New law waives requirement for NPs to have a written practice agreement with a physician.
New York is the newest state to grant nurse practitioners (NPs) full practice authority, joining 24 other states and Washington, D.C.
New York Gov. Kathy Hochul signed the state budget into law on Saturday, that includes legislation that eliminates the requirement for NPs to have a written practice agreement with a physician and allows them to provide the full scope of services they are educated and clinically trained to provide.
Granting full practice authority bolsters efforts to reduce healthcare disparities and increase health equity.
"Over the past two years, New York has waived unnecessary and outdated laws limiting access to healthcare. AANP applauds the state legislature and Gov. Hochul for recognizing that these provisions need to continue," Kapu said. "These changes will help New York attract and retain nurse practitioners and provide New Yorkers better access to quality care."
Full practice authority authorizes NPs to evaluate patients; diagnose, order and interpret diagnostic tests; initiate and manage treatments; and prescribe medications, all under the exclusive licensure authority of the state board of nursing.
This framework eliminates "unnecessary, outdated regulatory barriers" that prevent patients from accessing these vital care services directly from NPs, according to AANP.
Support for full practice authority continues to grow. The National Academy of Medicine's The Future of Nursing 2020-2030 report recommends that nurses be allowed to "practice to the full extent of their education and training by removing barriers that prevent them from more fully addressing social needs and social determinants of health and improving healthcare access, quality, and value."
New York joins an increasing number of states acting to "retire outdated laws that have needlessly constrained their health care workforce and limited patient access to care," said Jon Fanning, MS, CAE, CNED, chief executive officer of AANP.
"This is a no-cost, no-delay solution to strengthening health care for the nation. Decades of research show that states with full practice authority are better positioned to improve access to care, grow their workforce, and address healthcare disparities, while delivering quality health outcomes for patients. We look forward to more states following suit."
The American Medical Association and other physician groups, however, argue collaborations are needed for patient safety.
Besides fellowship and support, AONL members will find plenty of useful information to take home with them.
Nurse leaders are gathering this week in San Antonio, Texas, for AONL 22, the annual conference of the American Organization for Nursing Leadership (AONL).
In addition to keynote presentations and preconference classes on certification and finances, nurse leaders can learn and gather information from more than 50 breakout sessions.
Within those breakout sessions, several themes have emerged, including these five:
1. Staffing and retention
With the extreme shortage of nurses in healthcare, nurse leaders are seeking ways to build their staffing pipelines and hold on to the nurses they have.
Several breakout sessions will address this, including:
Hold On to Your Nurse Managers Through a Comprehensive Retention Program—Retaining effective nurse managers is critical, affecting financial and quality outcomes as well as nurse satisfaction and retention.
Securing the Workforce: Transforming Nurse Externs into Graduate Nurses—Externships streamline potential graduate nurses to their future nursing careers by allowing them to work in other clinical roles to gain experience, resulting in better patient care and cost-effective orientations.
The Role of Specialty Associations to Address the Nursing Shortage—A new project strengthens the academic-service partnership to include a specialty association, the Association of periOperative Registered Nurses (AORN), to attract and prepare nursing students to periop practice.
Successful COVID Facility Culture Validates Nurse Retention Framework—Elements of a highly successful nursing culture in a COVID facility were layered into a newly developed conceptual framework for nurse retention. The results were stunning.
2. Resilience
The past two years have required nurse leaders to be resilient and to help their staffs do the same.
Resilience and Mindfulness: Repair and Empower—Participants will learn to harness the power of mindfulness practice through an abbreviated program that is accessible, engaging, and supported by evidence so they can lead their organization's support for nurses' self-care.
Sink or Swim: A Holistic Approach to Nurse Manager Resilience—Assessment of a nurse manager’s work effectiveness both before and after structural changes.
Empowering Nurse Leaders to Support Staff Well-Being and Resilience—This session will provide leaders with actionable takeaways to better support the well-being of the nursing workforce of the future.
Public Health Nurses: Bridging the Gap to Health Equity—The role of public health nurses (PHNs) is to promote public wellness with a focus on the underserved and most vulnerable members of society.
Community Care Teams: Breakthrough Strategy for Health Care Equity—Community Care Teams is a strategy to improve healthcare equity and population health with 40% reduction in ED visits. The program is becoming a game changer for pediatric care providers, schools, and families.
Nurse Leaders: Empowered Advocates for Health Equity at the Board Table—Bringing the nursing perspective to organizational and public policy decisions emboldens advocacy for health equity and social change
4. Care models
With the nurse staffing shortage at crisis levels, healthcare organizations are required to rethink care models and look at alternative ways for future care delivery.
Implementing a Virtualized Clinical Care Model for Inpatient Nursing—Baptist Health System has implemented a virtualized nursing and clinical care services program in 345 medical-surgical beds across three hospitals.
Innovative Delivery of Care: Hospital at Home—Offering nursing care in the home for inpatients requires figuring out logistics for providing meals, implementing telemedicine to monitor vitals, and answering the patients' "call light."
Care Models of the Future: How & Why Complexity Leadership Theory (CLT) Works—CLT explains how the healthcare industry can adapt to the exodus and shortage of nurses. Results include significant improvements in retention, decreased patient harm, net promoter scores, and length of stay.
5. Diversity, equity, and inclusion
Increasing diversity in nursing is considered essential to improving health equity, according to research that indicates benefits to communication, access to care, and patient satisfaction.
A Guide to Building Mentoring Relationships with Black, Indigenous and People of Color—Even though leaders want up-and-comers to have a fair chance at success, BIPOC professionals (Black, Indigenous, and People of Color) have other challenges and not everyone understands how racial bias works.
Nursing Leading the Way: Advancing Diversity, Equity & Inclusion—Participants will learn how an interprofessional team took the lead in developing and implementing a DEI nursing strategic plan across a large, integrated healthcare system.
The new professional credential will be called the Certified Burn Registered Nurse (CBRN). After collaborating with the American Burn Association (ABA) on the initial development of the CBRN, BCEN will own and maintain the CBRN certification program.
"Following years of extraordinary advocacy by the American Burn Association and the burn nursing community to set the stage for a burn nursing-specific professional credential, and knowing the impact specialty certification has on ensuring optimal patient safety and outcomes as well as nurse success and satisfaction, BCEN is honored to take on this important endeavor," BCEN CEO Janie Schumaker, MBA, BSN, RN, CEN, CENP, CPHQ, FABC, said in a press release.
Understanding the pathophysiology of a burn injury is crucial to effective treatment, which is why burn certification for RNs is key to better outcomes for burn patients.
"The CBRN will advance our specialty by promoting the knowledge, skills, and abilities needed to care for those impacted by burn injury, thus encouraging quality nursing care and best patient outcomes," said Gretchen J. Carrougher, MN, RN, research nurse supervisor, Department of Surgery, UW Medicine Regional Burn Center at Harborview Medical Center, Seattle, Washington.
"I have been impressed by the dedication by many in our specialty and appreciative of the support by the ABA and BCEN in this long-standing effort," added Carrougher, who chairs the ABA's nursing certification committee.
Burn nursing was formally recognized in August 2020 as a nursing specialty by the American Nurses Association (ANA)—a move that highlights "the essential role of burn nurses and the function of burn nursing practice across the healthcare spectrum,” ANA president, Ernest Grant, PHD, RN, FAAN, said at the time, himself a burn nurse for more than 35 years.
CBRN will be BCEN's sixth specialty nursing certification program, joining five current specialties: emergency, pediatric emergency, trauma, flight, and critical care transport.
More than 50,000 RNs and advanced practice registered nurses (APRNs) hold one or more of the BCEN credentials.
92% of survey respondents suggest nurse labor shortage will get worse without swift action, new study says.
An extreme shortage of nurses and supportive care personnel has created a "devastating" effect on the entire healthcare system, with drastic change "long overdue," new research says.
"We are beyond the point of no return," according to the new study, Nursing's Wake-Up Call: Change is Now Non-Negotiable. "We must implement swift and meaningful actions if we are to move beyond the paralysis."
The study, published by Wolters Kluwer in partnership with UKG, surveyed 300 U.S. nurse leaders in late 2021 to examine how COVID-19 has run roughshod over current labor models and how an intensifying labor shortage will affect future nursing labor models.
Study findings include:
92% of respondents predict they will be short of budgeted headcount over the next 18 months.
Due to financial constraints, 58% of respondents do not expect to bring in additional staff or new roles but are instead focused on retaining their current workforce.
The average shift remains 12 hours for nurses in acute and post-acute settings, despite widely reported burnout.
Acute settings have been slow to embrace new models of care, except for float pools; 92% of respondents in the acute setting plan to expand or establish float pools in the next 18 months.
Though 75% of respondents use staffing technology in some capacity, but day-to-day staffing is often handled manually.
Key components to positive changes include staffing levels, workforce flexibility and resiliency, and technology implementation to optimize productivity, the research says.
Yet, a "wide disconnect" exists between the challenges healthcare facilities acknowledge they’re experiencing and the plans they already have in place—or that they plan to put in place in the future—to respond to workplace challenges, according to the study.
"Results show that healthcare leaders have a grasp on the day-to-day challenges but not on all of the levers of change they have available to them," the study says.
"The results also show respondents have deprioritized or remain status quo on opportunities to (1) improve staffing levels; (2) foster more flexibility and more resiliency into the workplace, thus affecting retention and workplace satisfaction levels; and (3) optimize productivity through tools and technology available to them," it says.
Nurse leaders can steer toward positive change, thereby improving workplace satisfaction and care quality, by taking a more active role in understanding the challenges on the front lines, the study advises.
"Dramatic action to support our nurses is long overdue. Experts have forecast nursing shortages for years, but few could have predicted the impact that COVID-19 would have on this workforce," said Anne Dabrow Woods, DNP, RN, CRNP, ANP-BC, AGACNP-BC, FAAN, chief nurse of Wolters Kluwer, Health, Learning, Research and Practice.
"To ensure the best care is delivered to all patients across care settings, healthcare organizations need to rethink care models to achieve greater agility within the nursing workforce," she said. "Nurses can’t do more, so we need to ensure we’re doing more to make care delivery models sustainable."
One solution the study offers is adopting a team-based model using unlicensed assistive personnel (UAPs), licensed practical nurses (LPNs), and less-experienced RNs to allow nurses to practice at the top of their license.
Healthcare organizations also should consider offering flexible shift options, other than the regimented 12-hour shifts, to provide better work-life balance, the study suggests.
Much more, however, is required, according to the study authors.
"There is recognition that nursing care delivery has to be as efficient and effective as possible," the study reads. "But completely changing the paradigm requires novel innovation, which would start with taking a collaborative approach to changing care models that are no longer sustainable."
Criminalizing RaDonda Vaught's 'unintentional' mistake is the 'wrong approach,' says Robyn Begley, CEO of AONL.
The conviction of former Vanderbilt nurse RaDonda Vaught for gross neglect of an impaired adult and negligent homicide will have a "chilling effect" on the culture of safety in healthcare, Robyn Begley, CEO of the American Organization for Nursing Leadership (AONL), said in a statement released today.
"Criminal prosecutions for unintentional acts are the wrong approach," Begley said. "They discourage health caregivers from coming forward with their mistakes and will complicate efforts to retain and recruit more people in to nursing and other healthcare professions that are already understaffed and strained by years of caring for patients during the pandemic."
Vaught was convicted Friday of a 2017 fatal drug error after a three-day trial that continues to capture the attention of nurses across the country, many of whom worry that the case could set a precedent of criminalizing medical errors.
Vaught, scheduled to be sentenced May 13, faces three to six years in prison for neglect and one to two years for negligent homicide.
"The Institute of Medicine’s landmark report To Err Is Human concluded that we cannot punish our way to safer medical practices," Begley said. "We must instead encourage nurses and physicians to report errors so we can identify strategies to make sure they don’t happen again."
Vaught has consistently taken responsibility for the deadly error, which occurred when the patient, a 75-year-old woman, was supposed to get Versed, a sedative intended to calm her. Instead, Vaught accidentally administered vecuronium, a powerful paralyzer, which stopped the patient's breathing.
Vanderbilt received no punishment for the fatal error.
The American Nurses Association (ANA) also expressed dismay at the "harmful ramifications of criminalizing the honest reporting of mistakes."
Mistakes inevitably will occur and systems will fail, the ANA said in a statement, adding, "It is completely unrealistic to think otherwise."
"There are more effective and just mechanisms to examine errors, establish system improvements, and take corrective action. The non-intentional acts of individual nurses like RaDonda Vaught should not be criminalized to ensure patient safety," the ANA said.
"This ruling," the statement concluded, "will have a long-lasting negative impact on the profession."
Trinity Health's top nurse makes it her mission to prepare the health system's chief nurses to be strategic partners within their own hospital's leadership team.
A hospital or health system's chief nursing officer (CNO) is unparalleled in the direct link to patient care, so it is "a miss" if the organization doesn't welcome that lineal perspective to the senior leadership table, says nurse executive Gay Landstrom, PhD, RN, NEA-BC, FACHE.
Landstrom, senior vice president and CNO of Trinity Health, has a seat at the table and helps prepare the health system's CNOs to be strategic partners within their own hospital's leadership team.
Through mentoring, development, and leadership programs, Trinity CNOs gain the skills necessary to plan organizational strategy and make high-level decisions.
HealthLeaders spoke with Landstrom about her work with CNOs to prepare them to be part of their organization’s leadership team.
This transcript has been lightly edited for length and clarity.
HealthLeaders: How far along, right now, are nurse executives in getting seating at a hospital or health system's leadership table?
Gay Landstrom: I've been in a CNO role since 1994 and a system chief nurse since 2009, and over that time, there has been a steady evolution of organizations recognizing that the chief nursing officer is not just the person who's running a big part of an organization, hospital or otherwise. CNOs are responsible for a lot of the operations—usually the biggest chunk of the people who work in an organization. Because they have such direct access to the biggest chunk of the workforce, and it's their workforce that is directly caring for the customer—the patient—they have a direct view of the service, or care, that's being provided every day.
They're also creative. They see what doesn't work well. Many CNOs are innovative in their view as to how we could do this better and better meet patient care needs or improve quality or improve safety. So, it's a miss if you don't have the chief nursing officer at that senior leadership table where strategy is discussed and decisions are made.
That said, not all organizations are there, but there's been a steady evolution. From a system standpoint, even a dozen years ago, there weren't a lot of people who had experience doing what I do as a system CNO and now there really are. We probably tripled or quadrupled the number of system chief nursing officers, and in the system, chief nursing officers very typically are sitting at the executive strategy tables.
HL: How prepared are most CNOs to be strategic partners within their hospital's leadership team?
Landstrom: We've probably talked about it for at least a couple of decades, that historically, did we take a great clinician and make them a nurse manager? Absolutely. But we've recognized that we've got to start developing those people and, if possible, develop them before they take that kind of responsibility.
That development is a constant process. One of the things that we work on developing is their ability to be strategic. Within my organization, Trinity Health, we have a strategic leadership program, and we get new CNOs right into it to make sure that they have a good dose of not only thinking strategically and understanding the theoretical underpinnings of strategy, but that they get to collaborate with multidisciplinary teams.
One of the important skills you have to have as a CNO is not just knowing nursing; you have to be able to work with and translate to lots of other disciplines, where they have a financial, strategic, or marketing background. You have to be able to translate and tell stories and convey what it is that you know, in ways that can be understood. Not everybody has that innate ability, so we work on developing that.
The other thing is education for nursing leaders has evolved. I have for a number of years advised if someone wants to become a CNO they have to look at getting started with their doctoral education because that helps augment that that ability to think in different ways and think strategically and creatively.
HL: You've touched on this briefly, but let's talk a bit more about what CNOs uniquely bring to the leadership team.
Landstrom: I often will find myself on a leadership team with the most realistic and current knowledge of what our colleagues, employees, and clinicians might be struggling with day to day [and] what their work is, what their challenges are, and what barriers might stand in their way, as well as what the issues might be with pipelines for developing our workforce in coming years.
And while other people might have pieces of information—like the human resource officer might be aware of the numbers and where we hire people from—I'm the one that's thinking about the pipeline and the relationships with schools and making sure that we will have an adequate flow for coming years.
For the workforce, I will often need to be the one that really can tell the story of what's happening at the bedside—why patients might be frustrated or what new barriers are being encountered by our employees as they're caring for patients. So very often, I might be the only one carrying that kind of perspective of the primary product that we deliver as a health system.
There usually is a physician at the table, and they understand the medical side of things and one aspect of patients, but it's my employees who are with them 24 hours a day, and it usually is nurses with whom patients will be most honest and forthright about their concerns, their worries, their frustrations, and so forth.
So that is often what I have to bring into that discussion. As we're considering our challenges and what decision options we might have, I have to be sure I represent all those pieces, so we take them all into account as we make decisions.
HL: What are some of the tools necessary, then, for the next generation of nurse leaders to be strong organizational leaders?
Landstrom: I'll preface this by saying I have some pretty strong opinions about this and not all my colleagues necessarily think this way. CNOs have to have strong relationship skills. They have to learn how to lead in an environment where they're empowering clinicians and not making the rules and telling people what they need to do. They must engage people in governing their own practice and improving that practice and help people participate in better understanding the system and helping make decisions to make it better. That's just an essential skill.
And here's the part that people don't always think about. The health systems that we have today increasingly are not hospital systems. There are some that are purely acute care, but with more systems, you have acute care hospitals, post-acute services, long-term care, and PACE [All-Inclusive Care for the Elderly] programs. You've got a lot of different healthcare and distinct parts of the continuum.
Many CNOs grow up in acute care; it's where the largest numbers of RNs practice still, but CNOs of the future need to learn more than acute care. They need to gain experience in other parts of the continuum and have an appreciation of what is different and how all the pieces fit together because frankly, our patients flow through that whole continuum. And if all you understand is one part of it, then I don't think you can do justice to the role.
One of the things I'm developing right now is a fellowship that gives an aspiring leader the ability to have some time with different parts of the continuum and give them that appreciation of how all these pieces fit together so that they have the perspective they need to be a strong CNO.
The North Carolina hospital was fined for failing to conduct N95 respirator fit tests, among other violations.
HCA's Mission Hospital in Asheville, North Carolina has been cited and fined nearly $30,000 for not adequately protecting nurses and other healthcare workers from COVID-19.
The Occupational Health and Safety Division (OSH) of the North Carolina Department of Labor concluded its occupational health and safety investigation and issued citations for:
Failing to conduct an annual fit test for employees who were required to wear an N95 respirator
Failing to establish a record of employee fit testing
Failing to notify the North Carolina Department of Labor of the death of an employee due to COVID-19 in a timely manner. HCA waited nearly two weeks to notify the Department of Labor of the death, according to the citation.
Failing to report each work-related COVID-19 inpatient hospitalization within 24 hours of learning about the hospitalization. HCA delayed notifying the Department of Labor about an employee hospitalization for more than a month, the citation states.
Fines for the issued citations totaled $29,775.
Dozens of Mission nurses participated in interviews and walk-throughs with state OSH investigators since October 2021, according to a press release issued by National Nurses Organizing Committee/National Nurses United (NNOC/NNU).
The RNs also have claimed and protested unsafe working conditions.
"We union nurses have been fighting for a safer workplace throughout the pandemic," said Kerri Wilson, RN in the cardiac step-down unit at Mission Hospital. "Our workplace is safer because we spoke up, we reported safety violations, and we took the time to show OSH investigators what needed to be corrected."
Susan Fischer, an RN in the float pool, applauded North Carolina's Department of Labor for ensuring that Mission's nurses and healthcare workers remain safe.
"Mission was not ensuring that we had proper-fitting personal protective equipment," she said, "and now the hospital has been cited for failing to protect us and has made corrections."
The legislation includes $280 million for Title VIII Nursing Workforce Development programs—$16 million over fiscal year 2021 levels. It also provides $181 million for the National Institute of Nursing Research (NINR), an increase of almost $6 million over the previous fiscal year.
In passing the bill, Congress also provided significant funding for many within the nursing profession:
Sexual assault nurse examiners
Studies and grants to improve models of maternal care for racial and ethnic minorities
Investments in a rural maternal and obstetric care training program.
"The passage of H.R. 2471 signifies an important step as we elevate the need for enhanced federal investments to support our current and future nursing workforce," said a statement released by the Nursing Community Coalition (NCC).
"The NCC sincerely thanks Congressional Leadership, Senate and House Appropriations Committees, and our Congressional Nursing Caucuses for their dedication to the nursing profession," the statement read.
The NCC is comprised of 63 nurse organizations, including the American Organization for Nursing Leadership (AONL), American Nurses Association (ANA), American Association of Nurse Practitioners (AANP), Emergency Nurses Association (ENA), and the American Association of Critical-Care Nurses (AACN).
In prepared testimony in June 2021 for the U.S. Senate Appropriations Subcommittee on Labor, Health and Human Services, and Education and other agencies, NCC explained how increased federal resources for current and future nurses are even more imperative.
"Title VIII programs are instrumental in bolstering and sustaining the nation’s diverse nursing pipeline by addressing all aspects of nursing workforce demand," according to that testimony.
Indeed, the Bureau of Labor Statistics projected that by 2029, demand for RNs would increase 7%, illustrating an employment change of 221,900 nurses. Furthermore, the demand for most Advance Practice RNs (APRNs) is expected to grow by 45%.
"This is just one example on why continued and elevated investments in Title VIII Nursing Workforce Development Programs in FY 2022 is essential and will help nurses and nursing students have the resources to tackle our nation's healthcare needs, remain on the frontlines of the COVID-19 pandemic, assist with the distribution and administration of the vaccine, and be prepared for the public health challenges of the future," NCC's testimony read.
NCC also pushed hard for research and innovation funding.
"Rigorous inquiry and research are indispensable when responding to the everchanging healthcare landscape and healthcare emergencies, such as COVID-19," according to NCC.
"From precision genomics to palliative care and wellness research to patient self-management, NINR has been at the forefront of evidence driven research to improve care," NCC says. "It is imperative that we continue to support this necessary scientific research."
New law is a major victory in healthcare workers’ health and well-being.
Legislation that earmarks funding to provide mental health wellness to frontline healthcare workers has been signed into law by President Joe Biden—a move celebrated by the Emergency Nurses Association.
Establishing grants for training healthcare professionals on ways to reduce and prevent suicide, burnout, substance abuse, and other mental health conditions.
Grant funding for employee education, peer support programming, and behavioral health treatment
Creation of a national education and awareness campaign focused on encouraging healthcare workers to seek support and treatment.
"As importantly, this bill's signing signals to everyone that it is OK to speak up, it is OK to seek help, it is OK to prioritize your self-care instead of suffering in silence," Schmitz says. "Lives will be saved because of the help this new law provides to healthcare workers."
The bill, which received bipartisan support, was named for Breen, a physician at New York Presbyterian Hospital in Manhattan, who died by suicide on April 26, 2020, after working around the clock for weeks to treat COVID-19 patients.
She declined getting help for the stress and burnout she was experiencing because she feared seeking mental health help would end the only career she ever wanted and that she would be ostracized by her colleagues, according to the foundation established in her name.
Unique collaborative education model gets doctors, nurses, and other healthcare professionals working together from the get-go.
Future nurses work with future doctors in clinical rotations for an entire school year as part of a new collaborative model for nursing education by NYU Rory Meyers College of Nursing.
"We operate on the premise of teamwork and collaboration because there's not just one individual that is responsible for the care of the patient," says Selena Gilles, DNP, ANP-BC, CNEcl, CCRN, associate dean of the undergraduate program at NYU Meyers.
The program, based at NYU Langone Hospital-Long Island, is an example of interprofessional education (IPE), designed to develop effective working relationships between different types of healthcare students and practitioners to support health outcomes.
Research shows that interprofessional healthcare has many benefits, such as improving patient care, fewer preventable errors, reduced healthcare costs, and improved working relationships.
"To my knowledge, there isn’t another structured interprofessional education program like this at other nursing schools," Gilles says. "Some schools do one-off interprofessional simulations or experiences, but our program at NYU Langone Hospital-Long Island is unique."
Creating healthcare teams
The program, which began in fall 2021, paired 12 students in their first year of the nursing program with second-year medical students.
"We pair them into a dyad and when the students are in the clinical setting, they are working together on the unit to care for the same patient," Gilles says. "They are doing health histories and physical assessments together, which involves them working as a team, which is meeting one our objectives—teamwork and collaboration."
The student teams also complete a social determinants of health (SDoH) assessment on their patient to ascertain how social factors—conditions such as housing, education level, income, and access to healthy foods—may affect that patient's outcomes, she says.
"And then they're able to collaborate and develop a plan of care for that individual, based on the information they have," she says.
Each team attends and participates in interdisciplinary rounds, where they meet with other care team members—the attending physician, residents, social worker, and occasionally physical therapists and pharmacy students.
"They are able to bring back the information they gained from doing that social determinants of health assessment and present to the team the concerns that they might have regarding that patient meeting their outcomes and also recommend who on the healthcare team can help this patient meet their outcomes," she says.
"It's not just about them being able to take care of the patient together," Gilles says, "but also going back to the larger team and being a part of that."
Developing the program
The interprofessional education program, funded by a $7 million gift from Howard Meyers and his late wife Rory, began with its own collaboration among nursing and medical teams and faculty members. This work group met frequently to develop program objectives and operations, Gilles says.
"We wanted to involve other members of the healthcare team—like physical therapy, occupational therapy, pharmacy—and make sure that we designed an experience where our students are also able to interact with those professionals," she says.
Coordinating those different curriculums required intense planning, Gilles says.
"What our students learn, when they learn it, and how it's taught are very different in the different healthcare professions, though ultimately, we all have the same goal of finding safe and effective care for our patients, and helping them to have good outcomes," she says. "Because these program structures and timetables are different, and the curriculum is very different, we had to pay very close attention to where they might align and at what point in the program the students could best interact in order for us to meet the program goals."
Those goals include improving quality of teamwork, collaboration, and communication among healthcare team members, she says.
Creating 'true understanding'
A school survey of participating students indicated that the program is doing what it was intended to accomplish.
"Overall, the students are really enjoying the experience," Gilles says. "It allows them to have a different level of appreciation for one another."
That's crucial in a changing healthcare landscape, she says.
"There are increasingly complex patient health needs, and it requires us to be innovative when it comes to patient care. We're often working alongside individuals without having a true understanding or appreciation of each other's role and what each other does," she says.
"Based on survey results and anecdotal data from students and their instructors, they have a different level of appreciation for each others' roles, and it's been able to show them how they might differ but are also the same, and that they have the same goal of ensuring good patient outcomes," she says.
In fact, students are requesting more team-based experiences, so the nursing school is developing other clinical-setting collaborations for them.
"Just two weeks ago, the nursing students went out to the School of Medicine and participated in an interprofessional experience with the same medical students and with pharmacy students," Gilles says.
"We put them in groups of six and we gave them a case. Some groups had a case study on geriatric rotation while other groups had a case study on a pediatric patient," she says. "We allowed them to work together to identify the patient concerns and identify the role that the different team members play in caring for that patient and ensuring that they meet their outcome."
Better patient outcomes
Students aren't the only ones who recognize the benefits of the IPE program; it's obvious to Gilles, as well.
"IPE promotes better team dynamics, which can ultimately end up resulting in things like healthier work environments or more positive attitudes toward each other," she says.
"Better understanding about each other's competencies, skills, and experiences allows us to share knowledge and skills and improve that team, because that team is responsible for the care of patients," she says. "There's evidence to show that IPE directly translates to improve patient outcomes, whether that's decreasing patients' length of stay or reducing the number of medical errors, so we certainly have evidence to support why IPE would be beneficial and at the very top of that list is teamwork and collaboration."
"I'm really glad to be a part of this program," she says, "and in the long run our students and our patients are going to have a huge benefit from it."
