healthcare transformation: advances, retreats, and ... · innovate! (even more!) evaluate! (even...
TRANSCRIPT
Healthcare Transformation:Advances, Retreats, and Strategy
for Nurse Practitioners
NONPF 38th Annual MeetingCharleston, South Carolina
April 12, 2012
Michael R. Bleich, PhD, RN, FAANDr. Carol A. Lindeman Distinguished Professor of Nursing
Healthcare Transformation is Serious Business
Advances, Retreats, Strategy
Advances are real: Workforce Public acceptance Enhanced roles Scope of practice Educational standards Science‐base for
practice
Retreats are equally real: Workforce imbalance
with public need Infrastructure issues Contextual knowledge
of the system lacking Cohesion within the
discipline Public knowledge
The Role of Strategy: NONPF
An organization's or discipline’s process of defining its strategy, or direction, and making decisions on allocating its resources to pursue this strategy within the context of the current environment to meet future demands
Strategy Requires Context and Voice, but also Energy and Responsiveness
Passion Messaging Risk taking Tenacity Clarity of purpose Strength of character
WHERE AND HOW DO WE USE OUR VOICE? Policy tables? Public awareness? Teaching students? Are we insular?
Nursing defined – (Bleich, AHNA Beginnings, February, 2012, p. 5)
“Nurses must unify to express this message: we are the sole health discipline that approaches health, disease, illness and chronic care management with knowledge drawn from a model of holistic care. We make decisions, provide and orient treatments, and take other critical actions based on independent observations and team‐based plans. We are the sole discipline that hardwires the perspective of the patient/client within the context of family and community, and care is coordinated and managed according to this context.”
Each discipline has a lens from which they “see” and assist the patient . . .
Physician: science of disease & cures
Physical Therapist: mobility expert
Nursing: holistic, health & disease, family & community
Psychologist: individual therapy of the mind/meaning
Pastoral care: for the spirit
Social worker: family therapy & social support
Three Strategic Foci for NPs NOW!
1. Revolution through Education: Student and Public Education
2. Revolution through Practice: Engagement with ACO development
3. Revolution through Science: Clinical focus must expand to organizational systems and policy analysis and critical thinking must be combined with critical action!
IOM Roundtable on Value & Science-Driven Health Care Culture Design & processes Patients & the public Decisions Care Outcomes & cost Knowledge
Health information The data utility Digital technology Trust fabric Leadership
Seven Complex Lessons in EducationFor the Future
Blind spots of knowledge: error and illusion
Principles of pertinent knowledge
Teaching the human condition Edgar Morin
Seven Complex Lessons in EducationFor the Future
Teaching Earth identity
Confronting uncertainties
Teaching comprehension
Ethics of the human genre
Edgar Morin
Graduate and Doctoral Education in Health Sciences and Health Services
Crucial Conversations about the level of R & R (rigor and relevance)
Crucial Conversations about pedagogy and shift in the mental models that students bring to the academy
Crucial conversations about the shifting realities in health care and academic economics
Crucial conversations about where science and inquiry need to go
The Report STRATEGIC BLUEPRINT:Scope of PracticeLifelong LearningAdvancing Education for Societal BenefitWorkforce DevelopmentExpanded CompetenciesFULL partnership with physicians & others in redesigning the healthcare system
Visit http://www.iom.edu/nursing to view the report
This is YOUR time – this is a time for CLARITY –and the other Traits the Define Being a
REVOLUTIONARY!
Analytics & Nurse PowerAccess and Reporting
What happened? (standard reports)
How many, how often, where? (ad hoc reports)
Where is the problem? (query/drill down)
What actions are needed? (alerts)
Analytics
Why is this happening? (statistical analysis)
What if these trends continue? (forecasting/extrapolation)
What will happen next?
(predictive modeling)
What’s the best that can happen? (optimization)
Analytic Stages Model
Analytically impaired
Localized analytics
Analytical aspirations
Analytical companies (schools?)
Analytical competitors
(Davenport and Harris, Competing on Analytics)
Analytics and a Reformed Health SystemREQUIRES:
PhD/DNPs who can: Doctoral Level expertise to answer:
Engage with other organizational, statistical, and complexity scientists
Shape clinical care delivery systems
Enter into the organizational decision‐making arena
Why is this happening?
What if these trends continue?
What happens next?
What’s the best that can happen?
Implications for Doctoral Graduates:
Not stand‐alone
Contributes to the value
chainCreates return on investment
Creates tangible assets
Benefits patients and organization
Knowledge and Research
We Are Called To:
Innovate! (even more!)
Evaluate! (even more – add economics and analytics and the public perspective)
Integrate! (with the re‐forming health system)
Communicate! (by testing for all scenarios – urban, rural, frontier)
Convergence and Forward!
The convergence of decades of hard work, growth in our science, linkage of academic‐service technology with the human condition, and health policy can reinvigorate our purpose for being nurses. Let us converge our energy for the sake of good.
Contact InformationMichael R. Bleich, PhD, RN, FAANDr. Carol A. Lindeman Distinguished Professor
Oregon Health & Science UniversitySchool of Nursing – SN‐ORD3455 SW US Veterans Hospital RoadPortland, OR 97239‐2941Phone: 503‐494‐7445Email: [email protected]