Robert Wood Foundation (RWF) Committee Work and IOM Report
The Future of Nursing report was developed during a propitious period in the U.S health care – an era typified by the increasing need for modifications in the care delivery framework. First, the “IOM Vision of the Future of Nursing” report was developed by the RWF committee that envisioned a future where disease prevention and primary care would be the healthcare system’s main focus. Second, RWF supplied the IOM with leadership and the human resources needed to produce the Future of Nursing’s blueprint report. For example, RWF staff spearheaded the research that identified the significant issues within the healthcare framework that the IOM sought to address. An opinion survey conducted by the foundation to establish the influence level nurses should be given on different healthcare aspects was cited in the report’s call of action for nurses to assume leadership roles (IOM committee, 2016). RWF also investigated the issues of the U.S. healthcare system and presented the findings to IOM. It made recommendations on how to address the distinguished problems.
Thirdly, the foundation financed numerous sponsorship and funding programs to promote its vision for the future of nursing. For example, it funded the Nursing Alliance for Quality Care to foster their vision for safe, quality, and patient-centered healthcare for patients, families, and communities. Through the RWJF leadership program, the institution provided an entry point for nurses to act as leaders in health policy changes (IOM committee, 2016). In this vision, nurses would serve as the main driving force for the attainment of these goals.
Key Messages of the IOM Report
The report was based on four recommendations: the need to transform nursing practice, nursing education, nursing leadership, and the demand for better healthcare data. The following are the key messages of the report (IOM committee, 2016):
- Nurses must be accorded the authority to practice to the maximum level of their training and education.
- Nurses must seek to attain higher education and training levels. An education structure that allows a continuous and smooth transition through academic levels would facilitate the attainment of higher education.
- Nurses should spearhead and lead the redesigning of the healthcare system.
- Improved data collection procedures and infrastructures will facilitate effective workforce planning and policy development.
Transforming Nursing Practice
The report recognized the role played by policy and regulatory measures in restricting nurses from adequately fulfilling their obligations. For example, it noted that Advanced Practice Registered Nurses’ (APRN) scope of practice is the same as that of nurses with lesser education and training in some states (IOM committee, 2016). It further asserted that allowing nurses to perform to the maximum level of their training and education would result in better health outcomes. Over the years, APRNs’ responsibilities have changed as states eliminate the practice-related barriers. For example, New Jersey and Florida have amended their legislation to expand the registered nurses’ scope of practice within the state (Joyce et al., 2019). Regarding the IOM’s vision of a future where the value was rewarded, value-based programs are becoming normalized in the modern healthcare system (Chee et al., 2016). The recommendations have influenced and shaped contemporary nursing practices.
Transforming Nursing Education
The IOM report highlighted the importance of nursing education in equipping nurses with the skills and competencies needed in meeting their professional obligations. It revealed that nursing had the least number of baccalaureate degree when compared with other professions. These findings influenced the employment requirements of nursing that currently need at least a BSN or an associate degree to get an entry-level job (IOM committee, 2016). The report recommended that the nursing curriculum reflect the healthcare system changes, for instance, teaching concepts of primary care and disease prevention as opposed to acute care treatment. In 2011, the National Council of State Boards of Nursing initiated transitions to the recommended models for new graduates (IOM committee, 2016). Furthermore, it also highlighted the significance of lifelong education. In response, various states currently mandate continuing education as a prerequisite for license renewal.
Transforming Leadership
The IOM recommendation that nurses spearhead the redesigning of the healthcare system demanded that they take up leadership positions. New roles in clinical nursing were conceptualized in the wake of the report. For example, the clinical nurse leader and care coordinators were established after the enactment of the Affordable Care Act (Joseph & Huber, 2015). The report further mandated nurses to take up leadership roles in advocating for health policies that improve patients’ health outcomes. In line with these recommendations, the ANA code of ethics requires nurses to always advocate for their patients’ rights. Therefore, the IOM report has also influenced the professional regulations related to the discipline.
Nursing Workforce Development
Effective data collection procedures can improve the understanding of the healthcare system and the healthcare workforce’s composition. Without adequate and pertinent information, the healthcare system cannot effectively plan for prospective employee needs. Through the recommendations of the report, data that reflect the future of nursing is now available. Statistics projections predict the need to recruit and train an additional geriatric-specialized workforce to meet the patient population’s future demands. In response, the Eldercare Workforce Alliance constituting of thirty-one national organizations was enacted to support the training of the nurses within the geriatric specialty. The endorsement of the value of data on workforce planning has helped the healthcare system to prepare for anticipated changes efficiently.
State-Based Action Coalitions
Fifty-one state action coalitions were created to aid in implementing the IOM report’s recommendations at the state and local levels. The state-based coalitions led a campaign to eliminate practice barriers, enhance professional collaboration, promote data collection practices, and support nursing leadership and education. They advanced these objectives by (IOM Committee, 2016):
- Developing and implementing strategies that addressed the unique needs of their states.
- Funding lifelong education through the provision of grants, loans, residency programs, and scholarships. They also developed competency-based nursing curriculums that reflect the recommendations of the IOM report.
- Identifying priority areas in relation to the IOM recommendations and seeking resources to support their goals in improving these distinguished priorities.
Initiatives Spearheaded by State Action Coalition
The Florida Action Coalition
To improve healthcare access, the Florida Action Coalition has actively campaigned to eradicate regulatory barriers associated with nursing practice. Through the initiatives spearheaded by the coalition, Florida has enacted a law that permits qualified nurse-midwives and nurse practitioners to practice without the physician’s supervision (“New law soon to provide Floridians,” n.d.). This program advances the nursing profession by allowing nurses to perform their roles to the maximum level of their training.
By expanding nurses’ practice scope, they will have more opportunities to increase healthcare access and improve value-driven, safe, and quality healthcare. The coalition also promotes IOM’s vision of nursing education in the region by providing scholarships and supporting BSN programs through the Patterson Foundation. It also supports a collaborative learning program that allows members to achieve qualifications similar to those of nurse educators. By funding education opportunities, the coalition helps nurses acquire the skills and competencies needed to address the demands of the healthcare system adequately.
State Barriers to Advancement in Nursing
The Florida Action Coalition published a report that outlined the barriers to advancing nursing leadership in the state. The impediments included perceptions that undermine nurses as leaders, limited opportunities for advancement, negative stereotypes surrounding the nursing profession, lack of long-term career goals, inadequate knowledge on policymaking, and nurses in the state focusing on acute care rather than disease prevention (“New law soon to provide Floridians,” n.d.). Nursing organizations address these hindrances by educating nurses on the approaches required to resolve the issues at the individual level. The state-based coalition developed a toolkit detailing effective strategies needed to address each identified barrier.
Conclusion
The IOM report was developed during an era typified by increased awareness of the need for change in the care provision framework to achieve the “Triple Aim” of improved patient encounters, reduced costs, and better public health. The RWF developed a significant number of approaches deemed essential in enhancing the quality of care delivery. The proposed strategies have played a crucial role in transforming nursing practice. For instance, currently, lifelong learning, an approach aimed at enhancing safe and quality healthcare service provision, is mandatory for all practicing nurses in the U.S. State-based action coalitions have also been instrumental in fostering the recommendations’ implementation.
References
Chee, T. T., Ryan, A. M., Wasfy, J. H., & Borden, W. B. (2016). Current state of value-based purchasing programs. Circulation, 133(22), 2197-2205.
New law soon to provide Floridians better health care options (n.d.). Campaign for Action. Web.
IOM Committee. (2016). The future of nursing: Leading change, advancing health. NCBI.
Joseph, L., & Huber, D. L. (2015). Clinical leadership development and education for nurses: Prospects and opportunities. Journal of Healthcare Leadership, 7, 55-64.
Joyce E., V., Teresa, M., Tracey, M., Kari, M., Annlouise, M., Lori, M., & Smith, A. L. (2019). Nursing’s future: What’s the message? Nursing Management, 43(7), 36-41.