Bureau of Health Workforce Division of Nursing and Public Health Advanced Nursing Education (ANE) HRSA Peer Review Webinar March 4, :00 p.m. - 4:00 p.m. E.T. Nancy Douglas-Kersellius Nurse Consultant U.S. Department of Health and Human Services Health Resources and Services Administration Bureau of Health Workforce Division of Nursing and Public Health Advanced Nursing Education Branch

Bureau of Health Workforce Division of Nursing and Public Health Advanced Nursing Education Purpose: To provide federal funding for projects that support the enhancement of advanced nursing education and practice at the masters and doctoral level

Bureau of Health Workforce Division of Nursing and Public Health Advanced Education Nurses Nurse Practitioners Nurse Midwives Nurse Anesthetists Clinical Nurse Specialists Nurse Educators Nurse Administrators Public Health Nurses

Bureau of Health Workforce Division of Nursing and Public Health Advanced Nursing Education For Fiscal Year 2015 ANE will support projects that: Develop and test innovative academic- practice partnerships models for clinical training Create one or more innovative partnerships between academic institutions and rural and/or underserved clinical practice sites that improve the quality of clinical sites and preceptors

Bureau of Health Workforce Division of Nursing and Public Health ANE grantees should implement new and innovative strategies and models for preparing graduate nursing students to address: Evolving needs of the healthcare system and practice- based environment Educating graduate nursing students in new models of health care delivery Providing health care to minority, underserved and rural populations Advanced Nursing Education

Bureau of Health Workforce Division of Nursing and Public Health ANE Program Requirements Applications must include: A detailed description of the innovative academic-practice partnership model either establishing at least one new innovative partnership or the enhancement of an existing partnership between academic institutions and rural or underserved clinical practice sites

Bureau of Health Workforce Division of Nursing and Public Health Program Requirements Applications must include: A detailed timeline for the establishment of the partnership(s) Details of the formal partnership arrangement(s) A plan for placement of students in the clinical partner site(s) by January 31, 2016

Bureau of Health Workforce Division of Nursing and Public Health Program Requirements Clinical practice sites must incorporate new models of health care delivery including team- based care or other innovative payment and service delivery models (i.e., Patient Centered Medical Home, Accountable Care Organization) Must also address the broad range of social determinants that influence health and health outcomes

Bureau of Health Workforce Division of Nursing and Public Health Academic-clinical partnership(s) must provide education and training for graduate nursing students and clinical preceptors in complex practice environments in rural and/or underserved clinics Program Requirements

Bureau of Health Workforce Division of Nursing and Public Health Academic-Clinical Partnerships Defined as strategic relationships between educational (academic) and clinical practice settings established to advance their mutual interests related to practice, education and research Beal, Judy Academic-Service partnerships in Nursing: An integrative review. Nursing Research and Practice

Bureau of Health Workforce Division of Nursing and Public Health Academic-Practice Model (s) Must include: Formal mechanisms for feedback and evaluation to inform program development and curricular enhancements Factors that augment preceptor quality and improve the outcomes of student’s clinical experiences Use of existing evidence-based tools and methods to measure preceptor competencies

Bureau of Health Workforce Division of Nursing and Public Health Academic-Practice Model (s) Use of existing evidence-based tools and methods to measure student clinical competencies A rapid cycle quality improvement strategy to test the effectiveness of the clinical training model and plan for ongoing feedback

Bureau of Health Workforce Division of Nursing and Public Health Evidence- and competency-based assessments and clinical evaluation tools to assess student performance and student readiness to practice Incentives to recruit, engage, and train preceptors (i.e., faculty appointments at the academic institution, and educational and/or professional development opportunities) Academic-Practice Model (s)

Bureau of Health Workforce Division of Nursing and Public Health Rapid Cycle Quality Improvement (RCQI) A "quality improvement method that identifies, implements and measures changes made to improve a process or a system." ( cycle-improvement-strategy

Bureau of Health Workforce Division of Nursing and Public Health RCQI Rapid-cycle improvement means changes are made and tested over periods of three months or less, rather than the standard eight to twelve months.

Bureau of Health Workforce Division of Nursing and Public Health RCQI Plan-Do-Study-Act (PDSA) is a commonly used rapid-cycle improvement strategy It is a four-stage rapid-cycle quality improvement strategy

Bureau of Health Workforce Division of Nursing and Public Health Eligibility Accredited schools of nursing Nursing centers Academic health centers State or local governments Non-profit health care facilities Other public or private non-profit entities

Bureau of Health Workforce Division of Nursing and Public Health Accreditation Schools of Nursing Commission on Collegiate Nursing Education (CCNE) Accreditation Commission for Education in Nursing (ACEN) Accreditation Commission on Midwifery Education of the American College of Nurse-Midwives (ACME) Council on Accreditation (COA) of Nurse Anesthesia Programs of the American Association of Nurse Anesthetists

Bureau of Health Workforce Division of Nursing and Public Health School of Nursing Accreditation All Nursing programs associated with the project and conferring degrees must be accredited for the purposes of nursing education Documentation of accreditation should be included with the application when submitted The only acceptable format is a letter from the accrediting body

Bureau of Health Workforce Division of Nursing and Public Health School of Nursing Accreditation New Nursing Programs need a letter of reasonable assurance from the U.S. Department of Education (attachment 3) Substantive Change Notification modified nursing programs must include documentation of the approval from the accrediting agency (attachment 3)

Bureau of Health Workforce Division of Nursing and Public Health Clinical Facility Accreditation To ensure that health care facilities are credible and reputable organizations dedicated to ongoing and continuous compliance with the highest standard of quality requires accreditation.

Bureau of Health Workforce Division of Nursing and Public Health Clinical Facility Accreditation Non-profit health care facilities responding to this funding opportunity announcement must provide documentation of accreditation with the application. (attachment 3)

Bureau of Health Workforce Division of Nursing and Public Health Project Staff Qualifications Project Director: RN, Doctorate in Nursing (preferred); must be employed by the applicant agency

Bureau of Health Workforce Division of Nursing and Public Health Use of Grant Funds To develop, coordinate and maintain at least one or more formalized partnerships between clinical training sites and academic institution(s) To develop and implement clinical field placements focused on serving rural and/or underserved populations To recruit, engage and train faculty to serve as preceptors to provide oversight and guidance to students (funds cannot be used for direct payment to preceptor and clinical sites)

Bureau of Health Workforce Division of Nursing and Public Health Use of Grant Funds To implement existing evidence-based tools to measure student and preceptor competencies To support curricular enhancements specific to clinical competencies To implement Rapid Cycle Quality Improvement strategies to evaluate the innovated clinical training mode

Bureau of Health Workforce Division of Nursing and Public Health Budget Justification Narrative that explains the amounts requested for each line item in the budget Each item should support the achievement of proposed objectives For subsequent budget years, the justification must highlight the changes or clearly indicate that there are no substantive budget changes during the project period The budget justification MUST be concise

Bureau of Health Workforce Division of Nursing and Public Health Funding Restrictions Funds may not be used for: Student support (tuition, stipends, salaries, travel) Student books and fees Direct payment to preceptors and clinical sites Subsidies or paid release time for project trainees or participants Construction and/or renovations Food and drinks

Bureau of Health Workforce Division of Nursing and Public Health Funds may not be used for: Promotional items and memorabilia, purchase of gift cards, franchise fees and expenses Accreditation, credentialing, continuing education Funding restrictions: Only one Project Director Salary amounts cannot exceed $181,500 Funding Restrictions

Bureau of Health Workforce Division of Nursing and Public Health Salary Limitation Example Individual’s actual base full-time salary: $255,000 50% of time will be devoted to project Direct salary $112,500 Fringe (25% of salary) $28,125 Total $140,625 Amount that may be claimed on the application budget due to the legislative salary limitation: Individual’s base full time salary adjusted to Executive Level II: $181,500 50% of time will be devoted to the project Direct salary $90,750 Fringe (25% of salary) $22, Total amount $113,437.50

Bureau of Health Workforce Division of Nursing and Public Health Funding Preference Funding of a specific category of approved applications ahead of other categories of approved applications Applicants receiving the preference will be considered ahead of others without the preference Applications that do not receive a funding preference will be given full and equitable consideration during the review process

Bureau of Health Workforce Division of Nursing and Public Health Funding Preference Requested in the Project Abstract and documented in Attachment 11 : A “high rate” of graduates accepting positions in practice settings that: Substantially benefit rural populations or Substantially benefit underserved populations or Help meet public health nursing needs in state or local health departments

Bureau of Health Workforce Division of Nursing and Public Health Substantially Benefits Rural Populations Students will have a field placement or practicum experience in a site serving rural populations, (see FOA for listing of sites) The curriculum must include content on rural culture and other health indices specific to rural health populations and provide precepted training experiences managing the care of patients with complex health needs. A “high rate” of graduates work in a site serving rural populations

Bureau of Health Workforce Division of Nursing and Public Health Substantially Benefits Underserved Populations The applicant organization is physically located in a Health Professional Shortage Area, a Medically Underserved Community, or serves medically underserved populations and focuses on primary care, wellness, and prevention strategies The curriculum incorporates content addressing the cultural and health indices specific to underserved populations and provides precepted training experiences managing the care of patients with complex health needs

Bureau of Health Workforce Division of Nursing and Public Health Substantially Benefits Underserved Populations Partners with schools deemed Historically Black Colleges and Universities, Tribal Colleges and Universities, Hispanic-serving institutions or with other schools, or consortia of schools, that educate nursing students from groups underrepresented in the nursing profession and A “high rate” of graduates work in a site serving underserved populations.

Bureau of Health Workforce Division of Nursing and Public Health Substantially Benefits Public Health Nursing Needs Linkage(s) with state, local and Federal health departments for student learning experiences Curriculum concentrates on the public health sciences and prepares students with the competencies needed to work as a public health nurse Curriculum provides precepted training experiences in care of patients with complex health needs, including, social determinants of health that influence access to specialty care and social services and A “high rate” of graduates working in a public health facility

Bureau of Health Workforce Division of Nursing and Public Health High Rate of Graduates Employed in Qualifying Areas of Expertise/Focus “High rate” is defined as a minimum of 40% of graduates in the academic year 7/1/ /30/2014 are employed in clinical practice sites substantially benefiting rural or underserved populations, or in state or local health departments

Bureau of Health Workforce Division of Nursing and Public Health Graduates in Practice Settings Setting No. of Graduates Community Health Centers Migrant Health Centers Health Care for the Homeless National Health Service Corps sites Indian Health Service Sites/Tribal Health Sites Federally Qualified Health Centers State or Local Health Departments Ambulatory Practice Sites Designated by State Governors Health Professional Shortage Areas (HPSAs) Rural Populations Rural Clinics Underserved Populations/Settings Total Number of Graduates Employed in these Settings from 7/1/2013 – 6/30/2014 Total Number of Graduates (from 7/1/2013 to 6/30/2014) Percentage of Graduates Employed in these Settings

Bureau of Health Workforce Division of Nursing and Public Health To Calculate “High Rate” of Graduates Percentage of graduates employed in practice settings is determined by: Total number of graduates employed in these settings [divided by] Total number of graduates from July 1, 2013 to June 30, 2014

Bureau of Health Workforce Division of Nursing and Public Health Student Enrollment Enrollment should be included for all three years of the project Placement of students at the clinical partner site(s) by January 31, 2016

Bureau of Health Workforce Division of Nursing and Public Health Application Content Project Abstract Project Narrative Purpose and Need Response to Program Purpose Work Plan – includes a logic model Methodology Resolution of Challenges

Bureau of Health Workforce Division of Nursing and Public Health Application Content Project Narrative Impact Evaluation & Technical Support Capacity Project Sustainability\ Organizational Information, Resources & Capabilities Program Specific Information Budget & Budget Justification

Required Application Contents Project specific description Abstract and narrative Accreditation documents Curriculum-related description Position descriptions of clinical preceptors and project personnel Bio sketches of key personnel Maintenance of effort Bureau of Health Workforce Division of Nursing and Public Health

Application Contents If applicable the following application contents are also required: Letters of agreement/MOU Approval documentation for new programs Administrative and other letters of support Consultant Information Request for funding preference (should include table for graduates in practice settings, see page 23) Bureau of Health Workforce Division of Nursing and Public Health

Bureau of Health Workforce Division of Nursing and Public Health Review Criteria Critical indicators have been developed for each review criterion to assist the applicant in presenting pertinent information related to that criterion and to provide the reviewer with a standard for evaluation. Please refer to pages of the funding opportunity announcement for the critical indicators for each review criteria

Bureau of Health Workforce Division of Nursing and Public Health Review Criteria 1. Purpose & Need 10 points 2. Response 30 points Work Plan – 10 points Methodology- 15 points Resolution of Challenges- 5 points

Bureau of Health Workforce Division of Nursing and Public Health Review Criteria 3.Impact 20 points Evaluation & Technical Support Capacity15 points Project Sustainability 5 points 4. Organizational Information 15 points Resources/Capabilities

Bureau of Health Workforce Division of Nursing and Public Health Review Criteria 5. Support Requested10 points 6. Program-Specific Information15 points

Bureau of Health Workforce Division of Nursing and Public Health Resources Logic models can be found at the following website: esign/logic_model.htm esign/logic_model.htm How to distinguish between a logic model and work plan: rief5.pdf rief5.pdf

Bureau of Health Workforce Division of Nursing and Public Health Rapid Cycle Quality Improvement Information to be supplied by group who developed the RCQI manual for the applicants

Bureau of Health Workforce Division of Nursing and Public Health Questions