Transcript Technical Assistance - Maryland Higher Education

Nurse Support Program II
Competitive Institutional Grants
Technical Assistance Meeting
April 1, 2015
Peg Daw- MHEC
Oscar Ibarra-HSCRC
Priscilla 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 I
MHEC 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 II
NURSING FOCUS:
Two Aims

1. Increase the number of registered
nurses

2. Increase the number of nurse faculty
Funded Nursing Programs
FY 2006- FY 2015
12 Universities
15 Community
Colleges
$7.1 mil
$6.3mil
$2.3 mil
3
3
$44 mil
16
27 SON
1
$3.8 mil
4
NSP II
Competitive Institutional
Grants Awarded ~ $63 mil
NSP II Program Evaluation
Types of Program Initiatives
(N=41)
Increase pre-licensure RN
graduates
Community
Colleges
2102
Increase graduate degreesMSN, DNP
Student Retention and Success
Historically
Black
Private
Public
College or
University University University
180
175
150
2607 New RNs
142
310
180
632 MSN/DNP
135
Increase RN to BSN completions
TOTALS
135 New RNs
275
302
577 RN-BSNs
805 Faculty/
Preceptors
Increase statewide resources,
faculty, preceptors, simulation
474
177
154
Total Graduates
2711
774
941
330
4756
7
Measurement and Evaluation
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
8
Measurement and Evaluation
No known
impact on
PhD
graduates
2005- 87 PhDs
2013-88 PhDs
621 new MS and 203 new DNP degrees directly attributed to NSP II
219 % Increase in MS degrees from 2006 to 2013
NSP II
Evaluation
SITUATION
Shortage estimates
Associated hospital cost
Faculty shortage
Turned away students
IMPACT
27% of New RNs
Renewed (5 yrs)
$75 million
5 New InitiativesRelated to IOM Goals
Evaluation &
Dissemination
INPUTS
9
Resources
New Faculty- new hires
Project Directors
Instructional supplies
Funding- grant and
In-kind
Clinical Simulation
External Consultants
Professional development
Instructional Technology
Collaborations
OUTCOMES
2237 ADNs
621MSNs
505 BSNs
190 DNPs
577 RN-BSNs
245 NNFF
51 NEDG
296 GNF
805 Certificates
OUTPUTS
New/Expanded Programs
5 + MSNs, 2+ DNPs
2+ BSN, 3+ RN-BSN
Accelerated Programs
3 + ADN cohorts, 2 + WE
Technology/
Development
4+ Simulation labs
5+ Online4+ Faculty Development
10
HRSA Workforce Evaluation
2012
2025 Projected
Supply &
Demand
Demand
Supply
Maryland
60,600
72,000
59,900
-12,100
Virginia
69,900
87,300
106,700
+19,400
145,000
152,600
178,400
+25,800
10,600
12,500
16,200
+3,700
20,600
21,100
29,000
+7,900
2,897,000
3,509,000
State
Pennsylvania
Delaware
West Virginia
US
3,849,000
Difference
+ 340,000
Source: 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.
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 schoolsMHA and MNA
HSCRC renewed NSP II
for 5 more years ~ $75 mil on
1/14/15
NSP II Workgroup provided
guidance and new RFA
released 3/13/15
Nurse Support
Program II
Evaluation
http://www.hscrc.state.md.us/
documents/commissionmeeting/2015/01-14/HSCRCPublic-Pre-CommissionMeeting-2015-01-12.pdf
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
14
Workgroup Recommendations
5 New Competitive Institutional Grants
Initiatives
1. Pre-licensure RNs
2. Advance education RN-BSN, MSN,
Doctoral
3. Doctoral- prepared RN Faculty
4. Continuum of care- education/practice
5. Statewide capacity
Workgroup Recommendations
Baseline Data
Evaluation Tools
2 New Statewide Initiatives
1.
Leadership Consortium
2.
Clinical Simulation Resource Consortium
Dissemination Requirements
Initiative #1
 Increase
Nursing Pre-licensure
enrollments and graduates
 Academic
 To
Progression-Dual Enrollment
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
Mandatory Data Table for all Proposals and all Future Interim Annual and Final Reports
FACULTY for current AY ( 2014-2015)
Equivalents (Total FTEs)
FT
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
PT
Total Number
Data Tools- Students
Academic Year/Session for Indicated Program- Describe Program Type
Program Capacity (new students only)
Number of qualified applicants
Qualified but not admitted
Admitted who registered
Graduation Rate
Retention Rate
# Graduates per academic year (as appropriate)
Graduates
ADN
BSN
Master
Entry
RN-BSN
RN-MSN
MS
DNP
PhD
Data Tools- Diversity
Underrepresented Groups in Nursing
Ethnic/Racial Minority
% White
% NonWhite
Total Number
Nursing faculty (Full Time)
Clinical or part-time faculty
Nursing students
Underrepresented Groups in Nursing
Gender
Female
Nursing faculty (FT)
Clinical or part-time faculty
Nursing students
Male
Total Number
Data Tools- Geographic
Can we answer the question: Where do our RNs ( students/Faculty) work and live?
In-State or Out of State
State of Residence
Maryland
Nursing faculty (FT)
Clinical or part-time
faculty
Nursing students
Geographic
Neighbors (VA,DE,
DC, PA, West VA)
Other
States
Total
Number
Percent In
State
25
Findings- MONE Hospital Survey
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 Specialistoften misnamed Clinical Nurse Specialist (8 titles)
26
NSP II Faculty Survey (n=389)
 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.
27
5 NSP II Nurse Faculty Resources
Faculty Survey7/28-10/31/14
389 Respondents
245 NNFF
Recruit/retain
88% retention
51 NEDG awards for
Doctoral Completions
Leadership Consortium
Simulation Consortium
Hal and Jo Cohen GNF
28
Implications
No research has been identified that provides a
direct or indirect relationship between a state’s
investment in Nursing faculty or nurses and the cost or
outcomes of the state’s health care system…….
Without a strategic framework, model of change
and outcomes criteria………….
one solution will appear to be as good as any other ……….
Kowalski & Kelley (2013)
29
NSP II Return on Investment
Research is needed:




Evidence based faculty strategies
Innovative education initiatives
ROI to fund nurse faculty & workforce
Nurse’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 2019
Measure 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/c
ommission-meeting/2015/01-14/HSCRCPublic-Pre-Commission-Meeting-2015-0112.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 prenursing 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 Session
Do 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 enrollmentsin 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, localfor 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 Session
Where 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 Session
What 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
Can schools apply for the
Statewide programs?
Focused
 No- these are faculty
Funded Programs
focused initiatives
 Not part of the
guided by a Nursing
Competitive
Dean/ Director
nomination processInstitutional Grants
available to faculty in
 Listed for information
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 Aimbetter 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 Session


What 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 budgetwith narratives
 Excel format by email
Priscilla.Moore@maryla
nd.gov
 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/evaluatio
n/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]