The Institute of Medicine this week released an evaluation on its 2010 landmark "The Future of Nursing: Leading Change, Advancing Health" report.
The report made a series of recommendations pertaining to the roles for nurses in the 2010 healthcare landscape.
Shortly after release of the report, AARP and the Robert Wood Johnson Foundation launched the Future of Nursing: Campaign for Action to guide the report's recommendations. Last year, the Robert Wood Johnson Foundation asked the IOM to convene a committee to assess progress made on the report's recommendations and identify areas that should be emphasized over the next five years.
Here are the committee's recommendations, as presented by Committee Chairman Stuart Altman, a professor of health policy at Waltham, Mass.-based Brandeis University, during a Dec. 4 webinar.
1. Build common ground around scope of practice and other issues in policy and practice. Committee members said The Future of Nursing: Campaign for Action should involve more diverse stakeholders. "The campaign should build on its successes and work with other health professions groups, policy makers and the community to build common ground around removing scope of practice restrictions, increasing interprofessional collaboration and addressing other issues to improve healthcare practice in the interest of patients," they wrote in the report.
2. Continue pathways toward increasing the percentage of nurses with a baccalaureate degree. Committee members recommended The Future of Nursing: Campaign for Action, the nursing education community and state systems of higher education continue working to strengthen pathways toward increasing the number of nurses with a baccalaureate degree for nurses toward the baccalaureate degree. Mr. Altman said this applies to entry-level baccalaureate and people with an associate degree working toward a baccalaureate degree.
3. Create and fund transition-to-practice residency programs. Committee members recommended The Future of Nursing: Campaign for Action, in coordination with healthcare providers, healthcare delivery organizations and payers, lead efforts to explore ways of creating and funding transition-to-practice residency programs for registered nurses as well as advanced practice registered nurses. "Such programs are needed in all practice settings, including community-based practices and long-term care," the members wrote in their report. "These efforts should include determining the most appropriate program models; setting standards for programs; exploring funding and business case models; and creating an overarching structure from which to track and evaluate the quality, effectiveness and impact of transition-to-practice programs."
4. Promote nurses' pursuit of doctoral degrees. Mr. Altman said the committee emphasized the importance of promoting nurses' pursuit of both the doctor of nursing practice and doctor of philosophy degree, through incentives and expansion of programs. That way healthcare has an adequate supply of nurses for clinical care, research, faculty and leadership positions. "More emphasis should be placed on increasing the number of PhD nurses in particular," committee members wrote in their report. "To maximize the potential value of their additional education, nurses should be encouraged to pursue these degrees early in their careers. PhD and DNP programs should offer coursework that prepares students to serve as faculty, including preparing them to teach in an evolving healthcare system that is less focused on acute care than has previously been the case."
5. Promote nurses' interprofessional and lifelong learning. The committee also encouraged a focus on interprofessional and lifelong learning. Mr. Altman said lifetime learning is extremely important for nurses, especially with today's ever-changing healthcare environment. Therefore, committee members recommend the Future of Nursing: Campaign for Action encourage nursing organizations, education programs and professional societies, as well as individual nurses, to make lifelong learning, including continuing education, a priority so nurses are ready for these evolving healthcare environments. Members also recommended nurses work with other healthcare professionals to create opportunities for interprofessional collaboration and education. "The campaign could serve as a convener to bring together stakeholders from multiple areas of healthcare to discuss opportunities and strategies for interdisciplinary collaboration in this area," committee members wrote in their report.
6. Make diversity in the nursing workforce a priority. Committee members also want The Future of Nursing: Campaign for Action to continue to emphasize recruitment and retention of a diverse nursing workforce. Mr. Altman said the committee was impressed with nursing as far as expanding diversity, but there is more to be done. "In broadening its coalition to include more diverse stakeholders, the campaign should work with others to assess progress and exchange information about strategies that are effective in increasing the diversity of the health workforce," committee members wrote in their report.
7. Expand efforts and opportunities for interprofessional collaboration and leadership development for nurses. Committee members recommended the Future of Nursing: Campaign for Action expand its focus on supporting and promoting interprofessional collaboration and opportunities for nurses to design, implement and diffuse collaborative programs in care and delivery; and interdisciplinary development programs that focus on leadership. "Healthcare professionals from all disciplines should work together in the planning and implementation of strategies for improving healthcare, particularly in an interprofessional and collaborative environment," committee members wrote in their report.
8. Promote the involvement of nurses in the redesign of care delivery and payment systems. Additionally, committee members want The Future of Nursing: Campaign for Action to work with payers, healthcare organizations, providers, employers and regulators to bring nurses into the redesign of care delivery and payment systems. They suggested doing this by encouraging nurses to serve in executive and leadership positions in government, for-profit and nonprofit organizations, and healthcare delivery systems (e.g., as hospital CEOs or COOs), and advisory committees. Committee members also suggested the campaign expand its metrics to measure the progress of nurses in these areas.
9. Communicate with a wider and more diverse audience to gain broad support for campaign objectives. Committee members emphasized expanding the scope of its communication strategies to connect with a broader, more diverse, consumer-oriented audience and spur grassroots support. "The campaign, including its state action coalitions, should bolster communication efforts geared toward the general public and consumers using messages that go beyond nursing and focus on improving health and healthcare for consumers and their families," committee members said. Committee members also recommended the campaign recruit more healthcare professionals, such as physicians and pharmacists, as well as those outside of healthcare such as business leaders, employers and policy makers, as healthcare stakeholders to further demonstrate a collaborative approach in advancing the recommendations of The Future of Nursing report.
10. Improve workforce data collection. Mr. Altman said the campaign should emphasize improving workforce data collection and in that focus on the need for collaboration in terms of analysis and collection of workforce data. According to committee members, the campaign can use its strong brand and partnerships to help improve the collection of data on the nursing workforce.
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