Colorado Project to Curb Shortage of Home Health Care Nurses Gets Major Boost from RWJF-Supported Program

Program designed to increase number and competencies of home health nurses in Colorado is one of nine projects nationwide to receive funding from Partners Investing in Nursing's Future.

    • September 22, 2010

Hospital discharge does not always mean the end of care. In fact, for more than one-third of patients in Colorado, it means the opposite: It signals the beginning of a subsequent phase of care that helps patients make successful transitions out of the hospital and back into active lives.

To help ensure that all patients in Colorado are able to make successful transitions out of the hospital and back home, The Caring for Colorado Foundation, the Colorado Center for Nursing Excellence, and other health care agencies and schools of nursing in Colorado have teamed up to create a plan to attract and retain more home health care nurses.

The plan got a major boost last month when it was selected as one of nine programs nationwide to receive funding from Partners Investing in Nursing’s Future (PIN), a program led by the Robert Wood Johnson Foundation (RWJF) and the Northwest Health Foundation that aims to find innovative ways to create an adequate nursing workforce to meet the changing demands of the 21st century patient population.

The two-year $250,000 grant for the home health care plan will be matched by an additional $250,000 in local and regional funding and a much larger amount of in-kind contributions from partner agencies. The funding will help create a robust home health care nursing workforce in Colorado, said Susan Hill, M.S.P.H., vice president of programs at Caring for Colorado. “Home health care seemed to us a part of the health workforce that really wasn’t getting enough attention,” she said. “This project will improve continuity of care and help strengthen the health care delivery system.”

Called “Care and Career Transitions: Innovations in Home Healthcare, the Missing Link,” the project will develop ways to build a strong home health care workforce in Colorado. It will do that by training home health care nurses and nurse leaders; connecting home care to other health care access initiatives to ensure safe transitions of care; developing assessment and recruitment tools to further establish home health care nursing as a specialty practice; creating an innovative delivery methodology for developing and improving competencies of current home health care nurses; developing a structured home health care preceptor training program; establishing an orientation program for new home health care nurses and staff; and developing an assessment methodology to evaluate and validate nurse competencies.

Demand for Home Health Care Services Projected to Rise

Policy debates over health care have often focused on acute-care settings rather than home health care, which often flies under the radar in part because the home health care industry is comprised of smaller agencies that are scattered across urban and rural settings. But demand for home health care is surging due to demographic changes. In Colorado and across the nation, the number of people over the age of 65 is surging, and many of these people will need some form of assistance in their homes. For many individuals in Colorado, receiving care at home is the only option, as it is for individuals in other rural parts of the country.

The goal of the program is to build a home health care workforce and change the home health care system at large. Organizers hope the project will lead to fewer home health patients who are readmitted to hospitals; lower turnover rates among nursing staff; fewer unfilled positions and more applicants for jobs at home health agencies; more use of telemedicine; and increased compliance with government home health agency requirements.

Organizers also hope the program will serve as a model for other states facing home health care nurse shortages.

“As more patients gain access to insurance and enter our health care system, the need for well-prepared and highly experienced nurses will continue to rise,” said Susan B. Hassmiller, R.N., Ph.D., F.A.A.N., the Robert Wood Johnson Foundation’s senior adviser for nursing, in announcing the new PIN grants. “We are committed to finding the most innovative solutions to address nursing workforce issues so that we are able to meet this need for services and reduce the cost of care.”

Eight other community-based projects also received PIN funding this year. These projects will focus on key areas of concern in building a nursing workforce including education, capacity, recruitment and retention, and diversity. They are:

  • the Bingham Program in Maine, which will redesign nursing education with a specific focus on long-term care and home care serving urban and rural seniors;
  • the Community Foundation of SE Michigan, which will create a leadership development program to retain more nurses at acute and long-term care institutions in Southeast Michigan;
  • the Dakota Medical Foundation, which will change the image of nursing in the state to attract a more diverse population of students into the field;
  • the Endowment for Health in New Hampshire, which will expand the ethnic and racial diversity of the nursing workforce and nursing education faculty by raising awareness of the nursing;
  • the Humboldt Area Foundation in California, which will improve local nursing expertise with the use of a high-fidelity simulation educational tool;
  • the Texoma Health Foundation in Texas, which will create a virtual regional network aimed at building the capacity of the nursing workforce with career building, educational advancement and leadership development;
  • the Cleveland Foundation in Ohio, which will train non-traditional nursing instructors to deliver high-quality online education to graduate and undergraduate nursing students; and
  • the Horizon Foundation for New Jersey in New Jersey, which will help first-year graduate nurses pursue master’s degrees.

The PIN program is now in its fifth year. In its first four years, 88 foundation partners in 32 states and the island territories of the Western Pacific established more than 300 local partnerships among nursing organizations, funders and workforce development boards to address the nursing and nurse faculty shortages. The new grantees will bring the total number of private philanthropic organizations contributing to the solutions to nearly 100, and expands the number of states represented to 37.

“We know that the overall number of nurses in the U.S. is growing, but there are many issues that need to be addressed in order to create the nursing workforce we need for the future,” said Judith Woodruff, J.D., PIN program director and director of workforce development at the Northwest Health Foundation. “Investment by local philanthropy is essential for communities to come together to deal with challenges unique to their region or state.”

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