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Future of Nursing - Fort Wayne
Nancy Gillespie
PhD, RN, Dean




           Thank you.
Agenda
 Future of Nursing Presentation
 Panel Discussion
 Simulation Showcase
Mindy Yoder
DNP, FNP-BC, RN




Leading Change,
       Advancing Health
Overview
 Healthcare challenges in the U.S.
 Our Nursing Profession
 Healthcare Reform
 IOM Nursing Report-Call for
 Leadership
What is the state of our
   HEALTHCARE
    SYSTEM?
A short list…
 Unsustainable costs
 Equitability of access to care
 Difficulty building consensus
A short list…cont.
 Care coordination
 Primary care shortage
 Aging population and rise
 of chronic disease
 Poor outcomes
Why does U.S.
HEALTHCARE
cost so much?
Why $$$?
 Technology
 Prices are higher in the United States
 Price insensitivity to end consumer
 Judgment-based nature of MD care
 Values and culture
Future of Nursing - Fort Wayne
Per capita health spending and
          15-year survival for 45-year-old women.
     U.S. and 12 comparison countries, 1975 and 2005




Muennig P A , Glied S A Health Aff2010;29:2105-113
     ©2010 by Project HOPE - The People-to-People Health Foundation, Inc.
Demographics
         Starting in 2011

10,000 people in the U.S.
 have been turning 65 every day
Fastest Growing Population, 85+
20,000
                                                           19,041
18,000
16,000
14,000                                       14,198
12,000
10,000
                                    8,745
 8,000
                         6,597
 6,000         5,751
 4,000 4,240
 2,000
    0
     2000       2010      2020       2030      2040          2050

         Projected Number of Americans 85 years and over
Older Americans with
Multiple Chronic Conditions

                                                                                             Medicare beneficiaries
                                                                                               with at least one
                                                                                               chronic condition




                                                                                               Nation’s healthcare
                                                                                                spent on treating
                                                                                                  patients with
                                                                                                chronic diseases
Source: AARP. ―Beyond 50.09: Chronic Care: A Call to Action for Health Reform.‖ Washington, DC. 2009
What is the state of
  NURSING?
A short list…
 Lack of nursing educational preparation to meet
 the demands of our current healthcare system
 Practicing clinicians regularly make decisions
 on tradition rather than empirical evidence
 Chronic, cyclical nursing workforce shortage
 Nursing faculty shortage, yet faculty are poorly
 compensated
 Shortage of doctoral nurses
 Education—practice gap
Projected shortfall in 2020




1million
   NURSES
The bottom line
 High-quality, patient-centered health care for all
 will require remodeling of health care system
 Three national healthcare goals (Donald Berwick)
        Improve health
        Enhance the patient experience
        Reduce/contain costs
 Nurses are essential partners in achieving
 success
The challenges before
us require significant
improvement in public
and institutional policies
at national, state and
local levels.
What is the impact of
 HEALTHCARE
   Reform?
Patient Protection and Affordable Care Act 2010
                                     Health Insurance Reform
                                     • Expand insurance coverage
                                     • Expand consumer protections
                                     • Reform industry practices



   Status Quo
     • Health costs
       exceed general
       inflation
     • Sub-optimal
       population health
     • Unexplained                   Payment Reform,
       variations in                 Delivery Systems
       practice patterns             • Evolve Medicare payment
     • Questions about                 systems from fee-for-service
       evidence base of                to value based payment
       some procedures               • Test new payment methodologies
                                       and patient care delivery models
                                       for Medicare, Medicaid & CHIP
Source: Health Solutions Division,
Manatt, Phelps & Phillips, LLP
Payment Reform, Quality, and Delivery
   System Change Timeline
  2010                   2011          2012                 2013              2015

                                       Shared Savings/
 Dual                  New                                National pilot:
                                       Accountable                           Reduced
 Eligibles             Center, Medic                      Bundled
                                       Health                                payment for
 Office                are &                              Payments for
                                       Organizations                         hospital-
 established           Medicaid                           Hospital &
                                       (ACOs)                                acquired
                       Innovations                        post-acute care
 (FCHCO)                                                                     conditions
                       (CMMI)          Reduced
                                       payments for
                                       preventable            Estimate: these initiatives
                                       hospitalizations         will reduce Medicare
                                       Value-based             spending by $12b over
                                       purchasing                      10 years
                                       for hospitals
                                       Independence
                                       at home
                                       demonstration
                                       project
Source: Kaiser Family Foundation
Evidence-based
recommendations
  for education
  and practice.
Why Nurses?


              A high-quality health
              system will provide:
              •   Chronic care management
              •   Care coordination
              •   Prevention and wellness
              •   Care across the lifespan

              Nurses can help
              address these needs
The Future of Nursing
IOM Report
  Ensure that nurses can practice to the
  full extent of their education and training
  Nurses should achieve higher levels of
  education through an improved education
  system that promotes seamless academic
  progression
The Future of Nursing
IOM Report
  Nurses should be full partners with
  physicians and other healthcare
  professionals in redesigning healthcare
  in the United States
  Improve data collection and information
  infrastructure for workforce planning and
  policy making
8 Recommendations

 Remove scope of practice barriers
 Expand opportunities for nurses to
 lead and diffuse collaborative
 improvement efforts
 Implement nurse residency programs
8 Recommendations
  Increase proportion of nurses with
  BSN degree to 80% by 2020
  Double the number of nurses with
  a doctorate by 2020
  Ensure that nurses engage
  in lifelong learning
8 Recommendations

  Prepare and enable nurse to lead
  change to advance health
  Build an infrastructure to collect
  and analyze healthcare workforce
  data
Future of Nursing - Fort Wayne
Growth in Doctoral Nursing Programs: 2006-2011

                                                                                                                      184
                                                                                                          153
                                                                                              120
                    DNP                                                     92
                                                        53
                                     20



                                                                                                125
                                                                                               124
                                                                                              120
Research-Focused Doctoral                                                                116
                                                                                        111
                                                                                  103


                            0   20          40          60          80      100         120         140   160   180         200

                                     2011        2010        2009    2008    2007        2006



       Source: © American Association of Colleges of Nursing. All Rights Reserved
Enrollments in DNP & Ph.D. Programs: 2003-2011
10000

 9000                                                                                               9,094

 8000

 7000                                                                                    7,037

 6000

 5000                                                                         5,165
                                           3,927     3,982       3,976                             4,907
                               3,718                                          4,161     4,611
 4000                3,439
           3,229
                                                                  3,415
 3000

 2000                                                 1,874

 1000                                       862
                      170       329
            70
   0
         2003      2004      2005       2006       2007       2008        2009        2010       2011

                      Research Focused Doctoral       Doctorate of Nursing Practice



    Source: © American Association of Colleges of Nursing. All Rights Reserved
Better Care




Healthy
People/Healthy
                               Affordable Care
Communities
Mindy Yoder
DNP, FNP-BC, RN




       myoder@sf.edu
   260-399-7700, ext. 8510
Future of Nursing - Fort Wayne
Dave Johnson
PhD, CNS, BC, USF Professor




Local, State and
   National Perspectives
Panelist


Judith A. Boerger MSN, MBA
   Sr. Vice President, Chief Nursing
          Executive, Parkview
Panelist

           Judith A. Halstead
           Ph.D., RN ANEF, FAAN
      Professor and Executive Associate Dean
     for Academic Affairs, IU School of Nursing,
Indianapolis, President, National League of Nursing
Panelist


Kimberly J. Harper, MS, RN
         Executive Director,
     Indiana Center for Nursing
Panelist


   Karra Heggen, MSN, RN
  Chief Nursing Officer, Dupont Hospital,
  Representing Lutheran Health Network
Panelist

 Amy Knepp, NP-C, MSN
     Chair, Department of Nursing and
  Assistant Professor, University of Saint
   Francis, Family Nurse Practitioner for
       Parkview Physicians Group
Panelist

       Diana Dee Swanson
              MSN, NP-C NP
        IU Health Southern Indiana
Physicians Group, Representing Coalition of
  Advanced Practice Nursing in Indiana
The Future of Nursing
IOM Report


  Ensure that nurses can practice to
  the full extent of their education and
  training
The Future of Nursing
IOM Report


  Nurses should achieve higher levels
  of education through an improved
  education system that promotes
  seamless academic progression
The Future of Nursing
IOM Report


  Nurses should be full partners with
  physicians and other healthcare
  professionals in redesigning healthcare
  in the United States
The Future of Nursing
IOM Report


  Improve data collection and information
  infrastructure for workforce planning
  and policy making
Future of Nursing - Fort Wayne
Dawn M. Mabry
MSN, RN, CNE




Simulation and the
        Future of Nursing
History
 2005 Simulation Lab Planning
 2007 Simulation Experiences
 2008 and 2011 iStan and Metiman
Demonstration
 Basic Assessment of a Teenage
 Athlete with Fluid and Electrolyte
 Imbalance
Roles
 Patient – Metiman
 Patient Voice – Jeb Ray, BSN student
 Registered Nurse – Janine
 Shane, BSN student
 Football Coach – Dr. Dave
 Johnson, faculty
Learning Objectives

 Performs an accurate basic physical
 assessment of the patient with fluid and
 electrolyte imbalance (APPLICATION).
 Identifies normal and abnormal assessment
 findings (APPLICATION).
 Documents normal and abnormal
 assessment findings in relation to fluid and
 electrolyte imbalance (APPLICATION).
Learning Objectives

 Identifies strategies for treating
 dehydration related to heat
 exhaustion (APPLICATION).
 Identifies teaching opportunities
 regarding heat-related illnesses
 (APPLICATION).
Prep Questions
 Describe the pathophysiology of dehydration.
 Which types of dehydration are most often associated
 with heat-related illnesses?
 What electrolyte findings are common with these types
 of dehydration?
 What assessment findings are consistent with dehydration?
 Describe the difference between heat cramps, heat exhaustion
 and heat stroke.
 How do symptoms and treatments differ for these three
 heat-related illnesses?
 What are the signs of rehydration?
Synopsis
The learner will be providing care for a 19-year-
old male admitted to the Emergency Department
(ED) for dehydration and electrolyte imbalance
caused by heat exhaustion. The patient is a star
athlete on his college football team. He passed
out this afternoon during practice. The
temperature was 90 F, and the relative humidity
was 80%. It is August, and the team has been
practicing for the last week.
Initial healthcare
provider’s orders
  Admit to Emergency Department
  CBC and
  Electrolytes, BUN, Creatinine, Glucose, STAT
  Start IV and give 500 mL 0.9% normal saline
  bolus
  Orthostatic blood pressures
  Notify of urine output of less than 30 mL/hour
  Oral fluids as tolerated
Debriefing
 Introduction: Discuss faculty role as a
 facilitator, expectations, confidentiality, safe
 environment for discussion
 Personal Reactions: Allow learners to recognize and
 release emotions, explore learner reactions
 Discussion of Events: Analyze what happened during
 the SCE, using video playback if available
 Summary: Review what went well and what did
 not, identify areas for improvement and evaluate the
 experience
Standards

Interprofessional   the Future of
Team Simulation     NURSING
                    EDUCATION
Research
Future of Nursing - Fort Wayne

More Related Content

Future of Nursing - Fort Wayne

  • 2. Nancy Gillespie PhD, RN, Dean Thank you.
  • 3. Agenda Future of Nursing Presentation Panel Discussion Simulation Showcase
  • 4. Mindy Yoder DNP, FNP-BC, RN Leading Change, Advancing Health
  • 5. Overview Healthcare challenges in the U.S. Our Nursing Profession Healthcare Reform IOM Nursing Report-Call for Leadership
  • 6. What is the state of our HEALTHCARE SYSTEM?
  • 7. A short list… Unsustainable costs Equitability of access to care Difficulty building consensus
  • 8. A short list…cont. Care coordination Primary care shortage Aging population and rise of chronic disease Poor outcomes
  • 10. Why $$$? Technology Prices are higher in the United States Price insensitivity to end consumer Judgment-based nature of MD care Values and culture
  • 12. Per capita health spending and 15-year survival for 45-year-old women. U.S. and 12 comparison countries, 1975 and 2005 Muennig P A , Glied S A Health Aff2010;29:2105-113 ©2010 by Project HOPE - The People-to-People Health Foundation, Inc.
  • 13. Demographics Starting in 2011 10,000 people in the U.S. have been turning 65 every day
  • 14. Fastest Growing Population, 85+ 20,000 19,041 18,000 16,000 14,000 14,198 12,000 10,000 8,745 8,000 6,597 6,000 5,751 4,000 4,240 2,000 0 2000 2010 2020 2030 2040 2050 Projected Number of Americans 85 years and over
  • 15. Older Americans with Multiple Chronic Conditions Medicare beneficiaries with at least one chronic condition Nation’s healthcare spent on treating patients with chronic diseases Source: AARP. ―Beyond 50.09: Chronic Care: A Call to Action for Health Reform.‖ Washington, DC. 2009
  • 16. What is the state of NURSING?
  • 17. A short list… Lack of nursing educational preparation to meet the demands of our current healthcare system Practicing clinicians regularly make decisions on tradition rather than empirical evidence Chronic, cyclical nursing workforce shortage Nursing faculty shortage, yet faculty are poorly compensated Shortage of doctoral nurses Education—practice gap
  • 18. Projected shortfall in 2020 1million NURSES
  • 19. The bottom line High-quality, patient-centered health care for all will require remodeling of health care system Three national healthcare goals (Donald Berwick) Improve health Enhance the patient experience Reduce/contain costs Nurses are essential partners in achieving success
  • 20. The challenges before us require significant improvement in public and institutional policies at national, state and local levels.
  • 21. What is the impact of HEALTHCARE Reform?
  • 22. Patient Protection and Affordable Care Act 2010 Health Insurance Reform • Expand insurance coverage • Expand consumer protections • Reform industry practices Status Quo • Health costs exceed general inflation • Sub-optimal population health • Unexplained Payment Reform, variations in Delivery Systems practice patterns • Evolve Medicare payment • Questions about systems from fee-for-service evidence base of to value based payment some procedures • Test new payment methodologies and patient care delivery models for Medicare, Medicaid & CHIP Source: Health Solutions Division, Manatt, Phelps & Phillips, LLP
  • 23. Payment Reform, Quality, and Delivery System Change Timeline 2010 2011 2012 2013 2015 Shared Savings/ Dual New National pilot: Accountable Reduced Eligibles Center, Medic Bundled Health payment for Office are & Payments for Organizations hospital- established Medicaid Hospital & (ACOs) acquired Innovations post-acute care (FCHCO) conditions (CMMI) Reduced payments for preventable Estimate: these initiatives hospitalizations will reduce Medicare Value-based spending by $12b over purchasing 10 years for hospitals Independence at home demonstration project Source: Kaiser Family Foundation
  • 24. Evidence-based recommendations for education and practice.
  • 25. Why Nurses? A high-quality health system will provide: • Chronic care management • Care coordination • Prevention and wellness • Care across the lifespan Nurses can help address these needs
  • 26. The Future of Nursing IOM Report Ensure that nurses can practice to the full extent of their education and training Nurses should achieve higher levels of education through an improved education system that promotes seamless academic progression
  • 27. The Future of Nursing IOM Report Nurses should be full partners with physicians and other healthcare professionals in redesigning healthcare in the United States Improve data collection and information infrastructure for workforce planning and policy making
  • 28. 8 Recommendations Remove scope of practice barriers Expand opportunities for nurses to lead and diffuse collaborative improvement efforts Implement nurse residency programs
  • 29. 8 Recommendations Increase proportion of nurses with BSN degree to 80% by 2020 Double the number of nurses with a doctorate by 2020 Ensure that nurses engage in lifelong learning
  • 30. 8 Recommendations Prepare and enable nurse to lead change to advance health Build an infrastructure to collect and analyze healthcare workforce data
  • 32. Growth in Doctoral Nursing Programs: 2006-2011 184 153 120 DNP 92 53 20 125 124 120 Research-Focused Doctoral 116 111 103 0 20 40 60 80 100 120 140 160 180 200 2011 2010 2009 2008 2007 2006 Source: © American Association of Colleges of Nursing. All Rights Reserved
  • 33. Enrollments in DNP & Ph.D. Programs: 2003-2011 10000 9000 9,094 8000 7000 7,037 6000 5000 5,165 3,927 3,982 3,976 4,907 3,718 4,161 4,611 4000 3,439 3,229 3,415 3000 2000 1,874 1000 862 170 329 70 0 2003 2004 2005 2006 2007 2008 2009 2010 2011 Research Focused Doctoral Doctorate of Nursing Practice Source: © American Association of Colleges of Nursing. All Rights Reserved
  • 34. Better Care Healthy People/Healthy Affordable Care Communities
  • 35. Mindy Yoder DNP, FNP-BC, RN myoder@sf.edu 260-399-7700, ext. 8510
  • 37. Dave Johnson PhD, CNS, BC, USF Professor Local, State and National Perspectives
  • 38. Panelist Judith A. Boerger MSN, MBA Sr. Vice President, Chief Nursing Executive, Parkview
  • 39. Panelist Judith A. Halstead Ph.D., RN ANEF, FAAN Professor and Executive Associate Dean for Academic Affairs, IU School of Nursing, Indianapolis, President, National League of Nursing
  • 40. Panelist Kimberly J. Harper, MS, RN Executive Director, Indiana Center for Nursing
  • 41. Panelist Karra Heggen, MSN, RN Chief Nursing Officer, Dupont Hospital, Representing Lutheran Health Network
  • 42. Panelist Amy Knepp, NP-C, MSN Chair, Department of Nursing and Assistant Professor, University of Saint Francis, Family Nurse Practitioner for Parkview Physicians Group
  • 43. Panelist Diana Dee Swanson MSN, NP-C NP IU Health Southern Indiana Physicians Group, Representing Coalition of Advanced Practice Nursing in Indiana
  • 44. The Future of Nursing IOM Report Ensure that nurses can practice to the full extent of their education and training
  • 45. The Future of Nursing IOM Report Nurses should achieve higher levels of education through an improved education system that promotes seamless academic progression
  • 46. The Future of Nursing IOM Report Nurses should be full partners with physicians and other healthcare professionals in redesigning healthcare in the United States
  • 47. The Future of Nursing IOM Report Improve data collection and information infrastructure for workforce planning and policy making
  • 49. Dawn M. Mabry MSN, RN, CNE Simulation and the Future of Nursing
  • 50. History 2005 Simulation Lab Planning 2007 Simulation Experiences 2008 and 2011 iStan and Metiman
  • 51. Demonstration Basic Assessment of a Teenage Athlete with Fluid and Electrolyte Imbalance
  • 52. Roles Patient – Metiman Patient Voice – Jeb Ray, BSN student Registered Nurse – Janine Shane, BSN student Football Coach – Dr. Dave Johnson, faculty
  • 53. Learning Objectives Performs an accurate basic physical assessment of the patient with fluid and electrolyte imbalance (APPLICATION). Identifies normal and abnormal assessment findings (APPLICATION). Documents normal and abnormal assessment findings in relation to fluid and electrolyte imbalance (APPLICATION).
  • 54. Learning Objectives Identifies strategies for treating dehydration related to heat exhaustion (APPLICATION). Identifies teaching opportunities regarding heat-related illnesses (APPLICATION).
  • 55. Prep Questions Describe the pathophysiology of dehydration. Which types of dehydration are most often associated with heat-related illnesses? What electrolyte findings are common with these types of dehydration? What assessment findings are consistent with dehydration? Describe the difference between heat cramps, heat exhaustion and heat stroke. How do symptoms and treatments differ for these three heat-related illnesses? What are the signs of rehydration?
  • 56. Synopsis The learner will be providing care for a 19-year- old male admitted to the Emergency Department (ED) for dehydration and electrolyte imbalance caused by heat exhaustion. The patient is a star athlete on his college football team. He passed out this afternoon during practice. The temperature was 90 F, and the relative humidity was 80%. It is August, and the team has been practicing for the last week.
  • 57. Initial healthcare provider’s orders Admit to Emergency Department CBC and Electrolytes, BUN, Creatinine, Glucose, STAT Start IV and give 500 mL 0.9% normal saline bolus Orthostatic blood pressures Notify of urine output of less than 30 mL/hour Oral fluids as tolerated
  • 58. Debriefing Introduction: Discuss faculty role as a facilitator, expectations, confidentiality, safe environment for discussion Personal Reactions: Allow learners to recognize and release emotions, explore learner reactions Discussion of Events: Analyze what happened during the SCE, using video playback if available Summary: Review what went well and what did not, identify areas for improvement and evaluate the experience
  • 59. Standards Interprofessional the Future of Team Simulation NURSING EDUCATION Research

Editor's Notes

  1. Welcome and self introduction by Nancy Gillespie, Dean, School of Health SciencesMention the incredible mix of the audience (students, educators, practicing LPNs and nurses and other professionals). What a unique opportunity, nursing profession essential to quality healthcare outcomes. When else has our nursing community had this opportunity to come together/
  2. (Nancy Gillespie)Thank you to all of our sponsors (name them) Lutheran Health Network, Franciscan Alliance, and Parkview Health. (Nancy and USF personnel should start an enthusiastic applause.) After that, you might mention what Franciscan Alliance is…some/most in the audience will not know the name. Thank the Sisters in the audience for joining us today (they can rise and we can applaud).Today’s event is the first in a series of lectures under the “Future of” concept. Periodically, the university will be holding public lectures on substantive topics that we believe benefit our community. The University of Saint Francis is proud to introduce our signature series with the Future of Nursing—which represents a deeper conversation of this vital and dynamic profession in the healthcare field.”
  3. (Nancy continues…name features of today’s program AND the names of the presenters)Future of Nursing by Dr. Mindy Yoder, BSN/MSN Program Director, Department of Nursing. Explain the origin of the study (Robert L. Wood Foundation of Johnson & Johnson fame led ION to commission the study). …we will then dig deeper by looking at the Future of Nursing by asking what Chief Nursing Officers and other experts know about the future of nursing locally and across the state. Panel Discussion moderated by Dr. Dave Johnson, Professor, Department of Nursing…looking again to the future, we will turn our attention to MetiMan—on stage with us now for a demonstration of how USF student nurses are learning the profession to become future nurses. Simulation Showcase led by Dawn Mabry, Director, School of Health Science Simulation Lab and assisted by a USF student (name nursing student, or let Dawn do that when she is up.)We will wrap up with ….Summary comments by Amy Knepp, Chair, Department of NursingDon’t worry, we will do our best to keep on track today…we’ll even squeeze in a seventh inning stretch to keep us all alert (NG to ad lib this part…).You each should have received a packet that includes a summary evaluation sheet. That is the form you will need to turn in as you exit today. There will be USF students at the doors collecting your evaluations and distributing certificates for two contact hours. I would like to (thank representative’s name?) from Lutheran who helped us facilitate the contract hours certification. Even if you are not collecting contact hours, we would like your feedback on the presentation to prepare for future events.
  4. 17% of the GDP is spent on healthcare in the U.S. (as compared with 3-5% in other countries) and is projected to increase to 20% within 7 years (SOURCE: Kaiser Family Foundation based on data from Congressional Budget Office, March 2009); focus on rescue care/sick care vs. preventive care; unnecessary re-hospitalizations allocation of healthcare resources: where are we spending HC dollars?-----healthcare disparities part of being in a democracy is that everyone has a voice and everyone’s opinions differ greatly Care coordination: fragmentation of care, duplication of services, safety/errors Outcomes: Ranked 29th in infant mortality rates by OECD (industrialized countries) Organization for Economic Cooperation and DevelopmentRanked 37th in overall health system performance by WHORanked 24th in D.A.L.Y. (disability adjusted life years)All of this has prompted an urgency for healthcare reform
  5. 17% of the GDP is spent on healthcare in the U.S. (as compared with 3-5% in other countries) and is projected to increase to 20% within 7 years (SOURCE: Kaiser Family Foundation based on data from Congressional Budget Office, March 2009); focus on rescue care/sick care vs. preventive care; unnecessary re-hospitalizations allocation of healthcare resources: where are we spending HC dollars?-----healthcare disparities part of being in a democracy is that everyone has a voice and everyone’s opinions differ greatly Care coordination: fragmentation of care, duplication of services, safety/errors Outcomes: Ranked 29th in infant mortality rates by OECD (industrialized countries) Organization for Economic Cooperation and DevelopmentRanked 37th in overall health system performance by WHORanked 24th in D.A.L.Y. (disability adjusted life years)All of this has prompted an urgency for healthcare reform
  6. Per Capita Health Spending And 15-Year Survival For 45-Year-Old Women, United States And 12 Comparison Countries, 1975 And 2005
  7. The 85+ population’s growth rate is 2 times that of those 65+ and almost 4 times that for the total population.As the population ages, the number of dementia cases is projected to more than double, exceeding 11 million by 2050.If this trend continues, how will total health care spending change? Where will dementia patients live? Who will provide care? Who will finance their care?
  8. How will the increasing diversity of the older population change the total prevalence of chronic conditions?What will the impact of increased obesity be on disability rates?Cultural SensitivitiesLifestyle ChangesChronic conditions are the #1 cause of death and disability in the U.S.45% ofAmericans suffer from at least 1 chronic disease
  9. 56 percent of current Indiana nurse educator workforce is projected to retire by 2010 2006 report shows an immediate need to fill 48 vacant positions in Indiana Schools of Nursing Nursing shortage is directly related to schools’ inabilities to expand enrollment due to a shortage of nurse educators. Approximately 1,600 qualified students seeking admission are turned away annually (INWDC annual survey of Indiana nursing programs). http://www.ihaconnect.org/Issues/Workforce/default.aspx (Indiana Hospital Association)
  10. Current economic crisis is keeping nurses in the workforce at presentInter professional collaboration within health care is criticalEducation and practice have different missions
  11. Source: U.S. Health Resources and Services AdministrationProjected shortfall of nurses in 2020= 1 million
  12. Donald Berwick (born 1946) is the outgoing Administrator of the Centers for Medicare & Medicaid Services (CMS), and was formerly President and Chief Executive Officer of the Institute for Healthcare Improvement (IHI)[1] a not-for-profit organization helping to lead the improvement of health care throughout the world. (was appointed as head of CMS in July 2010 by President Obama)
  13. PPACA (A.K.A. Affordable Care Act or “Obamacare”)passed 24 months ago is trying to address these 4 important problems. While the public hears more about the expansion of insurance coverage, the part that will affect providers most is payment reform and testing new delivery systems.CHIP= Children’s Health Insurance Program
  14. These are not far-into-the future changes, they are happening now. With 2012 being an inaugural year for several new initiatives.
  15. Landmark, evidence-based report (600 pages) written by a neutral party– 17 member Board/Commission made up of largely non-nurses, published in October 2010.Report discusses: what does the public need in a transformative, sustainable healthcare system? The answer is: nursing will lead us. Nursing has a holistic view and the mentality that “it is all about the patient”.
  16. Jch/ THIS IS WHAT WE DO!!!!!
  17. KEY MESSAGES-----relate to education,practice, leadership, data and diversityTHE CHALLENGE TO US: Seek significant improvement in public and institutional policies at national, state and local levels URGE audience to read the 8 page summary report (IOM Website) Provide opportunities for nurses to assume leadership positions and to serve as full partners in health care redesign and improvement effortsFoster interprofessional collaboration
  18. KEY MESSAGES-----relate to education,practice, leadership, data and diversityTHE CHALLENGE TO US: Seek significant improvement in public and institutional policies at national, state and local levels URGE audience to read the 8 page summary report (IOM Website) Provide opportunities for nurses to assume leadership positions and to serve as full partners in health care redesign and improvement effortsFoster interprofessional collaboration
  19. Bullet points not on screen:Identifying the “Right” Measures for Public Reporting and Performance-Based PaymentHHS Aims: measuring what is important to patients and construction of measures specific to patient populations rather than provider settings or diseasesDepartment of Health and Human Services (HHS) Chart illustrates National Quality Strategy Aims and PrioritiesMAPProvide upstream, public-private input to HHS on the selection of performance measures for use in public reporting, performance-based payment, and other programsIdentify gaps for measure development, testing, and endorsementAlign measurement across programs, settings, levels of analysis, populations, and between public and private sector programsPromote coordination of care delivery Reduce data collection burdenMeasure Topics in 5 Areas:Quality of Life: Functional Status Assessment, Health-Related Quality of Life, Palliative Care Care Coordination: Care Transition Experience, Communication with Patient/Caregiver, Communication with Healthcare Providers, Hospital Readmission, Medication ManagementScreening and Assessment: BMI Screening, Falls, Management of Diabetes, Pain ManagementMental Health and Substance Use: Alcohol Screening and Intervention, Depression Screening, Substance Use Treatment, Tobacco CessationStructural Measures: Health IT Infrastructure, Medical Home Adequacy, Medicare / Medicaid CoordinationOther: Patient Experience
  20. Dave Johnson PhD,CNS,BC Professor of Nursing, University of Saint Francis
  21. Judith A. Boerger MSN, MBA, Sr. Vice President, Chief Nursing Executive, Parkview
  22. Judith A. Halstead, PhD, RN, ANEF, FAAN Professor and Executive Associate Dean for Academic Affairs, Indiana University School of Nursing Indianapolis
  23. Kimberly J. Harper, MS, RN Executive Director, Indiana Center for Nursing
  24. KarraHeggen, MSN RN CNO, Chief Nursing Officer Dupont Hospital
  25. Amy Knepp NP-C, MSN, RN Chair, Department of Nursing and Assistant Professor, University of Saint Francis. Family Nurse Practitioner for Parkview Physicians Group
  26. Diana Dee Swanson MSN,NP-C NP IU Health Southern Indiana Physicians Group
  27. KEY MESSAGES-----relate to education,practice, leadership, data and diversityTHE CHALLENGE TO US: Seek significant improvement in public and institutional policies at national, state and local levels URGE audience to read the 8 page summary report (IOM Website) Provide opportunities for nurses to assume leadership positions and to serve as full partners in health care redesign and improvement effortsFoster interprofessional collaboration
  28. KEY MESSAGES-----relate to education,practice, leadership, data and diversityTHE CHALLENGE TO US: Seek significant improvement in public and institutional policies at national, state and local levels URGE audience to read the 8 page summary report (IOM Website) Provide opportunities for nurses to assume leadership positions and to serve as full partners in health care redesign and improvement effortsFoster interprofessional collaboration
  29. KEY MESSAGES-----relate to education,practice, leadership, data and diversityTHE CHALLENGE TO US: Seek significant improvement in public and institutional policies at national, state and local levels URGE audience to read the 8 page summary report (IOM Website) Provide opportunities for nurses to assume leadership positions and to serve as full partners in health care redesign and improvement effortsFoster interprofessional collaboration
  30. KEY MESSAGES-----relate to education,practice, leadership, data and diversityTHE CHALLENGE TO US: Seek significant improvement in public and institutional policies at national, state and local levels URGE audience to read the 8 page summary report (IOM Website) Provide opportunities for nurses to assume leadership positions and to serve as full partners in health care redesign and improvement effortsFoster interprofessional collaboration