"Texas Team" Hits the Ground Running

Texas nurse and non-nurse leaders planted the seeds of the Texas Action Coalition years ago.

    • February 26, 2012

In the nationwide campaign to improve health and health care by transforming the nursing profession, Texas may look like one of the newer kids on the block. But the Lone Star State was actively engaged in this work long before it was officially blessed last year as home to one of the Future of Nursing: Campaign for Action’s three dozen Action Coalitions now in place across the country. More Action Coalitions will be announced on March 6.

“We only became official in September,” said Alexia Green, RN, PhD, FAAN, professor and dean emeritus at Texas Tech University Health Sciences Center and co-leader of the Texas Action Coalition. “But we’ve been working diligently to increase the capacity of nurse education and accomplish other campaign goals for years now.”

Indeed, the “Texas Team” dates back to 2008, when Green, an alumna of the Robert Wood Johnson Foundation (RWJF) Executive Nurse Fellows program and a prominent nurse leader in her state, was appointed by the governor to attend a summit with other leaders on nurse education in Washington, D.C.

The team grew rapidly from that first meeting four years ago and forged partnerships with supportive organizations in education, health care, philanthropy and other sectors. Within a year of appointment, it had a plan in place to double the number of professional nurse graduates from the state’s school of nursing and to help ensure more student nurses graduate from the state’s nursing schools.

Emboldened by its early success, the Texas Team eagerly took on a new initiative last year: broadening its focus to implement the full range of recommendations made by a groundbreaking report released in 2010 by the Institute of Medicine. The report, The Future of Nursing: Leading Change, Advancing Health, lays out a strategy to ensure that all Americans have access to high-quality, patient-centered care in a health care system where nurses contribute as essential partners. The Texas Team held a statewide summit in March to expand its size and scope and was officially dubbed an Action Coalition in September.

Action Coalitions are the driving force behind the Future of Nursing: Campaign for Action, a collaborative effort of AARP, the AARP Foundation and RWJF to implement solutions to the challenges facing the nursing profession and to build upon nurse-based approaches to improving quality and transforming the way Americans receive health care.

More than 120 Partners

Led by the Texas Nurses Association and Blue Cross Blue Shield of Texas, the Texas Team now has more than 120 partner organizations from the business, health care, academia, and other sectors. A state-level executive committee oversees the Action Coalition’s activity and an advisory council provides strategic advice. There are three subgroups, focusing on recommendations involving the practice of nursing, nurse education, and advancing nurse leadership, as well as eight regional teams representing different parts of the state. A tactical and operations team, meanwhile, provides support in the areas of communication, coordination, execution, tracking, assessment and evaluation of planned and ad-hoc activities.

Although only recently dubbed an Action Coalition, the Texas Team is already making progress toward its goals. It is working to implement a “common core of prerequisite courses” in the state so that associate-level nurses can move easily into baccalaureate programs. It has held two roundtables on “scope-of-practice” issues. The executive committee is working with a nationally recognized economist to produce a commissioned report on the economic impact of advanced practice registered nurses (APRNs) on the Texas economy. And it has worked with partners to submit a government grant application to train hundreds of health professionals in quality science improvement.

But success won’t necessarily come easy in a state as large and diverse as Texas. “We have about 120 nursing schools over thousands of miles of land,” Green says. “What works in West Texas won’t necessarily work in East Texas.” The same holds true for nursing practice, she says. “Texas has some of the largest medical centers in the nation, yet we also have some of the most remote and rural areas. Different strategies and approaches are needed to assure we achieve the IOM recommendations across the entire state.”

But the state has its advantages, too. Texas boasts a strong nursing workforce center that provides reliable, comprehensive and respected data about the nursing workforce, Green says. And the state government is supportive of many of the coalition’s goals, she adds.

The state’s size can be a strength too, Green says, noting Texas is one of five states that together produce one-third of the country’s nurses. “Our size adds urgency to the campaign,” she says. “We can have a bigger impact on the future of health and health care, not only in Texas but across the nation.”