IOM's Future of Nursing Report: Big Splash, Lasting Impact

One year in, health care professions of all kinds are rallying around landmark study.

    • October 28, 2011

Viewed from any perspective, the nation’s 3 million nurses are members of a profession that is changing and changing fast. Driving the transformation are landscape-altering shifts in the nation’s demographics, looming shortfalls in the numbers of nurses and other health care professionals, enormous economic pressures on the health care system, ever-evolving medical technology, new and different models of care, and more. Three years ago, with those dynamics in mind, the Robert Wood Johnson Foundation (RWJF) and the Institute of Medicine (IOM) launched an initiative to assess and guide the transformation of the nursing profession. It led to the October 2010 release of the landmark report, The Future of Nursing: Leading Change, Advancing Health.

In the year since its release, the report has generated widespread activity from coast to coast, as grassroots and national organizations from across the spectrum of the health care professions have come together to advance the report’s recommendations.

Taken together, those recommendations are a blueprint for ensuring that all Americans get high-quality, cost-effective care, when and where they need it. The report recognizes the central role nurses already play in health care, and anticipates that nurses will take on ever greater responsibilities in the years and decades to come. Key recommendations from the report include: increasing the share of nurses with baccalaureate and advanced degrees, and transforming nursing education to help accomplish that; making nurses full partners with physicians and other health professionals in the ongoing redesign of health care; collecting better data to track nurses’ multi-faceted work and to head off a looming nursing shortage; and freeing nurses, and advanced practice registered nurses in particular, to practice to the full extent of their education and training.

Spearheading the effort to advance those recommendations is the RWJF’s Future of Nursing: Campaign for Action. Organized by RWJF in collaboration with AARP and its Center to Champion Nursing in America (CCNA), the campaign has provided support to Action Coalitions across the nation. No fewer than 36 states have campaign-designated Action Coalitions, bringing nurses and other health care professionals, business executives, academic and nonprofit leaders, and policy-makers and consumer advocates together to implement the IOM recommendations. Each Action Coalition chooses its own priorities, taking the realities of their state’s health care environment into account. As of late September 2011, the Action Coalitions had hosted more than 156 events related to the Campaign for Action, including statewide strategic planning sessions, stakeholder presentations, launch events and webinars. In addition, Campaign for Action spokespersons made presentations at more than 120 venues in nearly 20 states during the first year after the report’s release.

In addition to its work with the Action Coalitions, CCNA has convened a broad range of stakeholders through the Champion Nursing Coalition and its 48 national health care, business and consumer organizations, and the Champion Nursing Council and its 27 national nursing groups. The Coalition and the Council are both working to develop strategies to implement the IOM recommendations. In addition, earlier this year, health care leaders from 25 states, including the Action Coalitions, traveled to Washington to strategize and to meet with Members of Congress and their staff—conducting 119 congressional meetings, in all.

Mobilizing the philanthropic and research communities, RWJF has also launched a multi-funder research initiative to identify, generate, synthesize and share evidence essential to implementing the recommendations in the IOM report. Funded research will cover a broad range of topics at the heart of the Future of Nursing recommendations, including ways to advance inter-professional education models, achieving the “80 by 20” recommendation of increasing the percentage of nurses with baccalaureate degrees and higher to 80 percent by 2020, capturing and documenting the impact of state laws allowing nurses to practice to the full extent of their education and training, and more.

Two final measures of the report’s impact: In the space of just one year, it became one of the most downloaded online reports in the history of the Institute of Medicine and it has generated an estimated 64 million media “impressions,” a measure of the number of people thought to have seen the report or media coverage of it.

“We’re thrilled by the response to the report,” says Susan B. Hassmiller, PhD, RN, FAAN, RWJF senior adviser for nursing and director of the Future of Nursing: Campaign for Action. “I wouldn’t say we’re surprised, but we’re certainly thrilled and very grateful. We knew the report’s vision for health care in the future would resonate, not just with nurses but with all the other health care professions, as well as with patients and policy-makers. We have a lot of work ahead of us to make sure our profession is truly ready to seize its future, and we’re going to need all the help we can get. But the clear message from this first year after the release of the report is that we’re on the right trajectory.”