nurse support program ii competitive institutional grants technical assistance meeting april 1, 2015...
TRANSCRIPT
Nurse Support Program IICompetitive Institutional Grants Technical Assistance Meeting
April 1, 2015
Peg Daw- MHECOscar Ibarra-HSCRCPriscilla Moore-MHEC
Nurse Support Programs
NSP I- Hospitals
NSP II- Higher Education
Website: www.nursesupport.org
Health Services Cost Review Commission provides stable funding and oversight.
HSCRC administers NSP IMHEC administers NSP II
Nurse Support Programs NSP- HSCRC began funding Nurses ~~1986
NSP I- On July 1, 2001, HSCRC approved hospital revenue for hospital-based initiatives aimed at addressing the short and long term nursing shortage impacting Maryland hospitals.
NSP II – On May 4, 2005, HSCRC approved hospital revenue for use in expanding the nursing workforce through increased nursing faculty and nursing program capacity in Maryland.
Goals of NSP I and NSP IINURSING FOCUS: Two Aims
1. Increase the number of registered nurses
2. Increase the number of nurse faculty
Funded Nursing ProgramsFY 2006- FY 2015
$7.1 mil
$3.8 mil
$2.3 mil
4
1
$6.3mil 3
3
$44 mil 16
12 Universities
15 Community Colleges
27 SON
NSP II
Competitive Institutional Grants Awarded ~ $63 mil
NSP II Program Evaluation
Types of Program Initiatives (N=41)
Community Colleges
Private University
Public University
Historically Black College or University TOTALS
Increase pre-licensure RN graduates 2102 180 175 150 2607 New RNs
Increase graduate degrees-MSN, DNP
142 310 180 632 MSN/DNP Student Retention and Success 135 135 New RNs Increase RN to BSN completions 275 302 577 RN-BSNs Increase statewide resources, faculty, preceptors, simulation 474 177 154
805 Faculty/ Preceptors
Total Graduates 2711 774 941 330 4756
Measurement and Evaluation
7
5800 or 27% total 20,967 pre-licensure graduates attributed to NSP II
In 2013, 1,726 ADNs (58% increase)In 2006, 1,090 ADNs
In 2013, 1,615 BSNs (43% increase)In 2006, 1,127 BSNs
Measurement and Evaluation
8
621 new MS and 203 new DNP degrees directly attributed to NSP II
219 % Increase in MS degrees from 2006 to 2013
No known impact on PhD graduates2005- 87 PhDs2013-88 PhDs
NSP II Evaluation
9
IMPACT27% of New
RNs Renewed (5 yrs)
$75 million5 New Initiatives-
Related to IOM GoalsEvaluation &
Dissemination
OUTCOMES
2237 ADNs 621MSNs505 BSNs 190 DNPs577 RN-BSNs 245 NNFF51 NEDG 296 GNF
805 Certificates
OUTPUTSNew/Expanded Programs 5 + MSNs, 2+ DNPs 2+ BSN, 3+ RN-BSN Accelerated Programs 3 + ADN cohorts, 2 + WE Technology/ Development 4+ Simulation labs 5+ Online- 4+ Faculty Development
INPUTS Resources
New Faculty- new hiresProject Directors
Instructional suppliesFunding- grant and
In-kindClinical Simulation
External ConsultantsProfessional developmentInstructional Technology
Collaborations
SITUATIONShortage estimatesAssociated hospital costFaculty shortageTurned away students
HRSA Workforce Evaluation
10
2012 2025 Projected
State Supply & Demand
Demand Supply Difference
Maryland 60,600 72,000 59,900 -12,100
Virginia 69,900 87,300 106,700 +19,400
Pennsylvania 145,000 152,600 178,400 +25,800
Delaware 10,600 12,500 16,200 +3,700
West Virginia 20,600 21,100 29,000 +7,900
US 2,897,000 3,509,000 3,849,000 + 340,000Source: HRSA (2014).The Future of the Nursing Workforce: National and State Level Projections, 2012-2025 Notes: Projections assume demand and supply are equal in 2012 and nurses remain in their state of training.
Nurse Support Program II Evaluation
http://www.hscrc.state.md.us/documents/commission-meeting/2015/01-14/HSCRC-Public-Pre-Commission-Meeting-2015-01-12.pdf
In 2014, at the conclusion of ten years of funding, the HSCRC and MHEC staff, with the help of a 7 member Advisory Group completed the program evaluation.
Many stakeholders provided letters of support: 15 schools- MHA and MNA
HSCRC renewed NSP IIfor 5 more years ~ $75 mil on 1/14/15
NSP II Workgroup provided guidance and new RFA released 3/13/15
IOM Goals = NSP II Goals #4- Increase RNs to 80% BSN by 2020
#5- Double the # of RNs with Doctorates 2020
#6- Ensure lifelong learning for RNs
#7- Enable RNs to lead change
The Future of Nursing: Leading Change, Advancing Health (2010)
NSP II- New Goals & Metrics NSP II Workgroup Members: Dr. Steve Jencks- HSCRC Commissioner Advisory Group- NSP II Project Directors
& NSP I Nurse Leaders Chief Nursing Officers at Hospitals Maryland Board of Nursing Maryland Hospital Association MNA, MONE, MDAC, MHEC, HSCRC
Workgroup Recommendations
14
5 New Competitive Institutional Grants Initiatives1.Pre-licensure RNs 2.Advance education RN-BSN, MSN, Doctoral3.Doctoral- prepared RN Faculty4.Continuum of care- education/practice5.Statewide capacity
Workgroup RecommendationsBaseline Data
Evaluation Tools
2 New Statewide Initiatives1.Leadership Consortium2.Clinical Simulation Resource Consortium
Dissemination Requirements
Initiative #1 Increase Nursing Pre-licensure
enrollments and graduates
Academic Progression-Dual Enrollment
To meet IOM Goal #4, need community colleges nurse educators working alongside university and hospital nurse educators to prepare future RN workforce
Initiative #2 Advance the education of students and
RNs to BSN , MSN and Doctoral level
Programs approved by MHEC/MBON RN-BSN & RN-MSN (online-hybrid-
onsite) MSN ( entry level, 2nd degree, MS) Doctorates (DNP or PhD) To meet IOM Goals #4, 5, 6 & 7
Initiative #3 Increase the number of doctoral
prepared nursing faculty
DNP, PhD Nursing Faculty Careers MBON and MHEC program approvals
To meet IOM # 5, 6 & 7
Initiative #4 Build collaborations between education
and practice that develop new models that promote a patient centered continuum of care
Prepare RNs to lead change in hospitals
Utilize NSP I and NSP II Academic/Practice Leadership Increase primary care- APRNs, NPs To meet IOM Goals # 4, 5, 6 & 7
Initiative #5 Increase educational capacity
statewide
Develop innovations Standardize Share Disseminate
To meet IOM Goals # 4, 5, 6, & 7
Data Tools- Faculty
FACULTY for current AY ( 2014-2015) Equivalents (Total FTEs)
FT PT Total Number
Nursing faculty with PhD in Nursing
Nursing Faculty with PhD - Other
Nursing Faculty with DNP
Nursing Faculty with EdD
Nursing faculty with MSN
Clinical nursing faculty with BSN
Clinical nursing faculty with MS
Mandatory Data Table for all Proposals and all Future Interim Annual and Final Reports
Data Tools- Students
Program Capacity (new students only)
Number of qualified applicants
Qualified but not admitted
Admitted who registered
Graduation Rate
Retention Rate
Academic Year/Session for Indicated Program- Describe Program Type
Graduates ADN BSN Master Entry
RN-BSN RN-MSN MS DNP PhD
# Graduates per academic year (as appropriate)
Data Tools- DiversityUnderrepresented Groups in Nursing
Ethnic/Racial Minority
% White % Non-White
Total Number
Nursing faculty (Full Time)
Clinical or part-time faculty
Nursing students
Underrepresented Groups in Nursing
Gender
Female Male Total Number
Nursing faculty (FT)
Clinical or part-time faculty
Nursing students
Data Tools- Geographic
In-State or Out of State
State of Residence
Maryland Geographic Neighbors (VA,DE, DC, PA, West VA)
Other States
Total Number
Percent In State
Nursing faculty (FT)
Clinical or part-time faculty
Nursing students
Can we answer the question: Where do our RNs ( students/Faculty) work and live?
Findings- MONE Hospital Survey
25
Maryland Hospital CNOs reported: Top 3 hard to fill departments: ED(71%), ICU(68%) and OR(58%) Most difficult to fill RN roles: RN Manager (63%), Director(50%), Educator(47)
In 2015, 53% CNOs creating new RN jobs:Care navigator(64%), Documentation RN(64%),Care coordinator(50%), Quality/Safety RN(50%)
Hospital Educator- Professional Development Specialist- often misnamed Clinical Nurse Specialist (8 titles)
NSP II Faculty Survey (n=389)
26
86% of 79 Faculty with Doctorates (PhD, DNP, EdD) are over age 54 (n=68)
Younger Faculty- more diverse/less education/ less opportunity
Preference for Doctorates/Experience
50% all Faculty retiring in 10 yrs. 70% all Faculty retiring in 15 yrs.
5 NSP II Nurse Faculty Resources
27
Faculty Survey- 7/28-10/31/14389 Respondents
245 NNFFRecruit/retain88% retention
51 NEDG awards forDoctoral Completions
Leadership ConsortiumSimulation ConsortiumHal and Jo Cohen GNF
Implications
28
No research has been identified that provides adirect or indirect relationship between a state’sinvestment in Nursing faculty or nurses and the
cost oroutcomes of the state’s health care system…….
Without a strategic framework, model of changeand outcomes criteria………….
one solution will appear to be as good as any other ……….
Kowalski & Kelley (2013)
NSP II Return on Investment
29
Research is needed:
Evidence based faculty strategiesInnovative education initiativesROI to fund nurse faculty & workforceNurse’s impact on patient outcomes/cost
NSP II funded programs need to be evaluated and disseminated through peer-reviewed publications.
REQUIRED: Data Tables ( see pg. 6 & 18) Dissemination meetings ( see pg. 18 & 20)
NSP II Expectations Rigorous Reporting & Accountability Embed Retention, Simulation & IPE Collaboration among Project Directors Curricular Change/ Agreements Seamless Academic Progression Well Executed Programs/Innovations Hospital Leaders and Education Leaders Program Evaluation and Improvements
NSP II Evaluation 2019Measure Progress and Impact
NSP I and NSP II Goals for RNs INCLUDE:
1. Statewide strategies for the workforce
2. Right RN skills/mix =Triple Aim/Waiver
Next NSP II Evaluation Due 2019
References Institute of Medicine, (IOM) 2010 report, The
Future of Nursing: Leading Change, Advancing Health. Washington, DC: The National Academies Press.
Kowalski, K. & Kelley, B.M. (2013). What’s the ROI for resolving the nursing faculty shortage? Nursing Economics, 32(2), 70-76.
Nurse Support Program II. Accessed at www.nursesupport.org
Nurse Support Program II Faculty Survey, completed October 31, 2014, released at NSP II Advisory Group meeting on November 19, 2014.
References
Nurse Support Program II (NSP II) Outcomes Evaluation FY 2006- FY 2015 and Recommendations for Future Funding
http://www.hscrc.state.md.us/documents/commission-meeting/2015/01-14/HSCRC-Public-Pre-Commission-Meeting-2015-01-12.pdf
Addendum During the NSP II Technical Assistance
Meeting, many questions arose. The program is essentially the same; however, many participants had specific questions about the new data requirements and items that might be allowed.
Afterwards, some who did not attend requested more assistance, so the following
Q & A Session slides were developed!
Q & A Session
Can we write a grant for more than 1 initiative? No, please
address one major initiative per proposal.
Can we write more than one grant proposal?
Yes, there is no limit on the number of good proposals that a school can submit.
Q & A Session
Can we write grants for equipment?
No, there is an option for instructional technology, but it is not the main focus/funding of a proposal that measures progress in nurse graduates.
Can we ask for funding for pre-nursing students? Probably not, we did
not have any of these discussions in the Workgroup and are not familiar with how to measure actual RN graduates within a grant’s time frame.
Q & A SessionDo we have to complete the enrollments listed on pg 16?
Yes, that is background information- include in the narrative a snapshot of the program’s enrollments- in addition to the required data set.
Is the Cover sheet and data tables part of our 15 page limit?
No- they are not counted in your narrative section.
Please number all pages!
Q & A Session
What are Dissemination Activities?
Conferences, meetings, & activities to share best practices and progress on successful programs on IOM Goals – national, state, local- for Maryland’s RNs.
Do we have to include funds for faculty to attend the Maryland Action Coalition meetings?
Yes- the MDAC is our lead organization reporting on movement towards IOM Nursing Goals.
Q & A SessionWhere do I find the data required?
The Workgroup consulted with Deans/Directors of Nursing Programs.
Consult with yours.
How did you decide on these data?
Deans and Directors/ Nursing Programs report standard, readily available data to the MBON and Accreditation Boards.
These data are defined and consistent.
Q & A SessionWhat is the deadline for the electronic files?
The Deadline for submission is 4/24.
All items- electronic proposals and excel budget with hard copies are due in MHEC’s offices- 10th Floor.
Do we have to submit the hard copies by 4/24?
Yes
The Receptionist leaves at 4pm, therefore, proposal packages can be hand delivered up until that time.
Q & A Session
What are Statewide Initiatives?
Faculty Focused Funded Programs
Not part of the Competitive Institutional Grants
Listed for information
Can schools apply for the Statewide programs?
No- these are faculty focused initiatives guided by a Nursing Dean/ Director nomination process- available to faculty in nursing programs.
Q & A Session
Can hospitals apply for NSP II? No
Hospitals have NSP I funds. However, nursing schools and hospitals are encouraged to partner and share NSP I and NSP II Funded programs/ initiatives.
Why did the Workgroup emphasize Hospitals and Higher Education collaboratives?
It is a natural fit- they share the same end goals- a highly educated RN workforce that meets the needs of Maryland’s Waiver & the Triple Aim- better care & better health/ patient experience at lower cost.
Q & A Session
What about Nurse Residency Programs?
Nurse Residency could be considered as an aspect of an NSP II Education Focused program, i.e.: Academic credits for Residency Courses
What about the NSP II Simulation and Leadership Consortiums?
Hospital Nurses/ Leaders are eligible, as well as Nurse Faculty. The CNO or designee can nominate participating hospital RNs/ educators and Deans/Directors can nominate faculty.
Q & A Session
What is the abstract?
A well written abstract – 1-2 paragraphs- less than 200 words.
It briefly describes the program- may be included verbatim in future outlines/ or on the www.nursesupport.org
What if we need to have more pages to explain our proposal and funds request?
The panel may have 27 proposals to review. They are RNs or hospital professionals and well informed.
Please make sure you deliver a clear, concise proposal.
Answer anything a potential reviewer would question.
State the case in the first 1-2 pages- then build it.
Use addendum for job descriptions, etc.
Q & A SessionWhat about the budget pages?
The budget needs to be completed on a single budget sheet for each year.
In addition, all years of the grant proposed should be submitted in Excel.
How do I deliver the budget?
Electronic copies- PDF signed budget-
with narratives Excel format by email
Send signed hard copy with copies of proposal
Q & A Session What about the Evaluation Plan?
HSCRC and MHEC expect the evaluation to be clear, well considered and easy to follow.
Recommended: prepare a Logic Model for your program proposal. Sample templates at
http://www.uwex.edu/ces/pdande/evaluation/evallogicmodelworksheets.html
NEW Mandatory Requirements Data Tables
Page 7, 8 & 9 Appendix A behind
Cover Sheet
Format & Data required
Dissemination Activities
Part of the Evaluation Plan
Funded in the Budget
Activities reported within Annual and Final Reports
Location of MHEC Offices Maryland Higher Education Commission 6 N. Liberty St., 10th Floor Baltimore, Maryland 21201 Located in MSDE/ Nancy Grasmick
Building Across from the First Mariner’s -on the
corner of W. Baltimore and Liberty St.Questions: Contact Priscilla Moore at 410-767-
3099 or email at [email protected]