Nurses Leading the IOM Report in Wisconsin:Pathways, Progress, & Potential

Judith M. Hansen, MS, BSN WCN Executive Director

Taking the LEAD for Nursing in WisconsinRWJF 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

DWD Model 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

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

Age Group

Census 2000 Projected 2015

Projected 2035 Percent Change

0-17 1,368,756 1,349,090 1,448,200 5.8

18-64 3,292,406 3,739,160 3,720,200 13.018-24 520,629 553,530 577,800 11.025-44 1,581,724 1,547,380 1,570,350 -0.745-64 1,190,053 1,638,250 1,572,050 32.165 & over 702,553 900,170 1,485,570 111.565-84 606,928 764,710 1,263,020 108.185 & over 95,625 135,460 222,550 132.7

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

Wisconsin projected population growth 2000-2035

2012 Wisconsin RN Survey Findingsn = 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 Findingsn=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 Employment2012 RNs: •53.6% hospitals•17.3% ambulatory care•10.7 % nursing home/extended care•5.7% home health•Average age: 48 •Average experience: 15 years2013 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 NursesSource: 2012 RN & 2013 WI LPN At-a-Glance

CaucasianAfrican

AmericanHispanic Other

WI RN 93.5 2.0 1.4 3.0

WI LPN 91.0 6.3 1.9 3.8WI Population 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:2012-2035Wisconsin Department of Workforce development Office of Economic Advisors Feb 2014

Closing the RN Gap

New graduates needed annually to close the projected demand

2010 Observation 2,7002015 Scenario Estimate 4,5002020 Scenario Estimate 7,5002025 Scenario Estimate 11,3002030 Scenario Estimate 14,1002035 Scenario Estimate 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 South SE NE West North

Median age 48 48 48 49 49

% Female 93.3 94 94 91.9 93.1

% White 96.8 92.7 97.9 98.1 98.5

% Unemployed 1.8 2.5 2.3 2.3 1.9

% ADN 35.8 32.2 36.6 45.8 46.1

% BSN 43.3 48.9 44.7 34.7 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 AmericaRobert 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-

1/31/15FOCUS 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/practiceEmployer/Educator partnershipsEnhanced BSN completion programsTeam & community-based care modelsRepository, mentorship for boardsPilot 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 Nursingwww.wicenterfornursing.org

• Judith Hansen, Executive Directorjudi@wicenterfornursing.org

• Future of Nursing™ Campaign for Actionwww.campaignforaction.org