To Quote Arthur Ashe To achieve greatness Start where you are, Use what you have, Do what you can. SECRET: You Don t Need Bells & Whistles You Need Intentionality.

To Quote Henry Ford Coming together is a beginning; Keeping together is progress; Working together is success. SECRET: Find one like-minded person and get started.

Ignorance is not an option! SECRET: Always ask the naysayers, Under what conditions would this work?

Embrace Lewin s Change Theory: Unfreeze --> Move To A New Level --> Refreeze Create a sense of discomfort with status quo Provide motivation to change Assess driving and restraining forces Support driving forces Neutralize restraining forces Reinforce the change Integrate the change into behavior