current resident or Presort Standard US Postage PAID Permit #14 Princeton, MN 55371 Inside this Issue Nurses Taking Action in Texas: A Series–Living the IOM Report: Large Setting Employers Implementing Recommendations 3-4 12th Annual Nursing Leadership Conference 8 RN Coordination of Care: A New Model 9 NOEP Releases Major Update to AvidNurse App 11 Health Information Technology Goes Into the Classroom 12 Announcing: Texas Nurses Association CNE Workshop Schedule, Fall 2012 13 Membership Application 14 National Nursing Education Grant Awarded to Texas Focus Is On Building Highly Educated, Diverse Nursing Workforce Quarterly circulation approximately 293,000 to all RNs, LVNs, and Student Nurses in Texas. Join the Texas Nurses Association Today! Application on page 14 by J. Cunningham, TEXAS NURSING VOICE Staff A Robert Wood Johnson Foundation (RWJF) grant recently awarded to Texas to advance strategies for building a more highly educated, diverse nursing workforce is perhaps even more significant than its $300,000 face value. What it means for nursing in Texas is that a unique, collaborative partnership between associate degree nursing programs and baccalaureate programs can continue developing a statewide curriculum model that will allow nurses to more easily and seamlessly transition to higher levels of education. Currently, 61 percent of the nursing programs approved by the Texas Board of Nursing are associate degree nursing programs, and about 50 percent of nurses in Texas hold an associate degree (or diploma) as their highest level of education. Of those ADNs, only about 16 percent have historically returned to school to pursue higher education. Through the grant, Texas hopes to change that. The two-year grant funding, provided through a new RWJF program, Academic Progression in Nursing (APIN), will support statewide efforts of the Texas Team Action Coalition, convened to advance the Future of Nursing: Campaign for Action, to meet growing demand for high quality, patient centered, affordable and accessible health care. Just nine states were selected nationally to receive a new APIN grant. Other than Texas, they are California, Hawaii, Massachusetts, Montana, New Mexico, New York, North Carolina and Washington. Texas Nurses Association is a co-lead organizational sponsor of the Texas Team Action Coalition representing nursing. Blue Cross and Blue Shield of Texas is the other co- lead organization that represents non-nursing stakeholders. There are also over 120 partner organizations in the coalition representing business, health care, academia and other sectors. Action Coalitions in each state are working with academic institutions and employers of nurses on implementing strategies to help increase to 80 percent by 2020 the proportion of BSN-prepared nurses, a recommendation put forth in the Institute of Medicine report, The Future of Nursing: Leading Change, Advancing Health. If nursing is to lead the change that advances health, a different kind and a higher level of education will be required to care for an older, more diverse population who will present new health care challenges. About the APIN Grant Project The primary strategy in Texas for the APIN grant is to advance baccalaureate nursing National Nursing Grant continued on page 6 Page 9 Pages 3-4 Page 8
Transcript
current resident or
Presort StandardUS Postage
PAIDPermit #14
Princeton, MN55371
Inside this IssueNurses Taking Action in Texas: A Series–Living
Focus Is On Building Highly Educated, Diverse Nursing Workforce
Quarterly circulation approximately 293,000 to all RNs, LVNs, and Student Nurses in Texas.
Join theTexas Nurses Association
Today!
Applicationon page 14
by J. Cunningham, TEXAS NURSING VOICE Staff
A Robert Wood Johnson Foundation (RWJF) grant recently awarded to Texas to advance strategies for building a more highly educated, diverse nursing workforce is perhaps even more significant than its $300,000 face value. What it means for nursing in Texas is that a unique, collaborative partnership between associate degree nursing programs and baccalaureate programs can continue developing a statewide curriculum model that will allow nurses to more easily and seamlessly transition to higher levels of education.
Currently, 61 percent of the nursing programs approved by the Texas Board of Nursing are associate degree nursing programs, and about 50 percent of nurses in Texas hold an associate degree (or diploma) as their highest level of education. Of those ADNs, only about 16 percent have historically returned to school to pursue
higher education. Through the grant, Texas hopes to change that.
The two-year grant funding, provided through a new RWJF program, Academic Progression in Nursing (APIN), will support statewide efforts of the Texas Team Action Coalition, convened to advance the Future of Nursing: Campaign for Action, to meet growing demand for high quality, patient centered, affordable and accessible health care.
Just nine states were selected nationally to receive a new APIN grant. Other than Texas, they are California, Hawaii, Massachusetts, Montana, New Mexico, New York, North Carolina and Washington.
Texas Nurses Association is a co-lead organizational sponsor of the Texas Team Action Coalition representing nursing. Blue Cross and Blue Shield of Texas is the other co-lead organization that represents non-nursing stakeholders. There are also over 120 partner
organizations in the coalition representing business, health care, academia and other sectors.
Action Coalitions in each state are working with academic institutions and employers of nurses on implementing strategies to help increase to 80 percent by 2020 the proportion of BSN-prepared nurses, a recommendation put forth in the Institute of Medicine report, The Future of Nursing: Leading Change, Advancing Health. If nursing is to lead the change that advances health, a different kind and a higher level of education will be required to care for an older, more diverse population who will present new health care challenges.
About the APIN Grant ProjectThe primary strategy in Texas for the APIN
grant is to advance baccalaureate nursing
National Nursing Grant continued on page 6
Page 9 Pages 3-4
Page 8
Page 2 • Texas Nursing Voice October, November, December 2012
Published by:Arthur L. Davis
Publishing Agency, Inc.
www.texasnurses.org
TEXAS NURSING VoiceA publication of Texas Nurses Association
October, November, December 2012Volume 6, Number 4
Regional Directors of Texas Nurses AssociationJune Marshall, DNP, RN, NEA-BC – North Region
Eve Layman, PhD, RN, NEA-BC – South RegionKim Belcik, BSN, RN-BC – Central RegionViola Hebert, MA, BSN, RN – East RegionJo Rake, MSN, RN, CNAA – West Region
Texas Nurses Association and the Arthur L. Davis Publishing Agency, Inc. reserve the right to reject any advertisement. Responsibility for errors in advertising is limited to corrections in the next issue or refund of price of advertisement.
Acceptance of advertising does not imply endorsement or approval by Texas Nurses Association (TNA) of products advertised, the advertisers, or the claims made. Rejection of an advertisement does not imply a product offered for advertising is without merit, or that the manufacturer lacks integrity, or that this association disapproves of the product or its use. TNA and the Arthur L. Davis Publishing Agency, Inc. shall not be held liable for any consequences resulting from purchase or use of an advertiser’s product. Articles appearing in this publication express the opinions of the authors; they do not necessarily reflect the views of the staff, board, or membership of TNA or those of the national or local associations.
Texas Nurses Association Districts and PresidentsPresidents of the 28 statewide Districts of Texas Nurses Association, as well as some District offices, are listed below.
They invite you to contact them with questions or comments about TNA District membership and involvement in your local areas. For specific District locations, please refer to the TNA Tri-Level Membership District map on page 14.
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by Joyce Batcheller, DNP, RN, NEA-BC, FAAN, and Cole Edmonson, DNP, RN, FACHE, NEA-BC
About the Authors: Joyce Batcheller, DNP, RN, NEA-BC, FAAN, is a Robert Wood
Johnson Foundation Executive Nurse Fellow alumna, and senior vice president and system chief nursing officer, Seton Healthcare Family, Austin. Seton is a leading provider of health care services in Central Texas serving 11 counties and operating five major medical centers, two community hospitals, three rural hospitals, an inpatient mental health facility, three primary care clinics for the uninsured, and several other health facilities.
Dr. Batcheller is a member of the Executive Committee and co-leader of the Advancing Nursing Practice Team of the Texas Team Action Coalition, convened to advance the Future of Nursing: Campaign for Action. She is a member of Texas Nurses Association.
Cole Edmonson, DNP, RN, FACHE, NEA-BC, is a Robert Wood Johnson Foundation Executive Nurse Fellow, and vice president, patient care services and chief nursing officer at Texas Health Presbyterian Hospital Dallas. He has led facilities to achieve Magnet® designation and re-designation, and serves on community colleges of nursing and university nursing advisory boards, and as an advisor to nursing publications. He is adjunct faculty at UT Arlington and Texas Woman’s University, and the creator of www.stopbullyingnurses.com.
Dr. Edmonson is a member of Texas Nurses Association and president elect of Texas Organization of Nurse Executives. He is a member of the Executive Committee and co-leader of the Advancing Nursing Practice Team of the Texas Team Action Coalition.
Editors’ Note:It’s been nearly two years since the release of the milestone Institute
of Medicine report, The Future of Nursing: Leading Change, Advancing Health and just over a year since Texas Team was selected as an official Action Coalition of the Future of Nursing: Campaign for Action. The Campaign for Action is the implementation phase of the report’s recommendations for significantly changing nurses’ roles, responsibilities and education so they can better contribute to improving the U.S. health care delivery system.
Interested in the progress in Texas, editors of TEXAS NURSING VOICE called upon two of nursing’s leaders in two of Texas health care’s large hospital systems to fill readers in on how these large employment settings have begun their implementation of the IOM recommendations, including the report’s call for 80 percent BSN-prepared nurses by 2020. The following is what they shared. __________________________________________________________________
Batcheller: “It’s been more than two years since we started developing our long-term strategy for Seton’s nursing professional development.
The three objectives we identified are to increase the number of BSN-prepared new hires, increase nurse retention rates, and increase the number of our non-BSN-prepared nurses who are pursuing the BSN degree.
Many associates have asked why the process and decisions have taken so long. While we are eager to wrap up the plan, balancing workforce needs with the needs of our staff is a difficult task. I believe our efforts to incorporate feedback from nursing staff, managers and directors, and our deliberate approach will ensure we get this right. And, today, we are closer than ever to finalizing an implementation plan.
I’ve shared with our associates the changing landscape in health care and its increased demands on nurses including evidence-based practices, competencies in information and technology, and nursing research. To align with these national trends and maintain our commitment to Magnet® and Pathway to Excellence® designations, the Nursing Executive Council (NEC) of Seton is exploring how we might encourage more Seton nurses to earn a BSN or MSN degree.
We do know the minimum educational job qualifications for nurse manager level positions will be a BSN. The minimum job qualifications for a nurse director position will be a master’s degree. These requirements will begin January 1, 2013. While we are still working on the specifics for the impacted staff RN positions, I can tell you that any changes will be effective no earlier than 2017, and most will likely be effective no earlier than 2020. This shift will not happen overnight; the process will be thoughtful and sequenced.
Our vision has sparked some anxiety about how advanced-degree requirements may impact individual career paths. In response to those concerns, our NEC outlined these guiding principles:
• Ensure consistency from position to position and newly hired tocurrent associates
Nurses Taking Action In Texas: A SeriesLiving the IOM Report: Large Setting Employers Implementing Recommendations
Nurses Taking Action continued on page 4
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• Provideoptions for tenurednurseswhodonot plan to meet BSN degree requirements
• Continue to support career advancementfor non-BSN-prepared nurses
The NEC continues to work with Human Resources to outline and manage the specific implementation steps. The result of these efforts will honor all our Seton nurses, their experience as well as education.
I continue to remind nurses, where you start in nursing doesn’t matter; what matters is where you want to go.”
Edmonson: “As a recognized leader in nursing in North Texas, embracing and supporting the IOM’s Future of Nursing report was a priority, not only for nursing, but also for the entire organization. As a result, Texas Health Resources (THR) has integrated the report’s recommendations into the nursing strategic plan at the system and entity level in an effort to realize alignment of the IOM’s 2020 goals with the THR strategic plan and mission of improving the health of those in the communities we serve.
As an example, THR has committed to BSN preferential hiring and to assisting existing non-BSN RNs in achieving their BSN through both designation of funds and partnerships with innovative RN to BSN programs at local universities such as UT Arlington. In addition, THR has embraced new models of accelerated BSN programs for second-degree students through creative partnerships with education and service.
Exemplar, Texas Health Presbyterian Hospital Dallas (THD) achieved in one year a 12 percent increase in the number of BSNs at the bedside through focused recruitment and retention efforts along with funding and encouragement for non-BSNs to complete their BSN degrees. This brought the total bedside BSN percentage to 62 percent. Five staff nurses on the Neuro unit made a pact to begin and complete the RN to BSN journey together with support from their leadership team. All were successful and recently recognized by the chief nursing officer (CNO) as role models for living the Magnet® philosophy and for helping to achieve the vision of The Future of Nursing report. It’s really about creating a shared vision between leadership and direct care staff for achieving the IOM recommendations and the best outcomes for patients that everyone can believe in and support.
In 2011, Texas Health Dallas appointed the first nurse in the history of the organization to the Board of Directors after a search and a joint recommendation from the CNO, CMO and President. Not only did that elevate nursing, but it also fulfilled the IOM report’s Recommendation #7 to Prepare and enable nurses to lead change to advance health by preparing the ‘nursing workforce to assume leadership positions across all levels’ including getting nurses on boards.
In further support of IOM Recommendation #7, THD in 2011 was the first THR facility in Dallas to implement a new care delivery model that included the clinical nurse leader (CNL). It was the result of the vision, commitment and partnership of THR’s system CNO with Texas Christian University to bring the CNL role to
Nurses Taking Action continued from page 3 North Texas. THD has seen improvements in patient and nurse satisfaction metrics along with clinical metrics in the units with CNL coverage, and is implementing additional CNL roles.
Also in 2011, the CNO and Director of Professional Practice both completed their DNP degrees, advancing to five the number of doctoral prepared nurses on staff. Collaterally, this inspired others within the organization to begin their own journeys to doctoral preparation as a nurse. Our philosophy is that every nurse is a leader and we as nurse leaders must role model the behaviors and accomplishments that we ask our clinical colleagues to commit to.
And still in 2011, THD implemented a nurse residency after a long history of traditional internships. The Future of Nursing’s Recommendation #3 was Implement nurse residency programs that support nurses’ completion of a transition-to-practice program (nurse residency) after they have completed a prelicensure or advanced practice degree program or when transitioning into a new clinical practice area.
THD’s new Versant residency is an evidenced-based curriculum providing 20 weeks of residency, generational preceptors and mentors, looping experiences, an experiential clinical focus, and longitudinal metrics tracking. After only three cohorts, the results are demonstrating improvement across the board in all competency metrics and most importantly, the confidence of the residents in transitioning safely into practice. Again, the work this past year is supporting and aligning with the IOM recommendation on nurse residency.” ★
October, November, December 2012 Texas Nursing Voice • Page 5
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Page 6 • Texas Nursing Voice October, November, December 2012
education through the use of a multi-focused, statewide, standardized curriculum model. The grant project, named the Consortium for Advancing Baccalaureate Nursing Education in Texas (CABNET): A Statewide Model, would recruit nursing programs from across the state to adopt a statewide model of standardized, general education courses and prerequisites, as well as recruit other programs that would additionally implement concept-based curriculum at the associate and baccalaureate degree levels of nursing education.
Each participating community college and university nursing program would then recruit a partnering clinical site to assess competencies of “the nurse of the future,” specifically as they relate to leadership, cultural competencies/diversity, interprofessional collaboration, and quality and safety.
Another emphasis of the APIN grant project is on developing concept-based courses for BSN completion and master’s level courses. Concept-based curriculum at the associate and baccalaureate degree levels was chosen in order to manage content saturation and provide a method for content management. In the concept-based curriculum, students would apply the concepts of what they’ve learned to other patient situations.
Returning to SchoolFor CABNET, Texas Team Action Coalition
plans to include strategies for encouraging associate degree-prepared RNs to return to school for a BSN. A 2010 survey of the Texas Nurses Association Education Committee set about to gather perceptions of nursing students enrolled in associate degree programs concerning their plans to enroll in a BSN program. Survey responses revealed four main barriers: 1. lack of time; 2. family obligations; 3. lack of financial aid; and 4. the number of prerequisite courses needed. The standardized, seamless curriculum adopted statewide by associate degree and baccalaureate programs should be a step toward satisfactorily addressing the last barrier.
Also revealed in the TNA Education Committee survey of 2010 was the perception emphasized by students that the advantages of a BSN were either unknown or were not believed to exist. The reality is, the push to increase the proportion of BSN-prepared nurses by 2020 is driven by the marketplace where many employers particularly in urban areas are reporting preferential hiring
of BSN graduates. There is also a shifting health care environment where chronic conditions will replace acute illnesses, technology and health information systems will be more widely implemented, and competencies needed will include leadership, research, evidence-based practice, collaboration, and policy.
In Texas, the ethnic diversity of the state is not reflected in the nursing workforce. Approximately 75 percent of the Texas nurses are white; 10-12 percent, black; and only 4-7 percent Hispanic. In 2009, according to CABNET, the Texas Higher Education Coordinating Board reported that “a majority of students enrolled in nursing programs were white, although community college nursing programs enrolled more minority students…”
It is hoped that by encouraging associate degree prepared RNs to pursue a BSN program in a timely manner, a rise of minority nurses that more closely reflects Texas’ general state population could be expedited.
A Strong FoundationWith the APIN grant, Texas can build on the
work of a year long, recently completed Perkins Leadership Grant.* The Perkins grant was given to a consortium of eight associate degree nursing programs and four BSN programs in Texas (see sidebar of participants) to create a competency-based, seamless 1 + 2 + 1 BSN curriculum with an associate degree exit. Simply, the 1 + 2 + 1 RN-to-BSN format is one year of standardized general education requirements, plus two years of nursing curriculum; plus one more year of baccalaureate level preparation. The creation of CABNET is intended to promote wide adoption of the standardized general education courses.
Student outcomes are defined in the curriculum by 25 competencies included in the Texas BON Differentiated Competencies. The standardized approach was intended to improve transferability between colleges and universities, decrease barriers to associate degree nurses continuing their nursing education, and allow some local college control over prerequisites and core curriculum. Mainly, the standardization of general education courses and prerequisites reduces the time students spend on this component of their nursing education and facilitates transferability.
Of all the states, Texas has the highest percentage of uninsured people and a significant shortage of health care professionals to care for them, as well as a shortage of faculty to educate more health care professionals. A total of 293,000 additional nurses are needed in Texas by 2020 to meet expected demand for nursing care due in part to a nursing shortage and a retiring workforce.
Helen Reid, EdD, RN, CNE, provost, Health Science Center, Trinity Valley Community College, represented the ADN programs in the initial consortium project. She is now the project director of the recently awarded RWJF APIN grant.
Said Dr. Reid, “I am excited about continuing the tremendous collaboration between universities and community colleges started by the Perkins Leadership Grant group which created the Consortium for Advancing Baccalaureate Nursing Education in Texas. The APIN grant will strengthen these partnerships and include practice which will be vital in making progress toward the goal of 80 percent proportion of BSNs by 2020.”
*Perkins Leadership Grant was federal funds provided through the Carl D. Perkins Career and Technical Education Act of 2006 for the advancement of career and technical education. The grant was administered by the Texas Higher Education Coordinating Board (THECB) who was actively involved in the project.
National Nursing Grant continued from page 1
Participants in the Perkins Leadership Grant
Associate Degree Nursing Programs
• AustinCommunityCollege
• AlvinCommunityCollege
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• ElCentroCollegeoftheDallasCounty Community College District
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• SouthwestTexasJuniorCollege
• TrinityValleyCommunityCollege
• WhartonCommunityCollege
Baccalaureate Nursing Programs
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Joining Dr. Reid as a co-project director of the grant is Kathryn Tart, EdD, RN, founding dean, University of Houston – Victoria School of Nursing, and member of the Texas Team Action Coalition Advancing Nursing Practice Team. For the APIN grant project, Dr. Tart will represent baccalaureate degree nursing programs.
“The need for streamlining education for the nurses of our state,” explained Dr. Tart, “and the need for producing a highly competent nurse of the future are where we can bring our resources together through the RWJF APIN grant, for the benefit of the patients we aim to serve.”
Serving as co-project leader of the APIN grant project is Susan Sportsman, PhD, RN, ANEF, FAAN. Dr. Sportsman is a co-chair of the Texas Team Action Coalition Executive Committee, and co-leader of its Advancing Nursing Education Team. She is also director, Academic Consulting Group of Elsevier, and dean emerita of Midwestern State University. She is a past president of Texas Nurses Association and a member of the TNA Education Committee.
As a nurse educator, Dr. Sportsman is enthusiastic about the innovative approach to curriculum that the APIN grant will allow but also noted the aspects of faculty development and how to prepare faculty to effectively teach in a concept-based curriculum.
“The use of a concept based curriculum is a new approach to organizing nursing content,” explained Sportsman, “and faculty are interested in learning teaching-learning strategies that make this curricular approach most effective. The APIN grant and the in-kind contribution* of faculty-development webinars by Elsevier will ensure that Texas faculty is well prepared to implement new curriculum. This grant provides significant support for continuing the education trajectory of RNs in the state and builds upon the collaborative work that Texas nurse educators have been forging for the last decade.” ★
*Within the APIN grant, Elsevier Nursing and Health Professions through its Academic Consulting Group are to provide as an in-kind contribution four one-hour webinars for faculty teaching concept-based curriculum courses. The courses will be based on results collected from an online survey planned for the first quarter of the project that will assess faculty development needs related to teaching in a concept-based curriculum. It is hoped the webinars can be scheduled for the Spring of 2013.
October, November, December 2012 Texas Nursing Voice • Page 7
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Page 8 • Texas Nursing Voice October, November, December 2012
Always in demand during TNA’s Annual Nursing Leadership Conference is the latest, most relevant information on the status of Texas regulations, legislation, nursing initiatives and health care policy issues that affect nursing. Experts providing that information at this year’s conference were Elizabeth Sjoberg, JD, RN, Texas Hospital Association; Kathy Thomas, MN, RN, FAAN, Texas Board of Nursing; and Jim Willmann, JD, Texas Nurses Association.
HIG
HLIG
HTS
It’s not all serious business at an Annual Nursing Leadership Conference. Here Viola Hebert, BSN, MA, RN, (center), East Region director on the TNA Board of Directors, renews acquaintances with colleagues attending the event.
Dr. M. Ray Perryman, president of the Perryman Group, an economic and financial analysis firm in Waco, fascinated his audience with a unique and entertaining perspective on the current economic conditions that will bring implications to nursing. Dr. Perryman’s recently released, economic analysis report – The Economic Benefits of More Fully Utilizing Advanced Practice Registered Nurses in Texas: An Analysis of Local and Statewide Effects on Business Activity – supports the position that APRNs delivering care makes good economic sense for Texas.
Researcher and noted nursing economist Dr. Peter Buerhaus was back as a keynote speaker at TNA’s 12th Annual Nursing Leadership Conference, this year to preview his latest (and in September, not yet released) research. Here he’s caught by the camera in discussion with Claudia Turner, MSN, RN, TNA’s secretary-treasurer.
Meet TNA’s Board of Directors, hosts for this year’s Nursing Leadership Conference: (back row, left to right) June Marshall, North Region director; Karen Lyon, vice president; Margie Dorman-O’Donnell, president; Viola Hebert, East Region director; and Eve Layman, South Region director. Seated left to right are: Kim Belcik, Central Region director; Claudia Turner, secretary treasurer; and Jo Rake, West Region director.
Delivering a national view of the changing economic environment for nurses was Dr. Peter McMenamin, senior policy fellow of the American Nurses Association. Describing himself as a “seeker, finder and keeper of data,” Dr. McMenamin gave nursing leaders a statistical glimpse into changes in the demand for nurses in the future.
October, November, December 2012 Texas Nursing Voice • Page 9
by Ellarene Duis Sanders, PhD, RN, NEA-BC
The Practice Committee of Texas Nurses Association (TNA) has since May 2012 been working on a model for RN Coordination of Care. The committee has completed an extensive review of the literature and has devoted to new model development a majority of the agendas from three of its one-day meetings.
The new model was first shared publicly at TNA’s 12th Annual Nursing Leadership Conference held in September. Feedback from group exercises and follow up discussions during the presenting of the model will now allow Practice Committee members and TNA staff to further refine the model.
Defining Care CoordinationTNA has adopted the following definition released in June 2012 by
the American Nurses Association: “Care coordination promotes greater quality, safety, and efficiency in care, resulting in improved healthcare outcomes and is consistent with nursing’s holistic, patient-centered framework of care.”
TNA’s position is that the complexity of the patient population may require communication and collaboration across multiple health care teams and systems; therefore, coordination of care is an integral part of a registered nurse’s practice across a variety of settings and roles. Complex patient populations may require a designated care coordinator prepared at the master’s or higher level in nursing.
Registered nurses who provide direct patient care already provide many aspects of care coordination for their patients although that term hasn’t typically been used to describe their work. One attendee at the Nursing Leadership Conference relayed during group discussions that care coordination is embedded in our nursing scope of practice and that it includes patient advocacy. Registered nurses are uniquely positioned to identify and refer patients who would benefit from more complex or intense care coordination activities.
Titles, Costs, GoalsExamples of job titles for nurses who are care coordinators include
coordinator, navigator, manager, facilitator, expeditor, transition coach, discharge advocate, care manager, and others. These positions may be located in primary care, hospitals, community, insurance companies, public health, and other settings.
Current care coordinator positions tend to focus on medically complex patients; patients with two or more chronic conditions; patients by age (pediatrics, 65 and older, etc.); patients with specific chronic conditions such as diabetes, hypertension, renal failure, transplants, congestive heart failure; mental health diagnoses; patients with three or more ER visits in past year; highest cost patients, etc.
Cost for care coordination is generally borne by the site employing the care coordinator while major savings are generally to payors such as insurance, Medicare, Medicaid. Hospitals may see cost savings by prevention of readmissions. There are also proprietary models where individual patients contract with someone to perform some of these functions and advocate for them.
Evidence shows that care coordination that begins with initial in-person contact is most effective. Care coordinators then utilize ongoing phone contact, other technologies such as e-mail, cell phones with cameras, in-home visits, attendance at appointments, etc., to provide services.
Goals of Coordination of Care include maintaining continuity of care, collaboration and partnership with patient, fostering patient understanding, patient self management of health issues, preventing decline/readmission, medication reconciliation and management, connecting to community resources, “translation” of information between physicians and others to patients and families, facilitating appointments for follow up with primary care and specialists, addressing barriers, and facilitating patient accountability.
The care coordinator also reinforces patient teaching and information received during hospitalization to ensure that patients really have the information, and they provide additional teaching about diagnoses, medications, self care, and identify “red flags” that indicate a need for intervention so as to avoid an exacerbation of illness or a hospitalization.
Settings, FocusExamples of settings for care coordinators include inpatient, primary
care, emergency department, insurance companies, etc. Inpatient care coordinators facilitate evidence-based, high quality care in the acute care setting, e.g., compliance with core measures and other treatment protocols and may facilitate communication and integration of treatments when multiple teams and units are involved in patient care.
Inpatient care coordinators may focus on discharge transitions to community settings such as home, assisted living, long-term care, etc. They may make home visits, attend appointments with patients, and utilize phone contacts, e-mail, and other technology. They work on symptom management and avoidance of re-hospitalization.
Primary care coordinators maintain periodic contacts with patients on an ongoing basis to assure that essential patient information is maintained in the medical home. They integrate specialty and primary care in the best interests of the patient.
Care coordinators in Emergency Departments focus on the discharge process to ensure discharge plans, prescriptions, and follow up primary care are addressed for all patients. Uninsured patients are provided appointments to FQHCs (federally qualified health centers) which are funded by the hospital’s charity care program and Medicaid or to other charity clinics.
Care Coordinators in insurance companies work to manage patient populations with preventive services in order to avoid complications of chronic diseases. For those who have not yet started formal coordination of care, here are some examples of how to begin the process:
Small Facilities
• Identifytop5-10“frequentflyers”asfarasERvisitsand/oradmissionsin the past year
Additional factors that affect care coordination include limited health literacy (more than one-third of Americans have basic or below basic level literacy), direct to consumer drug marketing, cultural influences, ethical dilemmas, documentation, aging population, and long-term cases.
Page 10 • Texas Nursing Voice October, November, December 2012
Care Hospitals • 1 Subacute Unit • 5 Inpatient Rehabilitation Hospitals • 3 Transitional Care and Rehabilitation Centers • Outpatient Services • Homecare and Hospice
SAN mArcoS treAtmeNt ceNter, in continuous operation for more than half a century, is recruiting texas Licensed registered Nurses to become part of an experienced and effective treatment team.
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Qualifications include, but are not limited to:• AnAssociate’sDegreeinNursingfromanaccreditedcollegeoruniversity• Havebeenactivelyemployedinnursingforthepast3years• Long-termcareandclinicalexperience
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Federal Bureau of PrisonsFCI Bastrop is located Southeast of Austin. Our mission is to provide competent and appropriate medical, dental, and mental
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ConcordiaUniversityTexasiscurrentlyrecruitingforfull-timeCommunity Health and Mental Health Assistant/Associate Professors and a Part-time OB Adjunct faculty.• Master’sDegreeinNursing.• CurrentRNlicensureintheStateofTexas.• Previousteachingexperiencestronglypreferred.
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October, November, December 2012 Texas Nursing Voice • Page 11
Rebuilt app provides tobacco cessation referral tool and point-of-care enhancements.
The Nurse Oncology Education Program (NOEP) has released Version 2.0 of its AvidNurse™ application. Available free in the Apple App Store, AvidNurse is completely re-designed to make it easier to navigate its tools for care and evidence-based guidelines. A version for Android will launch this fall.
In addition to cancer screening recommendations, medication calculators and pain scales, AvidNurse now provides tobacco cessation education based on the “Ask, Advise, Refer” model and a patient referral tool that securely integrates with the Texas Tobacco Quitline® funded by the Department of State Health Services. Nurses earn “badge” achievements for every patient they refer to the clinically proven program.
The AvidNurse upgrade also features expanded medical calculator functionality and optional timed reminders to check on patients. The app provides access to videos accredited for continuing nursing education (CNE), with contact hours earned upon completing an associated test and evaluation on NOEP’s website. New social media features allow nurses to share badges they’ve earned for referring patients and other nurses or for participating in quizzes.
When AvidNurse was launched in January 2011, nurses were primarily using apps to access drug reference information and data management tools. Now, more nurses than ever are using smartphones in clinical settings for a variety of tasks and the market is growing. A recent survey conducted by Wolters Kluwer Health’s Lippincott Williams & Wilkins (LWW) found that 71 percent of nurses are already using smartphones for their job (Wyatt & Krauskopf, 2012). With the recent upgrade of AvidNurse, NOEP remains on the forefront of the mobile nursing trend and helps nurses provide better care for patients.
“We believe that nurses play a vital role in health care and deserve the best tools available,” said Kim Johnson, chief operating officer for Ringful Health, the app’s Austin-based developer. “We redesigned AvidNurse to make the current tools easier to use on more devices and enable nurses to connect to more resources.”
AvidNurse is made possible by the Cancer Prevention and Research Institute of Texas. NOEP is a nonprofit project of the Texas Nurses Association/Foundation. www.noep.org. ★
ReferenceWyatt, T. & Krauskopf, P. (June 2012). E-health and Nursing: Using Smartphones to Enhance
Nursing Practice. Online Journal of Nursing Informatics (OJNI), 16 (2), Available at http://ojni.org/issues/?p= 1706.
NOEP Releases Major Update to AvidNurse App
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For the sixth straight year, The University of Texas MD Anderson Cancer Center is ranked No. 1 nationwide in cancer care by U.S. News & World Report’s “America’s Best Hospitals” 2012 survey.
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It is the policy of The University of Texas MD Anderson Cancer Center to provide equal employment opportunity without regard to race, color, religion, age, national origin, gender, sexual orientation, gender identity/expression, disability, veteran status, genetic information or any other basis protected by federal, state or local laws, unless such distinction is required by law.
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Page 12 • Texas Nursing Voice October, November, December 2012
Members of the Health Information Technology (HIT) Task Force of Texas Nurses Association (TNA) and Texas Organization of Nurse Executives (TONE) presented the first of a new series of nursing curriculum – Nursing Informatics for Patient Safety and Quality – as part of the course in Informatics at The University of Texas Medical Branch (UTMB) School of Nursing in Galveston. As part of a pilot, task force members are working with schools of nursing sites in Texas to explore options for integrating curricula related to the topic of electronic health records (EHR) and its relationship to patient safety. Part of The Future of Nursing: Leading Change, Advancing Health report of the Institute of Medicine includes support of a HIT-enabled nursing practice and education, making it essential to address the assimilation of health care technology into current and future nursing curricula.
Health Information Technology Goes Into the ClassroomIn July 2012, was the first pilot site to receive
the curriculum as part of its informatics course. During an introductory overview, HIT Task Force member Molly McNamara, MHA, BSN, RN, shared information with the class through a 60-minute lecture that was followed by an engaging and energetic question-and-answer session with the 122 students.
Objectives of the lecture covered topics such as review of the different types of health informatics, current federal policies, funding sources, nursing safety and quality issues, and the nurse’s role in the current and future trends in HIT as they relate to nursing and nursing informatics.
Faculty member Bonnie Webster, MS, RN, BC, assistant professor of the UTMB School of Nursing, submitted a pre-assessment needs list to the HIT Task Force prior to the lecture. That allowed the presentation to be tailored to the students’ needs to understand terms such as Electronic Health Record (EHR), Electronic Medical Record (EMR), and the relationship and use of HIT systems in the management of day-to-day patient care operations.
In an effort to inform and enable future nurses to optimally utilize health care technology, the TNA/TONE HIT Task Force is reaching out to the nursing associate degree and baccalaureate programs in colleges and universities throughout Texas by offering this lecture series to share current insights and changes in HIT.Each presentation features content, concepts, and competency essentials that are necessary to prepare the nurse professional entering today’s workforce. Faced with the evolving health care changes, one area of focus for the task force is to provide up-to-date information in support of safe patient care and a quality rich health care environment. Student evaluations from the initial offering indicated that 89 percent of respondents believed objectives were met and 91 percent indicated the use of an EHR will enhance their delivery of patient care.
Other pilot sites on the calendar for TNA/TONE HIT Task Force presentations in 2012 include Texas Woman’s University – Dallas, to be presented by the HIT Task Force Co-chair Mari Tietze, PhD, RN-BC, FHIMSS, as well as Texas Woman’s University – Houston. A return invitation in the fall to UTMB School of Nursing is also scheduled.
For more information or to request a presentation in your ADN or BSN School of Nursing, please contact Molly McNamara at [email protected] or 713-566-6784. ★
prevention can start with you, too Scan this QR code to watch videos and read stories about Susan, and other everyday champions in CVD prevention.www.pcna.net/preventioninTX
Susan Bush, RN, FPCNA is a registered nurse in cardiac rehabilitation at the North Colorado Medical Center in Greeley, Colorado. As president of the Rocky Mountain PCNA Chapter, she leads area nurses in professional development and heart disease prevention. All around the world, nurses are catalysts for heart disease prevention in their clinics, hospitals and communities.
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This position will lead discipline-specific online and/or hybrid course development and pilot tests for grant project activity.
Minimum Qualifications:Master’sdegreeinNursing.Demonstrated instructional/curriculum development experience.Demonstrated field experience as a nurse.
Specific Position Duties:• Lead online and/or hybrid course curriculum development• DeveloppilottestsfortheNursingdiscipline• Maintain project documentation for grant compliance;• Other duties as assigned
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Enjoy going to work each day without the hassle of heavy traffic. Have an uncomplicated drive in the country and come to a facility that caresenough to make a difference in thelives of our residents.
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October, November, December 2012 Texas Nursing Voice • Page 13
The Fall 2012 continuing nursing education workshop schedule is now set and TNA is accepting reservations for both Approved Provider Workshops and Individual Activity Workshops. Check the entire schedule below and reserve your place today. Full details and registrations are accepted online at texasnurses.org > Education > CNE Calendar (activities are sorted by date) or by phoning the TNA CNE program at 512.452-0645 ext. 125.
Individual Activity Workshop – Uncovering the Mysteries of the CNE Activity
This activity is designed to introduce an organization to the process of developing single, individual CNE activities based on sound educational design. It will introduce participants to the new 2013 American Nurses Credentialing Center’s Commission on Accreditation and TNA criteria and guidelines for CNE, the individual activity application tool and the application process.
• Friday, November 9
• Wednesday,December 5
• Monday,December 17
Registration for the Individual Activity Workshop is $250 per TNA member; $300 per non-member. Lunch and workshop manual are included.
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Your next Nursing job is in Austin, TX
Sign-on bonus and relocationfor select positionsand facilities
Announcing: Texas Nurses Association CNE Workshop Schedule, Fall 2012Approved Provider Workshop
A must-attend workshop for organizations interested in seeking Approved Provider status beginning in January of 2013. Intended for those with experience in the CNE process.
• Monday, October 29
• Wednesday, November 14
• Friday, November 30
• Thursday, December 13
• Friday, January 4 (back up date)
Registration is $275 per TNA member; $350 per non-member. Lunch and workshop manual are included.
Texas Nurses Association/Foundation Provider Unit is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation. ★
Page 14 • Texas Nursing Voice October, November, December 2012
October, November, December 2012 Texas Nursing Voice • Page 15
Kootenai Health is a Joint Commission-accredited, Magnet designated, 246-bed hospital offering complete clinical services.
To review full job descriptions visit:www.kootenaihealth.org/careers
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poTeNTial FaculTyCreate your future with us! School of Nursing Faculty Positions: Loyola University New Orleans, a progressive Jesuit University, is seeking applications for outstanding adjunct faculty. Faculty must hold regular office hours and have same on campus availability.
If working in a place where you can blossom is of interest to you, please submit a letter of interest, vitae and three letters of reference for these positions to:Dr. Ann Cary, Director and ProfessorRobert Wood Johnson Executive Nurse Fellow 2008-2011School of Nursing, Loyola University New Orleans6363 St Charles Avenue, Campus Box 45, New Orleans, La. 70118Attn: Debbie Smith, Executive Assistant(504) 865-2823 [email protected] • http://css.loyno.edu/nursing
Candidates will have a doctoral degree and national certification as a Family/Adult Nurse Practitioner or Nurse Administrator. Experience in education and practice is desired. Rank and salary are commensurate with qualifications. Loyola is an EO/AA employer.
Application Deadlines:February 1st and November 1st
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