Advancing Healthcare Transformation A NEW ERA FOR ACADEMIC NURSING Advancing Healthcare Transformation A NEW ERA FOR ACADEMIC NURSING Manatt Health Project Team: Tom Enders, MBA Senior Managing Director Alex Morin, MA Manager Brenda Pawlak Managing Director Special Advisors: Margaret Grey, DrPH, RN, FAAN Annie Goodrich Professor Yale University School of Nursing Arthur Rubenstein, MBBCh Professor of Medicine University of Pennsylvania Raymond and Ruth Perelman School of Medicine MARCH 1, 2016 Dear Colleagues and Stakeholders, ransforming health care is a formidable challenge that can only be met through a coordinated response from academic and practice leaders from across the health professions. Nursing recognizes its important T role in steering this critical work and maintaining a laser focus on what is best for the public. Advancing Healthcare Transformation: A New Era for Academic Nursing was conceived from a desire to maximize nursing’s contribution to ushering in healthcare reform. Since 2013, AACN member deans from Academic Health Centers (AHCs) have engaged in robust discussions about the evolving role of schools of nursing in this unprecedented time of accelerating change. These forward thinking leaders were so passionate about this topic that they issued a call to action to the AACN Board of Directors. The deans formally asked the board to conduct a national study to better understand the possibilities and challenges ahead for academic nursing. In February 2015, AACN commissioned a comprehensive study on how to highlight nursing’s role in AHCs. Soon after, Manatt Health was selected to work with us in preparing this report on how to best position nursing schools for long-term success and sustainability. From the onset of this project, AACN was committed to ensuring that the scope of research would be comprehensive, discussions would be interprofessional, and final recommendations would be achievable. To commence this work, interviews were conducted with a variety of stakeholders in AHC and non-AHC affiliated institutions to uncover the issues and the opportunities facing academic nursing. Findings from the interviews were used as discussion points for a national summit of AHC leaders convened by AACN and Manatt in Washington, DC in August 2015. Following the summit, two surveys to AHC leaders were issued to better determine how academic nursing could make a greater contribution to the larger health enterprise. Armed with a fresh understanding of today’s landscape, this report identifies a path for achieving an enhanced partnership between academic nursing and academic health centers around the imperative to advance integrated systems of health care, achieve improved health outcomes, and foster new models for innovation. AACN is confident that lessons learned from this study will be important to the full universe of baccalaureate and higher degree nursing programs. The work initiated with those located in AHCs will continue. The dialogue has started. Academic nursing must play a significant role in advancing healthcare transformation at the local, state, and national levels. All those connected with this bellwether report, including dozens of academic and practice leaders who contributed insights and recommendations, are excited by its potential to magnify nursing’s impact on improving health and health care. AACN is looking forward to working with the full community of stakeholders to disseminate this report broadly, assess its long-term outcomes, and assist schools as they implement the recommendations. We invite you to join us as we move to meet the challenges ahead and reap the rewards that come with meaningful change. Eileen T. Breslin, PhD, RN, FAAN Deborah E. Trautman, PhD, RN, FAAN Chair, AACN Board of Directors AACN President and Chief Executive Officer This report was commissioned by the American Association of Colleges of Nursing and overseen by a Project Oversight Committee: AACN Board of Directors **Eileen Breslin, PhD, RN, FAAN Greer Glazer, PhD, CNP, RN, FAAN Dean, School of Nursing Dean, College of Nursing and Associate Vice University of Texas Health Science Center, President for Health Affairs San Antonio University of Cincinnati **Juliann Sebastian, PhD, RN, FAAN Dean, College of Nursing Anita Hufft, PhD, RN University of Nebraska Medical Center Dean, College of Nursing Texas Woman’s University Teri Murray, PhD, APHN-BC, RN, FAAN Dean, School of Nursing Kristen Swanson, PhD, RN, FAAN Saint Louis University Dean, College of Nursing Seattle University Judy Beal, DNSc, RN, FNAP, FAAN Dean, School of Nursing and Health Sciences **David Vlahov, PhD, RN, FAAN Simmons College Dean, School of Nursing University of California, San Francisco Susan Bakewell-Sachs, PhD, PNP-BC, RN, FAAN **Deborah Trautman, PhD, RN, FAAN Dean and Vice President for Nursing Affairs President and Chief Executive Officer Oregon Health and Science University American Association of Colleges of Nursing **Ann Cary, PhD, MPH, RN, FNAP ** Denotes Members of the Project Dean, School of Nursing & Health Studies Oversight Committee University of Missouri-Kansas City Harriet Feldman, PhD, RN, FAAN Dean, College of Health Professions and the Lienhard School of Nursing Pace University The authors acknowledge the invaluable assistance of Kathy McGuinn, MSN, RN, CPHQ, Director of Special Projects, AACN, and Shelley McKearney, Program Manager, AACN. The authors also wish to thank the many participants in this study including those interviewed, those who traveled to Washington for the Leadership Summit, and those who responded to the surveys. All were generous with their time and insights, and we gratefully acknowledge their contributions. Advancing Healthcare Transformation | A NEW ERA FOR ACADEMIC NURSING Contents EXECUTIVE SUMMARY .................................................................................................................................................. 2 SUMMARY OF FINDINGS .............................................................................................................................................. 2 SUMMARY OF RECOMMENDATIONS ......................................................................................................................... 3 DEFINITIONS OF MAJOR TERMS USED IN THIS REPORT ....................................................................................... 5 A NEW ERA FOR ACADEMIC NURSING ..................................................................................................................... 6 THE STATE OF ALIGNMENT OF ACADEMIC NURSING WITHIN ACADEMIC HEALTH CENTERS ...................... 8 Report Findings .............................................................................................................................................................. 9 Academic Nursing Leadership Summit ....................................................................................................................... 16 BUILDING A STRONG PARTNERSHIP ........................................................................................................................ 17 Recommendation 1: Embrace a New Vision for Academic Nursing ........................................................................... 19 Recommendation 2: Enhance the Clinical Practice of Academic Nursing .................................................................. 20 Recommendation 3: Partner in Preparing the Nurses of the Future ........................................................................... 23 Recommendation 4: Partner in the Implementation of Accountable Care ................................................................. 26 Recommendation 5: Invest in Nursing Research Programs and Better Integrate Research into Clinical Practice ..... 28 Recommendation 6: Implement an Advocacy Agenda in Support of a New Era for Academic Nursing .................. 31 IMPLEMENTATION STRATEGIES ................................................................................................................................ 32 Recommendations for Deans of Nursing ..................................................................................................................... 33 Recommendations for Deans of Medicine ................................................................................................................... 34 Recommendations for Health System Executives ....................................................................................................... 35 Recommendations for University Presidents, Chancellors, and Vice Chancellors ...................................................... 35 CONCLUDING PERSPECTIVES ....................................................................................................................................36 APPENDICES .................................................................................................................................................................. 37 Appendix A – Organizational Self-Assessment ........................................................................................................... 37 Appendix B – Participating Institutions and Leaders .................................................................................................. 44 American Association of Colleges of Nursing in many communities. To date, the potential and Executive Summary opportunity for academic nursing in the transformation of AHCs into health systems has not been considered Advancing Healthcare Transformation: