Transforming Health Care:

Nurses Engaged in Policy

Nancy Ridenour, PhD, APRN, BC, FAAN

American Academy of Nursing

October 13, 2012

RWJ Health Policy Fellowship

http://www.healthpolicyfellows.org/home.php Founded 1973 12-18 month residency in DC 4 month orientation Work assignments on the Hill traditionally Administration /Agencies

TRANSFORMATIONAL

Twelve Academy Members Who are RWJ Health Policy Fellows

Mary Mundinger, RN, DrPH1984-1985

Virginia Trotter Betts, JD, MSN, RN, FAAN1987-1988

Ellen-Marie Whelan, PhD, NP, RN, FAAN2003-2004

Nancy Ridenour, PhD, APRN, BC, FAAN2007-2008

Margaret Moss, PhD, JD, RN, FAAN2008-2009

Margaret Wilmoth, PhD, RN, FAAN2009-2010

Janice Phillips, PhD, RN, FAAN2010-2011

Barbara Damron, PhD, RN,FAANCurrent Fellow

Hurdis Griffith, PhD, RN, FAAN1986-1987

Julie Sochalski, PhD, FAAN1992-1993

Sister Rosemary Donley, PhD, APRN, BC, FAAN

1997-1998

Liana Orsolini-Hain, PhD, RN, CCRN2011-2012

Being Inducted into the Academy This Evening!

Portfolio While at Ways and Means

– PPACA now ACA– Hospice– Hospital acquired

infections; conditions– Health care associated

conditions– Health Information

Technology; meaningful use

– E-prescribing– Transparency in ownership

of long-term care facilities

– Quality outcomes /Value Based Purchasing

– Funding for primary care– International

comparisons in health outcomes and health systems

– Chronic Care Coordination

– Clinical Outcomes/Quality

– Workforce

Health Reform 2007-2008

Cost

Access

Quality

Health Reform 2009-Now

Cost

AccessQualit

y

Lessons Learned Need more nurses on

the Hill Nursing professional

groups need to speak in “one voice”

Nurses need to make strategic partnerships

We need nurses to get PhDs in Health Economics!

Nursing needs to invest more in government relations

Research focus on issues to inform health policy

Translate profession specific language to stories for general public

Need more nurses in executive, legislative, and judicial branches

Characteristics of the Reformed Health System

Health Equity Patient/Consumer Centric Focus on Quality and Safety Value Based/Pay for Performance Evidence Based Practice Comparative Effectiveness Prevention and Early Intervention Increased Access

Reformed System Demographics: aging population

with increasing chronicity at all age levels

Meaningful use (HIT) Population based practice High Functioning Teams Workforce Issues

Numbers Distribution Best Mix

High Priority Health Problem/Issue

High Risk High Volume High Cost Closing the Gap between

Research and Practice

Biggest Impact

Increase Policy Relevance

Gap between clinical practice and research findings

Need to show public investment in research leads to benefits for patients

Timing Policymakers not interested in

theory Cost: usually more short-term than

long-term Know goals of agency, lawmaker, etc How are data being used? By

Whom?

Research Trajectories to Inform Policy

Design our research to inform and change policy

Design our research to evaluate current policy

Translate our current research into policy implications

Posit new policy approaches and test them

Research Agenda for Policy

Comparative Effectiveness Research ($3 Billion)

Interprofessional: research, education, practice

Team Science Workforce Quality; Safety Innovations in care delivery Outcomes Innovations in payment systems Health Information Technology Center for Innovation at CMS

• Why would someone be interested in your work?

• How can you humanize and personalize what you are doing?

• How can you help others see themselves as part of the solution you are proposing?

• What “niche” can you fill?

Think of Your Research, Practice, Teaching

Role of AAN

Each characteristic of the Reformed Health

System suggests a Major role for The Academy to Impact Health Policy and Contribute to the Nation’s Health!

Be Part of the Solution Increase involvement, visibility, and influence

in the health policy process Enhanced advocacy role

Briefings, hearings and testimonies Fellowship Opportunities: Robert Wood Johnson

Health Policy Fellowship; AAN/IOM Scholar Membership on key boards, committees, task forces Collect and provide data showing outcomes and

comparative effectiveness of nurse driven care

The Robert Wood Johnson Foundation Nursing and Health Policy Collaborative at University of New Mexico:

• Prepares nurses to become leaders in health policy through research and advocacy. • Offers generous financial support for full-time study.• Offers Web-based course study. • Targets those from underrepresented populations. • Provides funds to support student and faculty research.• Provides resources and support from Robert Wood Johnson Foundation Center for

Health Policy.

  

For more information about the Robert Wood Johnson Foundation Nursing and Health Policy Collaborative at University of New Mexico visit our Web site at www.nursinghealthpolicy.org or write to us at CON-RWJF@salud.unm.edu.

Robert Wood Johnson Foundation Nursing and Health Policy Collaborative at

UNM

• Develop and practice a 30 second “elevator” speech on your project

• Develop one page lay audience description of your research or practice and the impact on healthcare.

• Outcomes• Quality and Effectiveness• Cost savings or recovery• Safety

Things to Do

AND Communicate Disseminate Synthesize Across Disciplines Integrate Into Practice Accelerate the Pace of Policy

Development Provide data to inform and

evaluate policy

American Academy of Nursingtransforming health care policy and practice through nursing knowledge

AAN/IOM Scholars in Residence

2012 Marla Salmon ScD, RN, FAAN

ProjectFocus on micro-finance, nursing, and women’s development will impact domestic and global health policy

2010 - Pamela F. Cipriano PhD, RN, FAAN

ProjectImpact, implications of Health IT and identify technologies that reduce errors, waste and promote seamless care coordination

2009 - Julie A. Fairman PhD, RN, FAAN

ProjectInitiative on the Future of Nursing

Nurse Scholars

2008 - Mary E. Evans PhD, RN, FAAN

2007 - Carolyn Williams PhD, RN, FAAN

2006 - Ada Sue Hinshaw PhD, RN, FAAN

2005 - Jacquelyn C. Campbell PhD, RN, FAAN

2004 - Veronica D. Feeg PhD, RN, FAAN

2003 - Angela Barron McBride PhD, RN, FAAN

2002 - Bonnie M. Jennings DNSc, RN FAAN

Nurse Scholars

Sampling of Work of Expert Panels• Aging: Commented on proposed regulations regarding RNs in

LTC; Expressed concern to House leadership regarding ‘observational status”

• Emerging Infectious Diseases: Published policy brief Hepatitis C Screening and Testing: A Call for a National Response; Wide dissemination of policy brief on the need for routine testing for HIV

• Global Nursing and Health Care: Policy brief: Leadership needed to address the Global Nursing and Midwifery Workforce Shortage

Sampling of Work of Expert Panels• Quality: Preparing 6 positions papers– Measuring Episode of Care Outcomes– Measuring Care Coordination– Measuring the Economic Value of Nursing– Measuring Nurses’ Workload– Measuring Patient Engagement– Harmonizing Performance Measures—Implications

for Practice, Education, and Research

MedPAC Commissioner: Mary Naylor, PhD, RN, FAAN Transitions of Care

Chair National Health Workforce Commission:Peter Buerhaus, PhD, RN, FAAN

Initiative on the Future of Nursing

The Recommendations

Future of Nursing Report: Sue Hassmiller, Donna Shalala, Linda Burnes Bolton, Michael Bleich, Jennie Chin Hansen, Liana Orsolini-Hain

Action Coalitions: Multiple Fellows

HRSA Administrator:

Mary Wakefield

CMS Innovation Center: Ellen-Marie Whelan

Our Patients, Our Communities,

Our Health Care System, Our

NationNeed Nurses to Successfully Inform Policy Through Practice and Research

Through Engagement of Strategic Partners

Activate Strategic Partner Networks

Build Bridges with Common Vision

Soar to New Heights