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CORE Performance Measures
Creates a roadmap that others can follow for success
CORE IS A PERFORMANCE MEASUREMENT SYSTEM THAT:
Best Practices
Performance measurement is not just a tool.
It is an essential element in aligning resources with priorities
Source: “The 8th Habit” by Stephen R. Covey
Only 37% of employed people said they have a clear understanding of what theirorganization is trying to achieve and why.
Only 1 in 5 workers said they have a clear “line of sight” between their tasks and their team’s and organization’s goals.
If these results were applied to a soccer team, only 4 of the 11 players would know which goal is theirs.
Directing organizations is like flying an aircraft
What are the Key Indicators?
Am I going in the right direction at the right speed?
Rather than perception and anecdotal information CORE uses accurate measurements.
Are these lines the same length?
Stages in Model
INPUTSPROCESS/ACTIVITIES
OUTPUTSINTERMEDIATE
OUTCOMEOUTCOMES BOARD ROLE IMPACT
DefinitionWhat resources we invest
Actions taken to achieve the desired outcomes
Measurable products of a program’s activities
An outcome that is expected to lead to a desired end but is not an end in itself
Benefits to stakeholders, communities, systems, or organizations
Functions of the Board of Nursing
Are we achieving the right results?
Examples
TimeStaffMoneyPartnersEquipmentSpaceMaterialsTechnology
TrainFacilitateMeetingsWorkshops
PlansPolicyTraining
SkillsAwarenessKnowledgeAttitudesOpinionsMotivations
BehaviorPracticeDecision MakingPoliciesSocial Action
LicensureDisciplineEducationPracticeGovernance
Improved well-being for people
Sample
MoneyStaffPartnersTechnology
Train investigatorsInvestigate complaintsNegotiate consequences
Process reports of misconduct or incompetent practice in a timely manner
Guidelines for conduct and practice
Nurses are held accountable for safe and competent practice
Discipline
To safeguard the public’s health and well-being by providing guidance for and regulation of, entry into the profession, nursing education, and continuing safe practice
Metrics
Number of monitors
Number of investigators
Time from receipt of complaint to disposition of complaint
Length of time to complete a case
Recidivism
Logic Model
CORE
Data collected from boards of nursing and multiple stakeholder groups
1. Boards of Nursing2. Nurses 3. Educational programs4. Employers
1.9 1.9
Nurses and Employers Perception of the Board’s Effectiveness in Protecting the Public
Nurses Employers
Very Effective
Effective
Ineffective
Very Ineffective
Very Effective
Ineffective
Effective
Very Ineffective
4
3
2
1
4
3
2
1
Nurses’ and Employers Knowledge of How to Report a Suspected Violation of Nursing
Statute and Rules
2007
Nurses Employers
Percent who say they know how to report violation
64.5% 95.2%
Nurses’ Satisfaction with the Licensure Process
2.35
DissatisfiedVery
Dissatisfied SatisfiedVery
Satisfied
Nurses’ Satisfaction with the Renewal Process
2.36
DissatisfiedVery
Dissatisfied SatisfiedVery
Satisfied
Method Last Used to Obtain/Renew License
2007
Mail 39.2%
On-line for entire process 36.4%
Printed application from Board Web site and mailed/faxed in
10.3%
Other 9.8%
Walk-in 4.3%
Method Used by Employers to Verify Licenses
2007
Web-based verification system 79%
Phone – automated system 15%
Call-in 13%
E-mail 12%
Nursys 11%
Letter 5%
Fax 3%
2007 Too much regulation
Too little regulation
Please rate the degree or extent of regulation in this state in each of the following areas. (Scale: 4 =Too much regulation,3 = Adequate regulation, or 2 =Too little regulation)
Education Programs
Employers
Practice standards/scope of practice
2.6% 6.7%
Complaint resolution/discipline process
2.2% 17.4%
Education program approval/accreditation
10.8% 15.2%
Requirements for licensure 3.3% 9.2%
Ratings of Existing Statutes and Administrative Rules and Regulations
Using Information from CORE
Used the information to support purchasing a new $240,000 phone system - the prior number one dissatisfier/challenge from those surveyed in the state
Comparisons
Aggregate
State
Size (Number of Licensees)
Umbrella and Independent
Year AggregateA Board of
NursingVariance
2007 $48.80 $38.9120%
Below Avg.
Estimated Cost Per LicenseeBoard vs. Aggregate
Variable2002 2005 2007
Value Value Value
Expenses per licensee (total budget divided by number of nurse licensees)
$36.42 $37.89 $38.91
Estimated Cost Per LicenseeBoard Results Across Time
YearIndependentBoards Avg.
A Board of Nursing
Variance
2007 $48.30 $38.9120%
Below Avg.
Estimated Cost Per LicenseeBoard vs. Other Independent Boards
Year
Boards with Between 50,000 to
99,999 Licensees
A Board of Nursing
Variance
2007 $48.89 $38.9120%
Below Avg.
Estimated Cost Per LicenseeBoard vs. Boards of Similar Size
PERCENTAGE OF EXPENDITURES BY FUNCTIONAL AREA
Aggregate A Board of Nursing
Investigations/discipline 33% 51%
Licensure 19% 5%
Educational Programs 7% 12%
Other Indirect Expenses
36% 36%
2007
AggregateAverage
A Board of Nursing
Variance
Days
Months
2287.6 months
2187.3 months
About 10 days below
avg.
Estimated Days & Months to Resolve A Case
Employer’s Perceptions of New Graduates Preparedness by Function
Scale: 4 = very well prepared; 3 = well prepared; 2 = poorly prepared; 1 = very poorly prepared
AggregateA Board of
Nursing
Administer medication by common routes 2.88 2.97
Recognize abnormal physical findings 2.75 2.56
Communicate relevant information 2.75 2.59
Assess the effectiveness of treatments 2.69 2.54
Teach patients 2.69 2.61
Work with machinery used for patient care 2.67 2.56
Work effectively within a health care team 2.67 2.69
Respond to emergency situations 2.63 2.32
Do math necessary for medication administration 2.63 2.65
Perform thorough physical assessments 2.56 2.61
Create a plan of care for patients 2.5 2.64
Perform psychomotor skills 2.47 2.43
Recognize abnormal diagnostic lab findings 2.44 2.47
Supervise care provided by others 2.36 2.15
RN Perception of Education Program Preparation
50% 42%
57%
29%
0%
10%
20%
30%
40%
50%
60%
2002 2005 2007
Year
% V
ery
Wel
l Pre
pare
d fo
r P
ract
ice
Aggregate
A Board of Nursing
RN Perceived Preparation for Practice by Years of Licensure
0%
10%
20%
30%
40%
50%
60%
70%
80%
0 to 1years
1 to 2 years 2 to 5years
5 to 15years
15 to 25years
25 to 35years
35 or moreyears
Years Licensed
Per
cent
Ver
y W
ell P
repa
red
for
Pra
ctic
e
Perception of Board Functions by Nursing Education ProgramsScale: 4 = adequate; 3 = somewhat adequate; 2 = somewhat inadequate; 1 = inadequate
2002 2005 2007
Time spent on site during visit 3.91 3.70 3.95
Time given to correct deficiencies 3.90 3.80 3.94
Preparation time for Board visits 3.82 3.80 3.94
Interval between Board visits 3.67 3.90 3.89
Overall benefit of approval process 3.90 3.80 3.84
Communication with Board staff 3.92 3.60 3.84
Timeliness of providing feedback 3.91 3.80 3.79
Feedback/evaluation provided by Board 3.91 3.70 3.79
Due process for disagreements re. findings 3.89 3.56 3.75
Comprehensiveness of feedback provided 3.91 4.00 3.74
Fairness in monitoring compliance 3.89 3.90 3.72
Fairness/objectivity of Board findings 3.91 3.90 3.63
2007
AggregateA Board
of Nursing
Received Sanctions or Faced Closure
11.3% 12.6%
Percentage of nursing programs that received sanctions, faced closure, or been
the subject of additional monitoring in the last 2 years
Education Program Investigation
How well Board kept them informed
2005 2007 Improvement
Nationally 3.41 3.47 0.06
State 2.50 3.80 1.30
Assistance provided by Board staff
2005 2007 Improvement
Nationally 3.85 3.85 0
State 3.85 3.88 0.03
Scale: 4 = very well informed; 3 = well informed; 2 = minimally informed; 1 = not informed at all)
(Scale: 4 = consistently helpful; 3 = occasionally helpful; 2 = rarely;1 = not helpful at all)
Education Program Investigation Process
Fairness of Investigation Process
2005 2007 Change
Nationally 3.54 3.62 0.08
State 3.00 3.80 0.8
Appropriateness of Outcome
2005 2007 Change
Nationally 95% 95% 0
State 100% 100% 0
Timeliness of Investigation Process
2005 2007 Change
Nationally 93.8% 92.3% -0.015
State 100% 100% 0
(Scale: 4 = very fair;3 = fair; 2 = unfair; 1 = very unfair)
• Education unit has improved on most parameters
• Need to ascertain why fairness/objectivity perception decreased
• Continue to communicate frequently and timely with programs
• Explore ways to assist programs achieve excellence
Conclusions/Future Actions
Please rate your Board of Nursing’s review process in the following program areas. (Scale: 4 = very effective; 3 = somewhat effective; 2 = ineffective; 1 = not effective at all)
2005 2007
Program Area n Rating n Rating
Administration 541 3.70 1,222 3.79
Curricula 542 3.67 1,224 3.76
Clinical facilities 526 3.58 1,192 3.74
Classroom/lab 519 3.48 1,187 3.75
Student/faculty policy 534 3.60 1,200 3.76
Program Evaluation Plan
497 3.46 1,209 3.74
Please rate your Board of Nursing’s review process in the following program areas. (Scale: 4 = very effective; 3 = somewhat effective; 2 = ineffective; 1 = not effective at all)
2005 2007
Program Area Rating Rating
Administration 2.99 2.43
Curricula3.21
2.86
Clinical facilities 3.00
Classroom/lab 2.86
Student/faculty policy
2.86
Program Evaluation Plan
3.112.41
+0.4
+.86
+.83
Goal: Be within 0.5 of the aggregate rating
Compare 2007 and 2009 data (from the 2010 report) to determine if goals were met
1. Did response rate for education programs increase by 34%?
2. Did the ratings for administration and curricular requirements increase to within 0.5 of the aggregate results?
3. Did the rating for program evaluation plan requirements increase to with 0.5 of the aggregate results?
Were Your Goals Met?
No Discuss results with stakeholders and get ideas for improvement and revise action plan
Yes Move on to other results of concern, but continue to monitor these results
STRATEGIC GOAL: TO FACILITATE INFORMATION EXCHANGE BETWEEN THE BOARD AND ITS CONSTITUENTS
Objective: Effective communication with the public, including licensees, employers, policy makers, consumers
Performance Measure: If CORE findings indicate positive communications with
constituents
Incorporate into Strategic Plan
Interview boards in the upper 10% of respondents to determine what it is they do to get better results