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Transforming Health Care:
Nurses Engaged in Policy
Nancy Ridenour, PhD, APRN, BC, FAAN
American Academy of Nursing
October 13, 2012
RWJ Health Policy Fellowship
http://www.healthpolicyfellows.org/home.php Founded 1973 12-18 month residency in DC 4 month orientation Work assignments on the Hill traditionally Administration /Agencies
TRANSFORMATIONAL
Twelve Academy Members Who are RWJ Health Policy Fellows
Mary Mundinger, RN, DrPH1984-1985
Virginia Trotter Betts, JD, MSN, RN, FAAN1987-1988
Ellen-Marie Whelan, PhD, NP, RN, FAAN2003-2004
Nancy Ridenour, PhD, APRN, BC, FAAN2007-2008
Margaret Moss, PhD, JD, RN, FAAN2008-2009
Margaret Wilmoth, PhD, RN, FAAN2009-2010
Janice Phillips, PhD, RN, FAAN2010-2011
Barbara Damron, PhD, RN,FAANCurrent Fellow
Hurdis Griffith, PhD, RN, FAAN1986-1987
Julie Sochalski, PhD, FAAN1992-1993
Sister Rosemary Donley, PhD, APRN, BC, FAAN
1997-1998
Liana Orsolini-Hain, PhD, RN, CCRN2011-2012
Being Inducted into the Academy This Evening!
Portfolio While at Ways and Means
– PPACA now ACA– Hospice– Hospital acquired
infections; conditions– Health care associated
conditions– Health Information
Technology; meaningful use
– E-prescribing– Transparency in ownership
of long-term care facilities
– Quality outcomes /Value Based Purchasing
– Funding for primary care– International
comparisons in health outcomes and health systems
– Chronic Care Coordination
– Clinical Outcomes/Quality
– Workforce
Health Reform 2007-2008
Cost
Access
Quality
Health Reform 2009-Now
Cost
AccessQuali
ty
Lessons Learned
Need more nurses on the Hill
Nursing professional groups need to speak in “one voice”
Nurses need to make strategic partnerships
We need nurses to get PhDs in Health Economics!
Nursing needs to invest more in government relations
Research focus on issues to inform health policy
Translate profession specific language to stories for general public
Need more nurses in executive, legislative, and judicial branches
Characteristics of the Reformed Health System
Health Equity Patient/Consumer Centric Focus on Quality and Safety Value Based/Pay for Performance Evidence Based Practice Comparative Effectiveness Prevention and Early Intervention Increased Access
Reformed System
Demographics: aging population with increasing chronicity at all age levels
Meaningful use (HIT) Population based practice High Functioning Teams Workforce Issues
Numbers Distribution Best Mix
High Priority Health Problem/Issue
High Risk High Volume High Cost Closing the Gap between
Research and Practice
Biggest Impact
Increase Policy Relevance
Gap between clinical practice and research findings
Need to show public investment in research leads to benefits for patients
Timing Policymakers not interested in
theory Cost: usually more short-term than
long-term Know goals of agency, lawmaker, etc How are data being used? By
Whom?
Research Trajectories to Inform Policy
Design our research to inform and change policy
Design our research to evaluate current policy
Translate our current research into policy implications
Posit new policy approaches and test them
Research Agenda for Policy
Comparative Effectiveness Research ($3 Billion)
Interprofessional: research, education, practice
Team Science Workforce Quality; Safety Innovations in care delivery Outcomes Innovations in payment systems Health Information Technology Center for Innovation at CMS
• Why would someone be interested in your work?
• How can you humanize and personalize what you are doing?
• How can you help others see themselves as part of the solution you are proposing?
• What “niche” can you fill?
Think of Your Research, Practice, Teaching
Role of AAN
Each characteristic of the Reformed Health
System suggests a
Major role for The Academy to Impact Health Policy and Contribute to the Nation’s Health!
Be Part of the Solution Increase involvement, visibility, and influence
in the health policy process Enhanced advocacy role
Briefings, hearings and testimonies Fellowship Opportunities: Robert Wood Johnson
Health Policy Fellowship; AAN/IOM Scholar Membership on key boards, committees, task forces Collect and provide data showing outcomes and
comparative effectiveness of nurse driven care
The Robert Wood Johnson Foundation Nursing and Health Policy Collaborative at University of New Mexico:
• Prepares nurses to become leaders in health policy through research and advocacy. • Offers generous financial support for full-time study.• Offers Web-based course study. • Targets those from underrepresented populations. • Provides funds to support student and faculty research.• Provides resources and support from Robert Wood Johnson Foundation Center for
Health Policy.
For more information about the Robert Wood Johnson Foundation Nursing and Health Policy Collaborative at University of New Mexico visit our Web site at www.nursinghealthpolicy.org or write to us at CON-RWJF@salud.unm.edu.
Robert Wood Johnson Foundation Nursing and Health Policy Collaborative at
UNM
• Develop and practice a 30 second “elevator” speech on your project
• Develop one page lay audience description of your research or practice and the impact on healthcare.
• Outcomes• Quality and Effectiveness• Cost savings or recovery• Safety
Things to Do
AND
Communicate Disseminate Synthesize Across Disciplines Integrate Into Practice Accelerate the Pace of Policy
Development Provide data to inform and
evaluate policy
American Academy of Nursingtransforming health care policy and practice through nursing knowledge
AAN/IOM Scholars in Residence
2012 Marla Salmon ScD, RN, FAAN
ProjectFocus on micro-finance, nursing, and women’s development will impact domestic and global health policy
2010 - Pamela F. Cipriano PhD, RN, FAAN
ProjectImpact, implications of Health IT and identify technologies that reduce errors, waste and promote seamless care coordination
2009 - Julie A. Fairman PhD, RN, FAAN
ProjectInitiative on the Future of Nursing
Nurse Scholars
2008 - Mary E. Evans PhD, RN, FAAN
2007 - Carolyn Williams PhD, RN, FAAN
2006 - Ada Sue Hinshaw PhD, RN, FAAN
2005 - Jacquelyn C. Campbell PhD, RN, FAAN
2004 - Veronica D. Feeg PhD, RN, FAAN
2003 - Angela Barron McBride PhD, RN, FAAN
2002 - Bonnie M. Jennings DNSc, RN FAAN
Nurse Scholars
Sampling of Work of Expert Panels• Aging: Commented on proposed regulations regarding RNs in
LTC; Expressed concern to House leadership regarding ‘observational status”
• Emerging Infectious Diseases: Published policy brief Hepatitis C Screening and Testing: A Call for a National Response; Wide dissemination of policy brief on the need for routine testing for HIV
• Global Nursing and Health Care: Policy brief: Leadership needed to address the Global Nursing and Midwifery Workforce Shortage
Sampling of Work of Expert Panels• Quality: Preparing 6 positions papers– Measuring Episode of Care Outcomes– Measuring Care Coordination– Measuring the Economic Value of Nursing– Measuring Nurses’ Workload– Measuring Patient Engagement– Harmonizing Performance Measures—
Implications for Practice, Education, and Research
MedPAC Commissioner: Mary Naylor, PhD, RN, FAAN Transitions of Care
Chair National Health Workforce Commission:Peter Buerhaus, PhD, RN, FAAN
Initiative on the Future of Nursing
The Recommendations
Future of Nursing Report: Sue Hassmiller, Donna Shalala, Linda Burnes Bolton, Michael Bleich, Jennie Chin Hansen, Liana Orsolini-Hain
Action Coalitions: Multiple Fellows
HRSA Administrator:
Mary Wakefield
CMS Innovation Center: Ellen-Marie Whelan
Our Patients, Our Communities,
Our Health Care System, Our
NationNeed Nurses to Successfully Inform Policy Through Practice and Research
Through Engagement of Strategic Partners
Activate Strategic Partner Networks
Build Bridges with Common Vision
Soar to New Heights