Virginia Action Coalition Shirley Gibson, MSHA, RN, FACHE Susan Motley, CAE, CEO Virginia Nurses Association November 17, 2011

 To define the RWJF/AARP Center for Championing Nursing initiative  To define the Virginia Action Coalition  To describe the five workgroups  To review next steps Objectives

IOM Future of Nursing Campaign for Action One Year Anniversary

Link to video Linda Burnes-Bolton Vice Chair IOM Future of Nursing

Americans have access to high quality, patient-centered care in a health care system where nurses contribute as essential partners in achieving success Vision

Field strategy to move key nursing issues forward at local, state and national levels In 15 states before moving nationwide Capture best practices, track lessons learned and identify replicable models Short and long term Action Coalition Goals

 Campaign for Action: Key Messages Leadership Access to Care Workforce Data Education High- quality patient centered care Interprofessional Collaboration

1.Remove scope of practice barriers 2.Expand opportunities for interprofessional collaboration 3.Implement nurse residency programs 4.Increase proportion of nurses with BSN to 80% by Double the number of nurses with doctorates 6.Ensure that nurses engage in lifelong learning 7.Prepare and enable nurses to lead change and advance health 8.Build an infrastructure for data collection Future of Nursing Recommendations

 2010 Landmark IOM Report: Future of Nursing: Leading Change, Advancing Health  November 2010 RWJF/AARP Center for Championing Nursing Summit  State Action Coalitions – 5 pilots, New Jersey, New York, Michigan, Mississippi, California  Wave II – 10 States – Idaho, Utah, Colorado, New Mexico, Illinois, Indiana, Louisiana, Virginia, Florida and Idaho How action coalitions got started!

 Submitted February input from more than sixty stakeholders  Awarded designation in March 2011  RWJ Foundation and AARP Center to Champion Nursing in America  Focuses on technical support and exchange of best practices  Catalyst to convene diverse stakeholder around common themes Virginia’s Action Coalition Application

 Nurses should practice to the full extent of their education and training  Nurses should achieve higher levels of education and training through an improved educational system that promotes academic progress and explore residency programs  Nurses should be full partners, with all members of the healthcare team in redesigning healthcare  Develop strategies to ensure that nursing is skilled to provide leadership at all levels  Effective workforce planning and policy making require better data collection and an improved information infrastructure Virginia Action Coalition Goals

 Kickoff : June 16, 2011 Nursing Roundtable  Five workgroups with more than 150 participants  ww.vaifn.org website ww.vaifn.org  Blog and wiki that are the result of the media training that Chelsea, Lindsey and Linda participated in with AARP  Feature articles in the Virginia Nurses Today and media coverage across state for the Forty Under Forty awards Engagement

 Funding from the Virginia Nurses Foundation, VCNP, Virginia Nurses Association, and the Virginia Partnership for Nursing  Engagement of non nursing partners  PIN Synergy grant awarded to Richmond Memorial Health Foundation and partners Partnerships

 AARP volunteers including 4 state legislative specialists join VAC workgroups  AARP 2012 legislative platform includes supervision should be removed from the code of Virginia with regard to Nurse Practitioners  Testimony given “on the record” at Department of Health Professions Town Hall Meeting on supervision of APRNs being a barrier to access to care AARP Partnership

 AARP 2011 Voter Education Pamphlet Questions anyone running for VA General Assembly should answer :  If elected/re-elected, how would you ensure advanced practice registered nurses can practice to the full extent of their education and expertise?  Do you support or oppose allowing advanced practice registered nurses to practice without physician supervision? AARP Partnership

 Volunteer engagement with workgroups  AARP public policy platform: Supervision should be removed from the code of Virginia with regard to Nurse Practitioners  Testimony given “on the record” at Department of Health Professions Town Hall Meeting on barriers to access to care AARP Partnership

 AARP raises awareness  In print and on line Bulletin features article, “Nursing Shortage will Grow as Population Ages” (Susan Motley quoted) More to come! AARP Partnership

Education Advancement Linda Dedo and Deb Zimmermann Co-leads

 Educate nursing workforce and stakeholders on the importance of achieving higher levels of education  Support nursing leaders in the implementation of strategies to employ a more educated workforce  Convene stakeholders for the implementation of seamless education progression  Consider role of residency programs in the Commonwealth Education Objectives

 Regional meetings with clinicians, leaders, and academia have supported objectives  A forecasting & strategy tool was developed and is available for predictive modeling  Stakeholders have agreed to meet  Collaborating with recipients of Richmond Memorial Health Foundation PIN Grant on short and long term goals for seamless education progression Progress

Next Steps  Create four regions in the Commonwealth for communication, collaboration, and action  Meet with Board of Nursing, Virginia Hospital and Health Care Association leaders, Community College Presidents/Nursing Chairs, Magnet Consortium, VONEL, etc.  Develop a webinar on forecasting tool  Support grant holders with identification of best practice for seamless education progression

Access to Care Linda Ault and Cindy Fagan Co-Leads

 Nurses should practice to the full extent of their education and training  Nurses should achieve higher levels of education and training through an improved educational system that promotes academic progress and explore residency programs Access to Care Objectives

 One of the barriers to APRN practice was not just statutory (code) but that each facility determines what the practice parameters will be for their institution.  This has resulted in many “myths” regarding what the various APRNs are actually licensed to do  We are in the process of publishing a series of “Myth Busters” in VNT to educate nurses regarding what the various APRNs are actually licensed to do Progress

 Identifying individuals to take the Campaign for Action on the road to educate not only nursing professional groups but also non-nursing groups such as the League for Women Voters, service groups such as Rotary Clubs, legislators, business groups, health care institutions, the Virginia Chamber, and other consumers of health care on how nursing can fill the access to care gap  Call for stories: to demonstrate through real practice stories how APRNs were either able to successfully bridge a gap to care or how the current statutes hindered and negatively impact access to care throughout the state Outreach

 elimination of “physician supervision”  new language will provide for NPs to work in collaboration and consultation with a physician in a “patient care team” model  the practice agreement describes guidelines for the collaborative and consultative process in the work setting and prescriptive practices  the credentialing process in hospitals and health systems may serve in lieu of a practice agreement  the patient care team physician actively provides management and leadership to patients or groups of patients on the patient care team  the requirement that the physician "regularly practice" at the same location as the NP has been eliminated  collaboration and consultation may be through telemedicine  ratios have been retained but are increased to 6:1 from 4:1 Outcomes: Consensus Bill Salient Features

 Create a dashboard on the VAC website to track the speakers and organizations that have been addressed. To date we have visited various APRN meetings in Virginia to educate them on the VAC and recruit future speakers.  Secure more support statements for legislative change such as the one obtained by AARP  Long term goal: Implement legislative strategies to impact statutory and regulatory barriers that prevent nurses from practicing to the full extent of their education and training.  This can be done through the development of a white paper in addition to education of professional and consumer groups. Outcomes

Leadership Lindsey Cardwell-Jones and Loressa Cole Co-Leads

Develop strategies to ensure nursing is skilled to provide leadership from the bedside to the boardroom Leadership Goal

 Continue to determine strategic boards to which nurses could be appointed and work with stakeholders to identify, mentor, and recommend individuals for those appointments  Collaborate with schools of nursing to ensure the curriculum focuses on leadership skills necessary for today’s complex healthcare environment  Recognize leaders “from the bedside to the board room” at the annual Virginia Nurses Foundation Excellence in Nursing gala Leadership Objectives

 Continue “Nurse Leaders in the Boardroom” program piloted with Robert Wood Johnson and AARP in September, 2009  Continue to support the current and expanded Nurse Leadership Institute, a program of the Richmond Memorial Health Foundation and a 2007 Partners Investing in Nursing’s Future (PIN) grantee, by participating on committees, providing scholarships, assisting in encouraging employers to nominate fellows and nurses to serve as faculty Leadership Objectives

 The Team: Over 30 Registered Nurses from diverse backgrounds and geographic locations as well as a VA AARP Volunteer  2011 Meetings:  June 11, Orientation Conference Call  August 8, Strategy Overview & Review of Objective 1 via Conference Call  September 23, Implementation Strategy Session for Objective 1 and Overview of current Nurse Leadership Institute  Focus groups and engagement with the 40 under 40  The Strategy: The Leadership workgroup is utilizing WikiSpace to facilitate online discussion of objectives and hosting monthly conference calls to update the team on the background of objectives and develop implementation strategies for each objective. The team is focusing on one objective each month. Outcomes

Workforce Data Nina Beaman and Richardean Benjamin Co-Leads

Improve data collection and information infrastructure Workforce Data Objective

 Continue participation on DHP Healthcare Workforce Data Center  Conduct APRNs survey (in progress)  Participation and dissemination of information from the VA Workforce Development Authority to inform RAC workgroups  Participate in the Forum of State Nursing Workforce Centers (annual conference) Progress

 Support NCSBN’s efforts to standardize data collection  Achieve consensus around the minimum data sets  Develop and implement specific geographical demand models for nursing and other health professionals Progress

 Conducting briefings:  Results of recent Nurse Licensure Survey  HRSA plans to discontinue RSS  Compiling current resources to inform subgroup members about workforce data group issues  Drafting talking points presentation  Drafting framework for subgroup white paper Progress

Interdisciplinary /Team Based Care Delivery Sallie Eissler and Patti McCue Co-Leads

Develop and deploy best practices in team/interprofessional models that promote nurses and other health care professional in all settings to practice according to their level of education and licensure to improve and transform health care to patients, families and communities Objective

 Sept. 9 th ; Hosted by Centra in Lynchburg  Facilitated by Pamela Cipriano, PhD, RN, NEA-BC  Diverse group of participants including nurses, physicians, chaplains, pharmacists & nurse practitioners  Presentations: Centra ED model & NP Single Provider model  Two small workgroups: ambulatory and inpatient services Organizational Meeting

Next Steps  Meet quarterly in person (January 2012)  Add new and diverse participants  Identify best practices: ambulatory and inpatient  Implement pilots of interdisciplinary team based care delivery models  Develop a plan to market results  Link back to the other workgroups

 VNA Education Day – September 24, 2011  Linda Burnes-Bolton, Vice – Chair, CNO Cedasr-Sinai  Valentina Brashers, MD, Professor of Nursing UVA  Co-leads update  Next steps  Co-Lead Meeting to determine next steps Virginia Action Coalition

Virginia Action Coalition Engage! VNA Legislative Day 27 th Annual Nurses Day at the General Assembly February 8, 2012