Nearly a year after the release of the Institute of Medicine’s landmark Future of Nursing: Leading Change, Advancing Health report, its impact is already being felt. The latest evidence of growing momentum behind its vision for transformational change for the profession is the announcement by the Robert Wood Johnson Foundation (RWJF) of 21 new state-based collaborations, called Action Coalitions, that will help advance the report’s recommendations. They join 15 Action Coalitions already in place, working in concert with the Future of Nursing: Campaign for Action to improve health care for all Americans by strengthening nurse leadership and the nursing workforce.
“We are thrilled to add 21 more states to the Action Coalition network,” said Susan B. Hassmiller, PhD, RN, FAAN, senior adviser for nursing at RWJF and director of Future of Nursing: Campaign for Action. “The Campaign for Action must work at every level to build and sustain the changes necessary to improve health care for all Americans. The support demonstrated by the creation of Action Coalitions all across the country shows the energetic commitment that is propelling this effort."
The Campaign for Action is coordinated through the Center to Champion Nursing in America, an initiative of AARP, the AARP Foundation and RWJF. It is rallying support across the health care spectrum, engaging consumer leaders, prominent officials and groups representing government, business, academia and philanthropy. The Action Coalitions are the driving force of the campaign at the local and state levels.
Comprised of diverse groups of stakeholders, these groups capture best practices, determine research needs, track lessons learned and identify replicable models. They are focusing on: strengthening nurse education and training; enabling nurses to practice to the full extent of their education and training; advancing interprofessional collaboration among health care professionals to ensure coordinated and improved patient care; expanding leadership ranks to ensure nurses have a voice on management teams, in boardrooms, and during policy debates; and improving health care workforce data collection to better assess and project workforce requirements.
The 21 new Action Coalitions are in Arkansas, Delaware, Georgia, Hawaii, Kentucky, Kansas, Maryland, Massachusetts, Minnesota, Missouri, Montana, Nebraska, North Carolina, Ohio, Pennsylvania, Rhode Island, South Carolina, Texas, West Virginia, Wisconsin and Wyoming. They join Action Coalitions established within the last year in California, Colorado, Florida, Idaho, Illinois, Indiana, Louisiana, Michigan, Mississippi, New Jersey, New Mexico, New York, Utah, Virginia and Washington.
A Closer Look: Texas and Kentucky
In Texas, the Action Coalition’s initial priorities include working to remove scope-of-practice barriers for nurses in the state. “Our first goal will be to get nursing on the same page from a policy perspective, and to develop a policy agenda that can help us progress toward achieving that goal,” says Alexia Green, RN, PhD, FAAN, professor and dean emeritus of the Texas Tech University School of Nursing.
The Action Coalition also plans to focus on the Future of Nursing report’s recommendation to increase the proportion of nurses with BSN degrees to 80 percent by 2020. “Many large health care employers in Texas are moving to staffing models that are more dependent upon BSN-educated nurses, and thus are ‘propelling’ their staff up the education chain to BSN, or are only hiring BSN-educated nurses,” Green notes. “We are working to create a common/standardized prerequisite curriculum to streamline nursing education and decrease costs for consumers, and are working very closely with both associate degree and baccalaureate degree educators to address this goal.”
The lead organizations in the Action Coalition are the Texas Nurses Association and BlueCross BlueShield of Texas. A statewide kickoff meeting in March drew more than 300 nurses and other health professionals.
In Kentucky, the state’s new Action Coalition is spearheaded by the Kentucky Hospital Association, various state nursing organizations, chief nursing officers from hospitals around the state, chief academic officers from a number of educational programs, and the state AARP.
Jane Kirschling, DNS, RN, FAAN, dean of the University of Kentucky College of Nursing, is a leader of the coalition and, like Green in Texas, identifies the need to remove scope of practice barriers for nurses as a priority agenda item. “We will be working with the public and the Kentucky legislature to understand the critical role that APRNs play in meeting health care needs in Kentucky,” she says, “including rural communities. We will offer support to remove barriers for full scope of practice for APRNs.”
“We’re a rural state,” Kirschling continues, “and we struggle with an array of health issues. Nursing plays a critical role in access to quality care. Consequently we need a better educated nursing workforce to meet the growing demand for accessible and affordable health care throughout the Commonwealth of Kentucky… Collectively, we believe we can improve access to care for all persons who live and work in the Commonwealth.”
Similar activity is taking shape in each of the other states with Action Coalitions. In a letter to the newly named organizations, RWJF President and CEO Risa Lavizzo-Mourey, MD, MBA, extended her congratulations and described the scope of the challenge ahead. “As we look forward to the coming years and what we can accomplish by working together,” she wrote, “your knowledge, experience and expertise will continue to show the way. No question, this is a big responsibility. Together we must remain focused and diligent to ensure that we meet our goal of a transformed health care system that delivers high-quality, cost-effective care to all Americans. So many people and organizations have brought extraordinary energy and drive to this work. I am honored to be their partner—and your partner.”
Grassroots Groundswell Matched at National Level
The rapid outpouring of grassroots action at the state level over the past year has been matched by a rush of activity at the national level.
- The Center to Champion Nursing in America is rallying national organizations to the cause. It has forged two coalitions toward that end: the Champion Nursing Coalition, which consists of 48 national organizations not comprised of nurses, and the Champion Nursing Council, which includes 27 national nursing organizations.
- Since the release of the Future of Nursing report, Campaign for Action spokespeople have fanned out across the nation, making speaking appearances in more than 120 venues in nearly 20 states.
- The Future of Nursing report itself is now the single most viewed online report in the history of the Institute of Medicine, registering more than 62 million media impressions.
- In June, leaders from 25 states, including Action Coalitions, met in Washington, D.C. Over two days, these leaders participated in a total of 119 meetings with members of their congressional delegations as well as key committees of Congress.
- Earlier this year, RWJF announced that it would coordinate a unique, multi-funder initiative to identify, generate, synthesize and disseminate research in support of the Future of Nursing recommendations. RWJF will be accepting applications through January.
The Future of Nursing: Campaign for Action envisions a health care system where all Americans have access to high-quality care, with nurses contributing to the full extent of their capabilities. The Campaign is coordinated through the Center to Champion Nursing in America, an initiative of AARP, the AARP Foundation and the Robert Wood Johnson Foundation, and includes 36 state Action Coalitions and a wide range of health care providers, consumer advocates, policymakers and the business, academic and philanthropic communities.