Nurses Leading the IOM Report in Wisconsin: Pathways, Progress, & Potential Judith M. Hansen, MS, BSN WCN Executive Director Taking the LEAD for Nursing in Wisconsin RWJF State Implementation Program Grant #70696

July, 2014

Objectives

• Present nursing workforce data from the Wisconsin Center for Nursing, Inc.

• Share overview of Wisconsin Action Coalition • Provide updates on RWJF (SiP) Taking the LEAD for Nursing in WI grant focus areas • Present concepts for RWJF (SiP) Round 2 • Identify key regional issues & strategies to prevent workforce shortages, advance grant initiatives

WCN Mission

•

Assure an adequate, well prepared and diverse nurse workforce to meet the needs of the people of Wisconsin

Data Driven Process

• • Three surveys: RN, LPN, & Educational Survey designs; based on National Minimum Dataset: Supply, Demand & Education from National Forum of State Nursing Workforce Centers • • DSPS - Distribution of surveys DWD – Data security & initial analysis, forecasting tools • WCN – analyses by nursing researchers & dissemination w/ recommendations • Benchmark data from national reports

Data Model

RN and LPN Diversity Education DWD Model Workforce Report IOM Report

Trends impacting nursing workforce

• • • • • Growing elderly population Increasing diversity Aging healthcare workforce Faculty shortage & age Potential impact of healthcare reform, changing delivery systems • Economy, postponed retirements

Wisconsin projected population growth 2000-2035

Table 1. Wisconsin Projected Population by Age Group, 2000-2035 Age Group

0-17

18-64

18-24 25-44 45-64

65 & over

65-84

85 & over Census 2000

1,368,756

3,292,406

520,629 1,581,724 1,190,053

702,553

606,928

95,625 Projected 2015

1,349,090

3,739,160

553,530 1,547,380 1,638,250

900,170

764,710

135,460 Projected 2035

1,448,200

3,720,200

577,800 1,570,350 1,572,050

1,485,570

1,263,020

222,550 Percent Change

5.8

13.0

11.0

-0.7

32.1

111.5

108.1

132.7

Source: Egan-Robertson, D., Harrier, D. & Wells, P. (2008).

2012 Wisconsin RN Survey Findings

n = 78,159

• 83.9% actively working as nurse in WI healthcare settings • • • • 3.1% working in healthcare non-nurse 1.8% working in another field 45,821 working in direct patient care in WI 5,664 APRNs with Masters or higher • 5.7% APRNs in Wisconsin vs 8.7% nationally

2013 Wisconsin LPN Survey Findings

n=11,195

• 75.2% actively working as nurse in healthcare • 6.5% working in healthcare non-nurse • 4.2% working in another field • 8,402 (87.3%) working in direct patient care • 98.3% LPN Diploma, 4.5% ADN, 0.7% Bachelors • 4,025 (36%) enrolled to further education

Wisconsin Nursing Employment

• • • • • •

2012 RNs:

53.6% hospitals 17.3% ambulatory care 10.7 % nursing home/extended care 5.7% home health

Average age: 48 Average experience: 15 years

• • • • • •

2013 LPNs:

10.7% hospitals 29.1 % ambulatory care 42.1% nursing home/extended care 6.8% home health

Average age: 50 Average experience: 20 years

Wisconsin RNs 55 & older by work setting

Wisconsin LPNs 55 & older by work setting

Gender in Wisconsin Nurses

•

Assembly of Men in Nursing Goal: 20% Men by 2020 Wisconsin Nurses by Gender % Female % Male WI 2010 RN 93.2

6.8

WI 2012 RN 93.1

6.9

WI 2011 LPN 95.4

4.6

WI 2013 LPN 95.6

4.4

Source: WCN DWD 2010-2012-2013 Wisconsin Nurse Survey Summaries

Race/Ethnicity In Wisconsin Nurses

Source: 2012 RN & 2013 WI LPN At-a-Glance

WI RN WI LPN WI Population Caucasian African American Hispanic Other 93.5

91.0

2.0

6.3

1.4

1.9

3.0

3.8

85.0

6.0

6.0

3.0

US Population 78.1

13.1

16.7

6.4

RNs – Plan to Leave Direct Patient Care

LPNs – Plan to Leave Direct Patient Care

Source: 2013 Wisconsin LPN Survey

DWD Forecasting Tool

• • • • • Developed by economists Projections include a variety of scenarios All show similar results Potential gap: 34% - 36% by 2035

Potential gap of 15-20,000 direct care nurses

Source: Walsh, T., Udalova, V. & Winters, D. (2011). Wisconsin Registered Nurse Supply and Demand Forecasting: Results Report 2010-2035. Wisconsin Department of Workforce Development, Office of Economic Advisors. Retrieved from http://worknet.wisconsin.gov/worknet_info/projects/rn_forecasting/results_report_printer_friendly.pdf

DWD 2013 Updated Workforce Projections

Source: Wisconsin Registered Nurse Supply and Demand Forecasting Update:2012-2035 Wisconsin Department of Workforce development Office of Economic Advisors Feb 2014

Closing the RN Gap

2010 Observation 2015 Scenario Estimate 2020 Scenario Estimate 2025 Scenario Estimate 2030 Scenario Estimate 2035 Scenario Estimate

New graduates needed annually to close the projected demand

2,700 4,500 7,500 11,300 14,100 15,500

Source: DWD, OEA, 2010 RN Forecasting Model, Broad Nursing Workforce - Head Count

2013 Strategic Workforce Report

•

The Wisconsin Nursing Workforce: Status & Recommendations

• • Landmark, historical report Aligned w/ IOM Report –

The Future of Nursing: Leading Change, Advancing Health

• Identified issues in Wisconsin • http://www.wisconsincenterfornursing.org/workforce_report.html

Wisconsin Challenges

• • • 43.7% BSN 25,292 ADNs to advance Mean age for MSN completion is age 41; “degree a decade” • • • • 67% RN’s no immediate plans to return to school 0.6% Doctorates (includes PhDs & DNPs) 48% faculty are over age 55 59.9% nurses plan to leave workforce within 10 years • Only 5% of nurses from under-represented populations • APRNs are not completely independent

Wisconsin Regional Differences

WI RNs Median age % Female % White % Unemployed % ADN % BSN South SE

48 48

NE

48

West North

49 49 93.3

96.8

94 94 92.7

97.9

91.9

98.1

93.1

98.5

1.8

35.8

43.3

2.5

32.2

2.3

36.6

48.9

44.7

2.3

45.8

34.7

1.9

46.1

36

Overarching Recommendations

• • •

Triple the number of ADNs returning to school for BSN or higher, expand educational capacity Double # APRNs graduating by 2020 Remove Scope of Practice barriers

• • •

Double # doctoral degrees graduating by 2020 Increase diversity in nurses to reflect the population Expand participation of nurses as full partners in redesign of care models

•

Enhance healthcare workforce data collection

Multi-prong approach

• Retention of the workforce w/in new models of care • Recruitment & successful transition of new nurses to double the pipeline, but “keep the wisdom” • Recruitment of faculty; curricular redesign • Academic progression in partnership w/employers & schools • Innovative partnerships w/adoption & spread of best practices

Wisconsin Action Coalition

• • Wisconsin Center for Nursing, Inc.

Rural Wisconsin Health Cooperative • Future of Nursing™ Campaign for Action national partners:  Center to Champion Nursing in America  Robert Wood Johnson Foundation®  AARP

Wisconsin IOM Report ‘Inventory’

• • • • • • • National Summit Feb. 2013 – Washington DC; developed Wisconsin ‘gameplan’ – course of action Formal launch Wisconsin AC – May, 2013 Inventory questionnaire based on IOM Report recommendations.

WHA, ANEW, WI Nurses Coalition, WALHDAB, WI School Nurses, WI Health & Homecare Assn, WI Longterm Care Assn, RWHC, WMS, Wisconsin Medical Group Management Assn, WI Minority Nurses Assns. & more!

100+ responses, 500+ comments Report being developed by WCN (Fall 2014) Receiving national attention

Taking the LEAD for Nursing in Wisconsin

• RWJF State Implementation Program (SiP) grant 2/1/13 1/31/15 • • •

FOCUS AREAS:

Leadership - WONE, leadership development (20%), assess nurses on boards (10%), leadership tool kits Educational Advancement – Increase BSN completion (15% - 10%), WHA website, CNO Tool kit, push-pull models, rural/urban partnerships Diversity – inclusive excellence organizations, outreach to increase numbers of minority, male nurses, WI

Diversity Assessment Tool

Wisconsin Funders Network

• • • • Integrated into grant proposal Linking CNOs, Health system foundation directors, deans Regional meetings– Madison, Green Bay (to date) Next outreach; beyond healthcare, i.e., business, private foundations, etc.

• Faye McBeath Foundation – grant to assess nursing funding in Wisconsin being compiled by Public Policy Forum • Philanthropy - Need assistance making connections throughout state

NEXT: RWJF SiP Grants Round 2

• • • • • Proposals: October 1, 2014. Grant period 2/1/15-1/31/17 $150,000 over 2 years/$75,000 match by 10/1/14 Continue: BSN completion, leadership, diversity

New focus areas for consideration:

 Interprofessional education/practice  Employer/Educator partnerships  Enhanced BSN completion programs  Team & community-based care models  Repository, mentorship for boards  Pilot Wisconsin Diversity Assessment Tool

Thank you!

Questions?

Group Discussion

•

What is currently going on in this region to implement recommendations from:



IOM Future of Nursing Report ?



WCN 2013 Nursing Workforce Report?

•

What are the greatest needs in this region?

•

What might be possible strategies to address these needs?

•

Where would you like to see activities in the next grant round?

Websites & Contact Info

• Wisconsin Center for Nursing www.wicenterfornursing.org

• Judith Hansen, Executive Director [email protected]

• Future of Nursing™ Campaign for Action www.campaignforaction.org