When the Institute of Medicine (IOM) released its groundbreaking report on the future of nursing in 2010, observers wondered whether it would become a catalyst for real and lasting change—or simply gather dust on the proverbial bookshelves of history.
To avoid the latter fate, the Robert Wood Johnson Foundation (RWJF) and AARP joined forces to turn the report’s recommendations into reality—and improve health and health care for all. Together, they created the Future of Nursing: Campaign for Action, a joint initiative that is working to implement the report’s recommendations at the federal level and in every state.
The report has been downloaded more than 115,000 times, which is more than any other IOM report. That is one measure of its impact.
The IOM is seeking more comprehensive information about the impact of this report and, by extension, of the Campaign’s effort to implement its recommendations. To conduct an assessment, the IOM has convened a committee of experts—chaired by economist and health policy expert Stuart Altman, PhD—and is holding a series of meetings to gather information from stakeholders. The first two meetings were held in April and May; the third is scheduled for July 27 and 28 in Washington, D.C. Learn how to submit materials for the Committee's consideration or offer public testimony at the July meeting.
A “consensus study” on the report’s impact is due out later this year.
The report and the Campaign to enact its recommendations have made substantive progress toward transforming nursing, said Kate Locke, MPH, associate director of evaluation at TCC Group, a consulting firm that works to help nonprofit organizations and other groups achieve social impact. “We really have seen evidence of this culture change.”
There is now more hope about the possibility of real change, she said during a panel discussion at the May meeting. The nursing community and its allies have been able to coalesce around a set of strategic goals; barriers between oppositional factions are breaking down; new leaders have stepped forward; and new stakeholders have joined the movement since the report was released. “The IOM report ... brought a lot of new energy and allowed states to pick the areas that were most relevant for their state,” Locke said.
One clear example of progress relates to academic progression in nursing, she noted. The Campaign has had success in identifying new pathways for nurses and nursing students to advance their education—a key goal of the IOM report. And for the first time, more nurses are graduating with bachelor’s degrees in nursing than with entry-level associate degrees, according to a recent study. In addition, states are making changes through regulations and legislation to allow nurses to practice to a fuller extent of their education and training, said Jared Raynor, MS, director of evaluation at TCC Group.
Not All Rosy
It’s not all rosy, however. Some Action Coalitions have struggled to attract non-nursing stakeholders, experienced painful leadership battles, and—as volunteer “armies” without significant resources—risk burnout, Locke said. In addition, some are struggling to find ways to enhance the diversity of the nursing workforce. “States need more resources and assistance to think through how to do this in an authentic and effective way,” Raynor added.
Meanwhile, collecting and analyzing data to track implementation of the report’s recommendations—and capturing the full scope of change over the past five years—is “incredibly challenging, to say the least,” said Joanne Spetz, PhD, associate director for research strategy at the Center for the Health Professions at the University of California-San Francisco.
Locke, Raynor, and Spetz spoke at the committee’s second meeting in May, which covered progress toward implementing the report’s recommendations and the barriers that stand in its way. It featured more than a dozen experts in health professions education and training; health care policies and regulations; and health care organizations and providers.
Speakers included Mary D. Naylor, PhD, RN, FAAN, the Marian S. Ware Professor in Gerontology at the University of Pennsylvania School of Nursing; George Zangaro, PhD, RN, FAAN, director of the National Center for Health Workforce Analysis at the Health Resources and Services Administration; and Maryann Alexander, PhD, RN, FAAN, chief officer of nursing regulation at the National Council of State Boards of Nursing.
The first meeting was closed to the public, but included one open session that featured Susan B. Hassmiller, PhD, RN, FAAN, RWJF’s senior adviser for nursing, and RWJF evaluation associate Denise Herrera, PhD.
An Opportunity to Speak Out
The committee is calling on individuals and organizations to share ways the IOM report has affected health and health care. All interested parties are strongly encouraged to submit materials by email about what they believe the report’s impact has been—for them personally, for organizations, and generally for health and health care. Materials should be submitted to FONimpact@nas.edu or here.
There is an opportunity to offer public testimony at the committee’s upcoming meeting on July 28, beginning at noon. Those interested in giving in-person testimony must register by July 23. Register to attend, or to view the webcast.