The Road less Travelled –Expanding new avenues

Dr Sharon Vasuthevan - NEA Chairperson

2015 ANEC

The Road less Travelled

Collaboration, Continuity & Competence in terms of:• Professional Growth• Nursing Leadership

Professional Growth

2005

Resurrection

NEA Chapters

2009

Interim Board

Atlantic Philanthropies Funding

2010

NEA CEO & Office

Growth of NEA

2012

Self Sustaining NEA Chapters

Workshops

2015

Handing over to leaders developed within NEA

Journey of Influence, Learning & Activism

34 years and still developing1981

Started as a Curriculum Committee by the late Prof UysPrevious chairs include:• Prof Uys• Ms Kingsley• Prof A. van der

Merwe• Prof Mogotlane• Prof Gwele

Collaboration

• Public and Private sector nurses

• Employers

• Sponsors – Juta, Survival Technology, Pearson

• NEA & FUNDISA

• South African Nursing Education Network (SANEN) – All stakeholders including SANC, DENOSA and now the CNO Office

• Annual Nursing Education Conference – NEA, FUNDISA, CPAS, PHEPSA

• International Organizations• National League of Nurses (NLN)• International Council of Nurses (ICN through the ICN Education Network)• Sigma Theta Tau International (STTI) – task groups

Circle of Influence

Continuity

• Nurse Educator Development• Theme workshop• Symposia• Annual Conference• Newsletter

• Research Development – Novice Researcher Programme

• Influencing Nursing Education Policy• Nursing Education Standards• Public Colleges Position Paper as part of SANEN• Responses to various regulations and health related policy documents• Meeting with the Director General as part of SANEN

Competence

• Development of nurses involved in education and training

• Information sharing on key nursing education initiatives

• Participation in policy development

• Developing novice researchers

• Maintaining an active community of nurses interested in education

Learnings

• Professional development is individually driven.

• Huge benefits outside work

• Fast track your development through professional work

• Leadership opportunities

• Networking and collaboration opens new doors

• Professional association is voluntary, but it pays off

Nursing Leadership Journey

Group Nursing & Quality

Nursing Education

Nursing Practice

Infection Prevention

Quality

Collaboration in Nursing & Quality

From • Working in silos due to reporting

structure• Independent projects• Blaming & shaming• Duplication of effort• Artificial boundaries• Knowing and understanding your

own patch• Nursing trying to be everything

To• Cross functional integration

• Integrated projects • Joint responsibility• Efficiency & effectiveness• Nursing community• Working and learning together• Use other functions to support

nursing

Continuity

• Creating more awareness across functions between education, practice, infection prevention and quality

• Common nursing platform

• Strengthening nursing as the core business of the organization

• Continuous quality improvement and joint problem solving in patient care

• Enhancement of professionalism and image of nursing

• Promoting research

• Ensuring practice drives education

Competence

• Continuing Professional Development Strategy

• Clinical Education Model Implementation

• Evidence based practice – Best Practice Spotlight Organization

• Unit Manager Development programmes

• Leadership Development for Nurse Managers(iLEAP)

• Talent management - Shadowing & Training Young Leaders (STYL.com)

• Student Leadership

• In house conferences and publication

• Culture of lifelong learning

Professional Journey Pillars

Personal

Development

Professional Growth

Work Opportunities

Support System

You’re only as good as your last set of ofresults!

Where to from here?

Expanding new avenues

• Landscape of our changing world

• Healthcare demands

• Future of nursing

• Informing health policy

• Response required by nursing education

Our world is changing……Music

• Apple the largest US retailer above Wal-Mart

• From 1 million songs sold over 5days to 25 billion songs sold in March 2013

Books

• Amazon Kindle penetration faster than Apple’s iPod

• 1.7 e books sold for each paper book on Amazon

Movies

• 40% of movie consumption performed on demand, 15% through streaming platforms

Our world is changing…..

TV Series

• 29% of top US TV series dominantly viewed on demand

• Netflix

Classifieds

• More than 65% of classified look ups were performed on line in the US

News

• Google news has twice the number of hits as the Wall Street Journal

Trends in the Healthcare Sector• Shifting Demographics

• Growing, ageing, sicker, and transforming population

• Cost explosion• Continuing increasing cost of healthcare

• Demand supply mismatch• Higher imbalance in provision and quality of care

• New business models• Ongoing innovation in care delivery

• Digitalization of healthcare• Big data, mobility and technology reshaping healthcare

• Shifts in health systems• Government reforms reshaping healthcare models

Global Health Worker Shortage

• WHO suggests a health worker density (including doctors and nurses) of 25 per 10 000

• 4.3 million more health workers are necessary to combat current global health staff shortage with more than 800 000 of these workers needed in Africa alone

Nursing Challenges

• Nursing shortage

• Increased legislation influencing agency utilization

• High turnover of staff – age group 25 – 40 years

• Escalating salaries

• Diminished quality of nursing

• Increased expectations of patients

• Doctor demands

Nurse Leader’s Dilemma

• Fighting fires

• Maximum inputs with minimal results

• Dilemma of costs versus safety and quality of patient care

• Increased administration, reporting and regulation

• Increased management, minimal leadership

• Continual change in focus and priorities

• Financial management

• Qualitative versus quantitative approach

• Fighting for survival at the best of times

Future of Nursing – Expanding new avenues

• Staffing

• Technology

• Non traditional nursing careers

• Monitoring the quality of care

• Nursing Executives in the Boardroom

• Task Shifting

• New cadres of workers

Staffing Models

• Full time equivalent footprints

• Flexible staffing components

• Agency utilization

• Tools for managing efficiency

• Staff predictor tools

• Automated scheduling systems

• LEAN Management principles for staffing efficiencies

Do we adequately prepare our nurses for the proposed changes in staffing models?

Technology• Automation of key processes will free up nurses to focus on patient care• Electronic health records• Hand held devices for capturing data especially clinical and quality

outcomes• Paperless hospitals• Electronic Intensive Care Units• eBilling systems• Patients check in on line for hospital admissions• Electronic patient satisfaction/experience surveysAre nurses able to make informed decisions about automation in healthcare?How can we educate differently?

Non traditional nursing careers

• Forensic nursing

• Telenursing

• Nursing informatics

• Legal nursing

• Cruise ship nursing

• Travel health nursing

Time for out of the box thinking on nursing specialties!

Quality of Care

• Increased monitoring of patient care and experience by external parties

• Ranking and rating of hospitals based on quality of care

• Continuous measuring of the cost of care

• Nurses driving quality of care

• Nurse consultants doing clinical rounds

• Clinical career ladders for nurses:• Nurse intensivists to oversee intensive care units

Fact or myth:“Nursing is a clinical profession that moves further away from the patient with educational achievement.”

Nursing Executives in the Boardroom

Are we playing not to lose?or

Are we playing to win?

Do we understand the rules of the game?

Task Shifting

• Task shifting to tackle health worker shortages

• Process of delegation, where tasks are moved to less specialized health workers

• Allows for the efficient use of human resources

• Task shifting cannot be done without maintaining the quality

Many tasks are delegated to nurses?

Who do nurses delegate their tasks to?

New Cadres of Workers

• Operating department assistants

• Renal Technicians

• Phlebotomists

• ICU Technicians

• Clinical Associates

• Doulahs

How do we work together?

Informing Health Policy

• Political astuteness• Development of nurses while in training• Lobby politicians on key issues, writing letters to the mayor

• Engaging in policy advocacy

• Exerting influence in public policy

• Effectiveness of media advocacy to transmit key messages from the profession

• Professional organizations can play a role

Are we connecting our nursing initiatives to the main political agenda?

Who do we communicate to?

Key Takeaways

• Prepare for an environment of lower spending and increasing cost pressures

• Consider new nursing models to compete effectively and to serve different customer segments

• Consider the role of technology in driving the future of healthcare

• Prepare nurse leaders to work in a resource competitive environment

• Know the numbers

• Education that is relevant

• Prepare to work with new cadres of healthcare workers

• Communicate, collaborate and focus

Turbulent Times Build Great LeadersRobin Sharma

The 5 Rules

• Speak with candor

• Prioritize

• Adversity breeds opportunity

• Respond versus react

• Kudos for everyone

Life begins at the end of your comfort zone

Neale Donald Walsch

Thank Youenjoy the conference!