The American Association of Colleges of Nursing’s 2016 report “Advancing Healthcare Transformation: A New Era for Academic Nursing” is the result of a wish to enlarge nursing’s contribution to health care reform by aligning the efforts of baccalaureate and higher degree schools of nursing with those of health care systems. Just as the 2010 Institutes of Medicine report “The Future of Nursing” outlined a vision for the nursing profession as a whole, this report provides a specific framework for ways that nursing school deans and other institutional leaders can take steps to expand the role of academic nurses in health care’s overall effort to improve clinical outcomes, reduce costs, and enhance public health.
About the Report
To explore this vast topic, AACN commissioned a national study of opportunities to examine the potential for a greater partnership between academic nursing and Academic Health Centers (AHCs), which the report defines as “accredited degree granting institution[s] of higher education that consists of: an allopathic or osteopathic medical school, a school of nursing, and other health professional schools and an owned or affiliated relationship with a teaching hospital, health system, or other organized health care provider.” Like many other health care organizations, AHCs are undergoing organizational transformation as they deal with new financial models, a trend toward market consolidation, and a focus on wellness and prevention.
In their patient-centered role, nurses are often literally the face of health care. Beyond patient care leadership, academic nurses also serve as leaders in research and workforce development. Their comprehensive outlook and direct experience puts them in a unique position to act as agents of change and strategic-thinking experts who can help AHCs expand access to care, integrate new models of care delivery, and collaborate with other health care providers.
Key Findings: How well do Academic Nursing and Academic Health Centers align?
The AACN report provided three findings on the current state of alignment of academic nursing with AHCs, as well as six recommended actions institutional leaders can take to promote a greater role for academic nursing in AHC leadership. As the first part of a three-part summary of the AACN report, this article summarizes the three findings, while the second and third articles will present the six recommendations.
Finding #1: Academic nursing is not positioned as a partner in healthcare transformation.
Organizational obstacles can sometimes limit academic nurses from acting as full partners at AHCs. Nurses are not well represented on hospital boards — the AACN report cites a 2010 survey that found only 6 percent of hospital boards had nurses as members. A shortage of nursing faculty in health clinical systems or executive leadership positions also exists — unlike the norm at medical schools, where the dean and other faculty members regularly work with heath care executives.
In addition, teaching roles in hospitals are often filled by non-faculty members. Nursing research located in separate academic and health system silos prevent collaboration between the two departments, which presents obstacles to cross-institutional nursing research. Therefore, school of nursing faculty are not viewed as full partners and have limited opportunities for participation in developing strategic plans for clinical practice and research.
Finding #2: Institutional leaders recognize the missed opportunity of alignment with academic nursing and are seeking a new approach.
The report found that deans of nursing are feeling shut out of decision-making and strategic planning at AHCs in such areas as patient engagement, primary care, and informatics. Even though nursing-led research has gained prominence in recent years, they still feel that academic nursing’s potential as strategic contributors is undervalued. On the other side, health system CEOs and chief nursing officers acknowledged the importance and value of academic nursing as a partner in planning, but pointed to issues with alignment that result in a lack of opportunities for collaboration.
Finding #3: Insufficient resources are a barrier to supporting a significantly enhanced role for academic nursing.
The current financial model for academic nursing is built primarily on tuition, a limited resource. Deans of nursing who were interviewed for the study pointed out the gap between expectations of more participation at AHCs and financial realities. Recruitment and research support tends to be low. The report notes that “academic nursing received just over $133 million in total NIH funding in 2014, compared to significant amounts awarded to their colleagues in academic medicine ($11.4 billion), public health ($821 million), pharmacy ($252 million), dentistry ($179 million), and veterinary medicine ($158 million).”
While these findings may seem daunting, the report outlines six ways that nursing schools and AHCs can take action to ensure that academic nurses have more of a voice in health care’s future. Continue reading Part 2 and Part 3 of this article series to explore more.
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