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APNA 30th Annual Conference Session 2014: October 20, 2016
Creviston 1
Jake Creviston, DNP, RN, PMHNP‐BC
Michael Polacek, MSN, RN‐BC
APNA 2016 Annual Conference
Participants will be able to:
APNA 30th Annual Conference Session 2014: October 20, 2016
Creviston 2
1840’s Sisters of Charity (initial ascent)
The Nightingale Shift (progress and formalization)
Contemporary Reforms (regrouping)
State of the state (summit in view)
Idealized leadership (summit!)
Nursing Leadership and Reformation (base camp)
Healthcare Reform is a continual process
“History is revelation” (Libster & McNeil, 2009)
1840 Sister Matilda and Dr. Hughes Stokes open Mount Hope
Roles of the “nurse” and physician
Action evolves from care
Advices Concerning the Sick predated Notes on Nursing
Reformed care environment
Statistics and healthcare
Formal educational curriculum
Societal respect as a reformer
APNA 30th Annual Conference Session 2014: October 20, 2016
Creviston 3
Dix: advocacy for humane care
Barton: bedside to global care
Peplau: practice based on engagement
Bolton: leader in modern healthcare reform
“Nurse‐Doctor Game” (Stein et al., 1967)
Oppressed‐group dynamics
Nurses underrepresented on boards
2‐4% of hospital boards (Prybil , 2009)
2% of health care boards (Curran & Totten, 2010)
To Err is Human (IOM, 2000)
Crossing the Quality Chasm (IOM, 2001)
Social Determinants of Health (Commission on Social Determinants of health, 2008)
APNA 30th Annual Conference Session 2014: October 20, 2016
Creviston 4
The Triple Aim (Berwick , Nolan , &
Whit t ington, 2008)
Affordable Care Act (PPACA, 2010)
ACOs, CCOs and
behavioral health integration
Future of Nursing ( IOM, 2011)
8 recommendations
4 key messages
Interprofessional movement ( IPEC, 2011)
National
MHPA, TARP, Patrick Kennedy, the rules
Corrections: 16%‐24% SMI (Durmont, et al. , 2012)
Oregon (MHA, 2015)
MH Statistics
Coordinated Care Organizations boards: 2.7% nurses (Creviston, 2015)
Oregon Strategic Plan: 18‐member board 0 nurses (OHA, 2015)
Time, incentive, preparation, desire and lack of invitation l imit maximal leadership (Crev i s ton, 2015)
Nurses least l ikely to drive reform (Khoury et
a l . , 2011)
Fall warning, crevasses in area.
! Avalanche warning take alternative route.
Watch out, winter storm ahead
Caution high winds in area.
Warning low oxygen levels.
!
But we are the most trusted profession 11
we have clinical and leadership expertise
our leadership promotes patient outcomes 16
we are the largest segment of the workforce 15
and we are more successful in teams…10
APNA 30th Annual Conference Session 2014: October 20, 2016
Creviston 5
National Initiatives Future of Nursing Campaign
for Action Nurses on Boards Coalition
(10,000 nurses by 2020) Culture of Health
Oregon Initiatives Oregon Action Coalition;
Nurses on Boards grant ORAPNA Resource Center
Scroll down to bottom and click appropriate link:
Now go to:www.NursesOnBoardsCoalition.org
APNA 30th Annual Conference Session 2014: October 20, 2016
Creviston 6
Nurses are ideally prepared to contribute towards health
care reform to optimize patient outcomes.
We believe that nurses are crucial health care
stakeholders.
This requires participation at all leadership levels and
nurses on EVERY BOARD!
Research: Measure nurse trustee impact on health
Prepare: Seek and provide governance mentorship
and training
Start small e.g., nursing professional org
Participate: Promote national and local efforts
Join your state RWJF Action Coalition
Communicate via APNA member bridge
Follow the CampaignForAction.org
Do not wait for an invitation
Jake Creviston, DNP, RN, PMHNP‐BCAssistant Professor Linfield Good Samaritan School of Nursing, Portland, Oregon
Michael Polacek, MSN, RN‐BCProfessional Development Specialist, Salem Health, Oregon
APNA 30th Annual Conference Session 2014: October 20, 2016
Creviston 7
1 . Berwick D.M., Nolan T .W. , & Whitt ington, J . (2008) . The t r ip le a im: Care, hea l th and cost . Heal th Affa irs 27 (3 ) :759 ‐769 .
2 . Commiss ion on Soc ia l Determinants of Hea l th . (2008) . Clos ing the gap in a generat ion: Heal th equi ty through act ion on the soc ia l determinants of heal th . F ina l report of the commiss ion on soc ia l determinants of hea l th. Geneva, Switzer land: World Hea l th Organizat ion.
3 . Crev i s ton, J . (2015) . Doctor of Nurs ing Pract i ce (DNP) percept ions of l eadersh ip abi l i t ies in pol i cy and governance: Cl in i ca l inqu i ry projec t . [Doctoral Scho lar ly Pro ject ] . Retr ieved f rom http ://dig i ta l commons.ohsu.edu/etd/3695/
4 . Dumont , D. M., Brockmann, B. , Dickman, S. , Alexander, N., & Rich , J . D. (2012) . Publ i c hea l th and the ep idemic of incarcerat ion. Annual rev iew of publ i c heal th , 33 , 325 .
5 . Ins t i tute of Medic ine ( IOM). (2001) . Cross ing the qual i ty chasm: A new heal th system for the 21st century . Washington, DC: Nat ional Academy Press .
6 . IOM. (2001) . Cross ing the qual i ty chasm: A new heal th system for the 21st century .Washington, DC: Nat ional Academy Press .
7 . In terprofess ional Education Col laborat ive Exper t Panel ( IPEC) . (2011) . Core competenc ies for in terprofess ional co l laborat ive pract i ce : Report of an expert panel . Washington , D.C. : In terprofess ional Educat ion Col laborat ive.
8 . Khoury, C. , Bl i z zard, R. , Moore, L . , & Hassmi l ler , S. (2011) . Nurs ing l eadership f rom beds ide to boardroom: A Gal lup nat ional survey of opin ion l eaders . Journal Of Nurs ing Admin ist rat ion, 41 (7/8 ) , 299 ‐305. doi :10.1097/NNA.0b013e3182250a0d
9 . L ibs ter , M.M., & McNei l , B.A. (2009) . Enl ightened char i ty. Naperv i l le , I L : Golden Apple Publ i cat ions
10 . Menta l Hea l th Amer ica. (2015) . Par i ty or dispar i ty : The state of menta l heal th in America 2015 . Retr ieved f rom www.mentalheal thamerica.net/s i tes/defaul t/f i les/Par i ty%20or%20Dispar ity%202015%20Report .pdf
11 . Newhouse, R. , Stan ik ‐Hutt , J . , White , K. , Johantgen , M., Bass , E. , Zangaro, G. , & . . . Weiner , J . P. (2011) . Advanced pract ice nurse outcomes 1990 ‐2008: a systemat ic rev iew. Nurs ing Economic$, 29(5 ) , 230 ‐251.
12 . Oregon Hea l th Author i ty. (2015) . 2015 ‐2018 behav iora l heal th st rateg ic plan. Oregon Hea l th Author i ty: Addict ions and Menta l Hea l th Div i s ion. Retr ieved f rom http ://www.oregon.gov/oha/amh/CSAC%20Meet ing%20Shedule/Behavioral%20Health%20Strateg ic%20Plan%202015 ‐2018.pdf
13 . Ri f fk in, R. (2014) . Americans rate nurses highest on honesty , eth ica l standards . Retr ieved f rom http ://www.gal lup .com/pol l/180260/americans ‐ rate ‐nurses ‐highest ‐honesty ‐eth ica l ‐s tandards.aspx
14 . Ste in , L . , Watts , D. , & Howel l , T . (1990) . The doctor ‐nurse game rev i s i ted . New England Journal of Medic ine , 322(8 ) , 264
15 . U.S . Census Bureau. (2010) . Tab le 616 . Employed c iv i l ians by occupation , sex , race, and Hispanic or ig in : 2010 . Retr ieved f rom https ://www.census .gov/compendia/s tatab/2012/tables/12s0616.pdf
16 . Wong, C. , Cummings , G. , & Ducharme, L . (2013) . The re la t ionship between nurs ing l eadership and pat ient outcomes: a systemat ic rev iew update. Journal Of Nurs ing Management , 21 (5 ) , 709 ‐724. doi :10 .1111/ jonm.12116