Transforming the Future of Nursing in Ohio Nursing

Transforming the Future of Nursing in Ohio Nursing 2015 C. Renae Phillips, RN, MSN, CNAA-BC Vice President for Patient Care Services Chief Nurse Executive Dayton Children’s

Nursing 2015 Members of the Ohio Nurses Association (ONA), the Ohio Hospital Association (OHA), the Ohio Organization for Nurse Executives (OONE) are bringing their experience and intellect together in an unprecedented collaboration towards one important goal – enhancing the profession of nursing in Ohio.

Beginning the Project June 30, 2005 • “Group of 20” started talking • OHA, ONA, OONE began with presentations and dialogue

Unprecedented Collaboration Since June 30, 2005, these groups have been working collaboratively to create, from concept to implementation, a vision for the future of nursing in Ohio and a strategy for making that vision a reality.

“Group of 20” Vision

Statement of Professional Nursing Professional nurses are self-directed, accountable, and control their environment. Nurses are professionally empowered to influence the delivery of high quality care that promotes positive patient outcomes through nursing leadership, coordination, and collaboration. Nurses are adequate in number, diverse, highly educated, and valued as clinical leaders across the continuum.

Statement of Professional Nursing The profession of nursing is respected and valued. The practice environment is attractive, supportive of work life balance, flexible, and incorporates state-of-the-art technology. Compensation and benefits are reflective of nurses’ contributions to the delivery of care.

Collaborating It was critically important that this long term project was built on open dialogue and collaboration. The GOT formulated guiding principles to help provide structure and direction.

Guiding Principles 1. All stakeholders are “at the table” and actively participating. 2. Frontline providers involved and their voices heard. 3. The need for cultural changes is a key element in creating the future and is not overlooked or underestimated. 4. Communication is ubiquitous and consistent.

Guiding Principles 5. Changing processes and changing infrastructures lead to success. 6. Nursing care is provided in many alternative venues. The acute care setting is one of many settings for care and will be one of the venues as opposed to the primary venue. 7. Financial alignment between payers and providers accelerates change.

Guiding Principles 8. Education and preparation for tomorrow’s nursing workforce changes in advance of the nursing practice changes and opportunities. 9. Risk-taking is a prerequisite for creating tomorrow’s future.

Strategic Directions To move the initiative forward, the work was segregated into 4 groups. We choose a “Race to the Future” theme to provide identity and help motivate the groups to move forward!! Red, Yellow, Green, Blue

Yellow Team-Education Direction: Highly educated nurses are prepared to fulfill evolving roles in a dynamic health care system, and nursing resources meet increasing health care demands. Goals • Coalition of practice and education leaders and representatives agrees to a statement on essential education needed to meet evolving roles in a dynamic health care environment. • By 2015, at least 50% of practicing RNs will have achieved a BSN or higher degree. • Establish a strategic Plan that will equip Ohio nurses with the competencies and skills to enable them to be effective leaders external and internal to the profession.

Red Team-Environment Direction: Worksite standards support quality nursing care in an ergonomically safe environment with the end result being better consumer outcomes. Goals • Establish and promulgate minimum standards for all new build and renovated health care facilities that will protect staff from workplace injuries. • Issue a white paper that identifies impediments to effective work flow and communication and that proposes model processes and best practices across the continuum of care.

Green Team-Leadership Direction: Nurses are independently and collectively recognized for the leadership and value they bring to achieving high quality care and positive outcomes. Goals • Revise nursing reimbursement away from traditional models, such as nursing being included with room and board, by creating new models for reimbursement incorporating the concepts of quality; pay for performance based on clinical, financial, and service outcomes; resources requirements; and wellness. • Implement a statewide public relations campaign to educate Ohioans about nursing’s contribution to the health and well being of all Ohio citizens.

Blue Team-Culture Direction: Practice culture conditions and benefits provide a win-win for nurses, consumers, and the organizations. Goals • Create a comprehensive common frame of reference for developing appropriate staffing including a definition of work load elements such as compliance issues and critical thinking that are not captured on traditional measurement tools or staff ration assignments. • Define the elements of a highly attractive practice culture, i. e. , the forces of magnetism, that are adopted by OONE/OHA/ONA and then implemented and sustained within each organization’s sphere of influence.

Nursing 2015: Race to the Future Kickoff September 26, 2006 • 14 month collaborative • 250 nurses participated • Shared our vision and direction with nurses across the state • Encouraged broad based participation

Teams Formed Red, Yellow, Green, Blue

2015 is a 10 Year Endeavor • Message doesn’t change even if resources/volunteers do • Attract potential new team participants • 2015 needs to fit into the bigger picture of health care reform

The Work Continues • After the Kickoff… the teams got started • Each group formed … • Pit crew chiefs were identified and participants encouraged

March 6, 2008 2015 Update • 4 teams together to celebrate and communicate • 80 nurses & guests • Guest speakers: – Becky Patton – ANA (President) – Linda Everett – AONE (Past President) • Sharing and reinvigorating!

Your Blue Team • Email nursing 2015@yahoo. com • www. ohnurses. org

Next Meeting of Blue Team April 18 – 10 am – 2 pm Ohio Hospital Association Columbus, OH

Blue Team Activity

Meeting Dates • • • January 3, 2007 March 9, 2007 September 20, 2007 November 29, 2007 February 8, 2008

Blue Team Work • Gathered a team together and began to form as a group (forming, storming, norming, performing) • Reviewed the vision statement and relevant strategic directions • Established time lines, key achievements, and communication tools • Reviewed position papers and resources – OHA workforce initiative – The Association of Critical Care Nurses Healthy Environment

Blue Team Work • Reviewed the OHA/OONE Nurse Staffing Position paper • Literature review of various topics – evidence based practice – nurses “floating” – nursing leadership • Explored Nursing Models • Lots of dialogue and discussion

Blue Team Work The Blue Team conducted a current state of the nursing environment identifying both the positive and negative elements influencing the nursing environment for the following concepts: • Adequate staffing for quality care • Effective nursing leadership • Effective nurse to physician relationships • Staff participation • Support for nursing models of care • Clinically competent nurses

Blue Team Work The group has explored the models of nursing care. We identified • The practice environment components of the nurse work index • The AACN healthy work environment • The Magnet nurse work environment

Action Planning Time for action!!!!!!! We have done our reviews, talked about “everything” and are ready to act… Based on our Directions and Goals we have started our action planning…. • Staffing; Meaningful Recognition; Model of Care; Collaboration; Staff Participation; Technology

Brain-Storming Ideas Staffing • • • Education sessions Development of a Tool Kit Finance Definitions and Outcome measures Technical Support and Staffing Templates Staffing and Flexibility

Brain-Storming Ideas Meaningful Recognition • Staffing: retain seasoned nurses by retirement program that includes insurance • Tie performance evaluation to support educations opportunities • Conduct Ohio Nurse campaign • Recognition of staff for meeting objectives with innovative compensation plans • Certification for clinical leadership: path to first line manager

Brain-Storming Ideas Model of Care • Model reference tool kit • Ability to move from one model to another with unexpected surprises • Certificate for Preceptorship • Develop “certifications: for house floats and compensate accordingly • Evidence based practice resource data base

Brain-Storming Ideas Collaboration • Crucial conversations for all physicians • Inter-disciplinary education • Evidence based care team build best practice care plans • Certification for Nursing leadership • Comprehensive in depth mentoring preceptorships for new employees

Brain-Storming Ideas Staff Participation Performance improvement – LEAN process in place Help make front line managers secure, educated, supported and happy Establish an institute/“think tank” for nursing in Ohio Keep concept of 2015 going Tools for reporting offshift or change in caregivers

Brain-Storming Ideas Technology • Develop “historical reference” for technology • Opportunity/reimbursement for completion of computer skills class • Unit expert on all shifts • Handheld device for charting, bar coding, locator, phone, web

Where We Are Today February 8, 2008

Strategic Direction • Create a comprehensive common frame of reference for developing appropriate staffing including: – a definition of workload elements such as compliance issues and critical thinking that are not captured on traditional measurement tools or staff ratio assignments

Strategic Directions • Define the elements of a highly attractive practice culture (i. e. the forces of Magnetism that are adopted by OONE/ OHA/ONA and then implement and sustain within the organization’s sphere of influence

New Concepts to Explore • • • Safety in the workplace Collaboration Staff participation Technology Meaningful recognition and benefits

Thank You Please join a team Be involved!!! http: //nursing 2015. wordpress. com/