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The collaboration of the Institute of Medicine (IOM) with the Robert Johnson Foundation is among the key initiatives for the Future of Nursing. The principal goal of the project is to conduct a study that would produce a transformational report on the future of nursing as a profession. An innovative committee chosen for the project will evaluate the capacity and effectiveness of the nursing workforce in regard to meeting the needs and demands of the public healthcare system. This examination will lead to the development of national recommendations associated with the positive delivery of nursing services to the population. It is also intended to produce recommendations regarding the societal issues, the capacities of nursing schools, innovative solutions in the nursing practice, as well as attracting and retaining personnel.
Key messages of the project
In the course of the study, four key messages were formulated in order to guide the positive changes within the nursing practice. First, nurses should practice to the most complete extent that is allowed within their training and education. Second, nurses should reach the highest education and training levels through the enhanced system of training that promotes effective academic progression. Third, nurses are intended to be in full partnership with physicians and other professionals within the healthcare sphere in the shaping of effective health care. Fourth, efficient workforce planning and policy-shaping require enhanced data collection procedures as well as improved infrastructures of information (IOM Committee on the Robert Wood Johnson Foundation Initiative on the Future of Nursing, 2011).
The collaboration of the IOM with the Robert Wood Johnson Foundation intends to reach goals in a variety of activities, including stakeholder work, partnerships with nurses, patients, educators, policymakers, and insurers. These efforts are supported by Action Coalitions that would build connections between local stakeholders within states to facilitate change at both local and national levels. The role of the coalitions in the state-wide improvement of the nursing practice is linked to their strategic orientation. For example, the shift to the strategic activation and partnership development implies the “move beyond nursing and focus on improving health and health care for consumers and their families” or “have the courage to place the right leaders at the helm or remove weak, ineffective leaders” (IOM Committee on the Robert Wood Johnson Foundation Initiative on the Future of Nursing, 2011, p. 78). Such campaign imperatives focus on specific objectives that Action Coalitions should reach for activating strategic partnerships and practice development.
The two Action Coalitions to be explored in the paper include California and the Washing state coalitions. The work in the Washing state was focused on collaboration between healthcare professionals and policymakers to make positive changes in the sphere of nursing. The key goal of the Coalition is achieving a healthier population through advanced education of the nursing workforce. The current efforts of the Coalition in the state are focused on building on previous research and expertise to show Washington nurses how to promote the culture of health in their communities, with the assistance from additional guidance (Campaign for Action, 2019). The Coalition thus will work with dedicated and motivate healthcare facilities for creating action plans that would not only address the social determinants of health but also identify and track key performance indicators (KPIs) following the implementation of the action plan.
The California Action Coalition is intended to facilitate significant growth in the transformation of healthcare through nursing in the state. The policymakers in the region have already recognized the importance of the goal and are focused on long-term and sustainable change. Overall, California is working on the all-encompassing improvement of the population’s health in the state. In regards to the eight recommendations established to reach the objective, workgroups have been created to work collaboratively. The first recommendation is concerned with the removal of barriers to the scope of practice, which implies the need for analyzing gaps within the nursing sphere to compare the goals of the IOM Future of Nursing program to the policies and statutes applied to registered nurses in California. Another example is the third recommendation for implementing nurse residency programs. Within the recommendation, it is expected to widen nursing programs for new graduates to include a broad range of new community-based opportunities. Moreover, the recommendation consists of the need for creating a state-wide evaluation of current programs for informing the next steps.
The fifth recommendation is especially relevant in the broader context of the Institute of Medicine collaboration with the Robert Wood Johnson Foundation and calls for doubling the number of Registered Nurses with a doctoral degree by 2020. Within the program, the state of California also focuses on creating a robust infrastructure that would facilitate the collection and review of data concerning the interprofessional healthcare workforce (California Action Coalition, 2017). As applied to this recommendation, it is suggested to disseminate a reliable inventory of state-wide data for the reasons of analysis and workforce planning. Both California and Washington Action Coalition initiatives call for close collaborative work between recommendation workgroups and relevant stakeholders for assessing what data needs to be collected and analyzed for the strategies to be implemented.
Obstacles to achieving the goal
Despite the fact that the Future of Nursing initiative implemented in collaboration between IOM and APRN involves highly trained and competent professionals that offer a wide range of services, there are still a number of barriers that limit the reaching of the identified goals and objectives. The most prominent barriers include federal policies, state laws, ineffective and outdated models of insurance reimbursement, as well as limiting institutional practices and culture (IOM Committee on the Robert Wood Johnson Foundation Initiative on the Future of Nursing, 2011). The identified limitations create an environment of uncertainty as well as lacking cohesiveness. For example, when it comes to policies concerning credentialing and payment, there are differences in state practice laws that prevent the initiative from working in the same way in multiple states. As pointed by Hansen-Turton, Ritter, and Valdez (2008), credentialing causes significant complications. For instance, 53% of NPs were credentialed as primary health providers, and out of them, 56% were reimbursed at the same rate as primary care providers, while 38% were reimbursed at a lower rate (Hansen-Turton et al., 2008). The lack of cohesiveness in such simple issues as reimbursement limits the success of the Future of Nursing initiatives.
The Future of Nursing initiatives offers an all-encompassing perspective on the way in which the nursing practice should change in order to fit the modern health care context. From rapid technological advancements to changes in nurses’ reimbursement models, the program must consider the effects of shifting environments on the nursing profession. The initiative focuses on collaboration between experts and nurses for creating frameworks for the adequate provision of care for the population.
California Action Coalition. (2017). Nursing and the future of health care: California action coalition report. Web.
Campaign for Action. (2019). Campaign names 2019 innovations fund winners. Web.
Hansen-Turton, T., Ritter, A., & Torgan, R. (2008). Insurers’ contracting policies on nurse practitioners as primary care providers: Two years later. Policy, Politics, and Nursing Practice, 9(4), 241-248.
IOM Committee on the Robert Wood Johnson Foundation Initiative on the Future of Nursing. (2011). The future of nursing: Leading change, advancing health. Washington, DC: National Academies Press.