nursing workforce diversity updates and anticipated trends
TRANSCRIPT
Shanita D. Williams, PhD, MPH, APRNChief, Nursing Education and Practice Branch
Division of Nursing and Public Health Bureau of Health Workforce
Health Resources and Services [email protected]
Division of Nursing and Public Health: Nursing Workforce Diversity Updates and Anticipated Trends
AACN Spring 2016 Conference
Workshop: Building the Case for Diversity and Inclusive Learning
March 18, 2016 and March 23, 2016
BHW Priorities Spotlight: Preparing a Diverse Workforce
Programmatic Overview Legislative Authority: Nursing Workforce Diversity (NWD) Program
Why Diversity? Why NWD? NWD vs U.S. Population Demographics Benefits/Strengths of Diverse and Culturally Aware Workforce
Evidence-based Strategies to Increase Nursing Diversity in U.S. Population NWD Program Initiatives and Investments
Spotlight: Urban Universities for HEALTH Study: Holistic Review and Admissions in Nursing
Discussion and Questions
Presentation Outline:
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Bureau of Health Workforce Mission
Improve the health of underserved and
vulnerable populations by strengthening the health workforce and
connecting skilled professionals to
communities in need.
Collaboration
Accountability
Innovation
HRSA MissionImproving health and health equity through access to quality services, a skilled health workforce and innovative programs.
BHW Programs Snapshot
In FY 2015, BHW awarded over $1 billion to more than 8,500 organizations and individuals through more than 40 workforce programs.
Collectively, our programs increase the nation’s access to quality health care by developing, distributing, and retaining a competent health workforce.
Workforce Supply
Priorities
Program Design
Academic & Community Partnerships
Interprofessional Practice & TrainingRapid Cycle QI/Data Driven
Research and Resources
Bureau of Health Workforce
Preparing a Diverse
Workforce
Improving Workforce
Distribution
Transforming Health Care
Delivery
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Legislative Authority: Title VIII, Section 821 of the Public Health Service Act (42 U.S.C. 296m), as amended by Section 5404 of the Patient Protection and Affordable Care Act (P.L. 111-148). Annual Appropriations: $14.5 million/year1st Year of Appropriations/Awards: 1987
Nursing Workforce Diversity (NWD) Program:Goal: increasing nursing education opportunities for individuals from disadvantaged backgrounds (including racial and ethnic minorities underrepresented among registered nurses) Student scholarships, stipends, pre-entry preparation, advanced education
preparation, accelerated nursing degrees, and retention activitiesFY 2015:
11 - new awards - $3,488,008; 31 - continuing awards - $10,442,5261 - Interagency Agreement w/NIH National Institute on Minority Health and Health Disparities (NIMHD) - $150,000
Title VIII—Nursing Workforce Diversity
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Frequent Question:“Why do we need a dedicated funding stream for Nursing Workforce Diversity? Hasn’t workforce diversity been integrated into all funding priorities?”
Why Nursing Workforce Diversity Matters…
Why Nursing Diversity Matters?Nursing Diversity: Increases cultural competence Improves patient satisfaction Improves patient-provider communication Increases access to care
Vulnerable populationsUnderrepresented minorities more likely to practice
in underserved areas Economic advantages
Good business practice
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Participant Criteria NWD
Nursing Workforce Diversity (NWD) Program Disadvantaged Backgrounds1. Educational or Economic disadvantage2. Racial or ethnic minority
underrepresented among registered nurses
Demographic Profile*^ NWD National~WhiteBlackAsianHispanic/Latino
35.6% 83.2%23.4% 5.4% 2.9% 5.8%22.8% 3.6%
FemaleMale
76.3% 91.0%17.2% 9.0%
Disadvantaged BackgroundRural
73.4% 16.8%27.9% 16.0%
*Demographic Data from National Center for Health Workforce Analysis: NWD Program Annual Report CY 2013 -2014-unpublished^National Council of State Boards of Nursing (NCSBN) and Forum of State Nursing Workforce Centers (2013)~Registered Nurses
Constant Question:“What racial/ethnic minority recruitment and retention models implemented in undergraduate nursing programs have been successful in recruiting, retaining, and graduating students form schools of nursing”?
Nursing Workforce Diversity: Evidence-based Strategies That Work
Successful Strategies that Achieve Health Professions Student Diversity
Successful models include various combinations of evidence-based strategies: Academic support Professional and peer mentoring Student financial support Community partnerships Holistic Review and Admissions
What Works to Achieve Diversity: Insights from HRSA Grantees
Academic and peer support Before admission and during academic progression
Professional and peer mentoring Establishing mentoring networks Language partnerships
Visible minority faculty Financial support
Uninterrupted Social support Active Community partnerships
Nursing Workforce Diversity: Current and Future Directions
Social Determinants FrameworkSocial determinants are the conditions in which people are born, grow, work, live, and age, and the wider set of forces and systems shaping the conditions of daily life
World Health Organization
Five social ‘class’ determinants of student success and achievement:1. Challenged home intellectual environments2. Single parenthood3. Irregular parental work schedules4. Inadequate health car access5. Exposure to environmental lead
Economic Policy Institute (2015)
Social Determinants as a Nursing Workforce Diversity Strategy Move beyond individual-level strategies rooted in
deficit-based models and assumptions Multi-level and systems approaches
systems (college, university, and community-level) Partnerships
public and private sectors (beyond nursing)industry and other disciplines
Collective activity vs. Individual nursing school effort
From Social Determinants to Holistic Review and Admissions
Holistic Review and Admissions Admitting and graduating the best “nurses” vs the best
“students” Matching a student background/experiences to the
College/University mission, vision, and values Using diversity of admission criteria not exclusive of
quantitative metrics: GPA, GRE
Requires institutional leadership involvement starting at the top
HRSA’s Holistic Review and Admissions Investments2013: Urban Universities for HEALTH $265,000 HRSA Grant Survey of Admissions in the Health Professions examined how universities are admitting students into health professions programs, with a particular focus on “holistic review” as a strategy to increase diversity and cultural competence in the health professions, with the larger aim of improving access to care and achieving health equity
2015: Urban Universities for HEALTH $150,000 HRSA Grant Disseminating Evidence on Admissions project aim is to improve the understanding and use of evidence-based university admissions practices that lead to a more diverse and culturally competent nursing workforce
Shanita D. Williams, PhD, MPH, APRNChief, Nursing Education and Practice Branch
Division of Nursing and Public Health Bureau of Health Workforce
Health Resources and Services [email protected]
Division of Nursing and Public Health: Nursing Workforce Diversity Updates and Anticipated Trends
AACN Spring 2016 Conference
Workshop: Building the Case for Diversity and Inclusive Learning
March 18, 2016 and March 23, 2016