SPIN: Stimulating Practice Innovation Mary Terhaar, DNSc Krysia Hudson, DNP Carolyn Fowler, PhD Martha Sylvia, PhD, MBA, RN

Transcription

1 Institute Coaching Resources Collaboration SPIN: Stimulating Practice Innovation Mary Terhaar, DNSc Krysia Hudson, DNP Carolyn Fowler, PhD Martha Sylvia, PhD, MBA, RN

2 Have difficulty getting published Struggle to repeat the cycle of research Need to find collaborators & build relationships Asked to teach but may not have learned to do so Have to compete for funding Mock, Nolan, Allen et al (2008)

3 Newly Prepared Doctorates Struggle

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6 Strategies 1. Assessment DNPs Employers 2. Annual Institute 3. Online Community & Resource Center 4. SPIN Fellows Program 5. Enterprise-Wide DNP Council

7 Institute Coaching Resources Collaboration

8 ASSESSMENT Describe & Promote Outcomes Projects Grad Surveys DNP Outcomes CNO Survey Employer Survey Scholarly Work Anecdotes

9 Assessment - DNPs What are DNPs doing? What challenges do DNPs experience? How can we mitigate barriers & threats? How can we be helpful?

10 Practicing DNPs

11 First Credential 43 BSN Diploma AD

12 Role 43 Other Care Management Home Care Safety & Quality Health Policy Public Health Informatician Educator Admin CNS

13 NP Certification 26 Pedi Acute Care Safety & Quality Neonatal Peds Gero Family/Psych Family NP Adult Acute Care

14 CNS Certification 11 Other Peds Gero Child & Adol Psych Adult/Psych Adult Acute care

15 Location of Practice 44 Puerto Rico California North Carolina Delaware Florida Kansas Pennsylvania New York Virginia Maryland

16 Publication After Graduation Other Book Chapters Book Chapters Published Acdcepted Submitted

17 Presentations After Graduation Seven or more Five or Six Three or Four One - two None

18 Accomplishments JHH Nursing Publication Award **** Shirley Sohmer Award ** MNA Pathfinder Award Think Swiss Award Assistant Professor Appointment ****** Program Director **** NLN Nurse Educator Certificate Director of Nursing CNO *** Physician Collaboration Award National Committee Chair ****

19 Compensation for Performance 33 NO 18% YES 82%

20 Place of Employment Other Government Private Practice Joint Hospital Academe

21 Changed Employers 44 YES 23% NO 77%

22 Promotion Post Graduation 43 YES 42% NO 58%

23 New Title 19 Cant Share Lead NP Assistant Professor Director CNO

24 Reason for Changing Position Prepare for Future Promotion Relocation 11% 5% 20 Responsibility 16% Opportunity 68%

25 Teaching 43 Not Teaching 28% Classroon 32% Hospital 19% Clinical 21%

26 New Responsibilities None EBP Increased leadership Publication Translation Projects Program Development Precept DNP Students Policy Development QI Research

27 Very Often to Always 8 Advocate for colleagues Advocate for patients Provide organizational leadership to increase quality Impact practice in your facility Apply science to improve outcomes Demonstrate organizational leadership (systems) 3.23

28 Very Often to Always 9 Use evidence to change policy Collaborate with other disciplines to improve outcomes Apply analytics to decisions Demonstrate doctoral level clinical scholarship Change policy to impro ve o utco mes Lead collaborations between disciplines Impact health in your facility 3.0 0

29 Occasionally 6 Apply information systems solutions to raise quality Lead collaborations focused on prevention Impact health in your community Impact health nationally Impact practice locally Impact practice nationally 2.28

30 Almost Never 17 Impact health globally Impact practice globally 1.9 5

31 Barriers Competing priorities 1.97 Lack of funding 2.00 Lack of time 2.03 Lack of administrative support 2.31 Lack of executive sponsorship 2.60 Lack of statistics assistance 2.87 Lack of IT resources 2.79 Lack of data 3.21 The lower the score, the greater the difficulty

32 What organizational support would help?

33 Institute Coaching Resources Collaboration

34 Assessment - Employers

35 CNO Interviews - Methods Round 1: Survey refinement (respondent N = 1) Round 2: Survey administration and refinement (N=7) Round 3: Development of web-based CNO survey Round 4: Selected follow-up

36 CNO Interviews Key Findings DNP degree program is not well understood My greatest concern is the lack of understanding and appreciation of what a DNP can bring to an organization. One of our greatest challenges is educating the organization, and especially physicians, about the DNP role and what advantages there are to the organization

37 CNO Interviews Key Findings DNP degree program is not well understood [A senior physician colleague] approached me in the hall and said: I m very concerned about nursing s movement to produce all these DNP s. Nursing is better off having a few high-quality doctorallyprepared students than an army of people with lesser qualifications

38 CNO Interviews Key Findings Skills considered essential for DNP graduates working in I would expect them to be able to define leadership and know how to assess [it] using various models. [I expect them to be] able to operate at both a strategic and tactical level. They must be able to take on more complex system issues

39 CNO Interviews Key Findings Selected limitations of DNP training I definitely think there is a difference between the skills I would expect them to have and what they are getting prepared for because when I looked at DNP programs what they provide in leadership [training] is very variable

40 CNO Interviews Key Findings New themes They were shining stars before they did the DNP; they came back with enhanced skills, and are even better than they were before. The most successful had a crossover experience because she blended her work and scholarly pursuit

41 CNO Interviews Key Findings Selected limitations of DNP training I think it has been stronger in concept than in execution and I think it has been stronger for nurse practitioners in advanced practice roles than it has been for those going into executive or management roles

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43 CNO Interview Results Anticipation of DNPs contribution Desire to support DNPs Desire to put DNPs abilities to good work Connect DNP to mission & triple aim

44 Institute Coaching Resources Collaboration

45 Annual Institute Provide all DNPs in Maryland the opportunity to disseminate knowledge and increase confidence so they will be effective in the work of translation and innovation in practice.

46 SPIN Initial Improved 3 day program once a year Nice hotel Abstracts Un-conference Statistical Process Control Role transition N=50 2 day program twice yearly On campus Abstracts Un-conference Writing for publication Calculating ROI N=45

47 Institute Coaching Resources Collaboration

48 Online Community & Resource Center Develop and test social and professional network. Facilitate networking and collaboration among DNPs across Maryland. Alpha testing by DNPs across Maryland in Refined in 2013.

49 Online Community In-House (JHU/JHH Community) Bubbler (JHED) State Wide Linked In Collaboration Have we missed anyone?

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51 Institute Coaching Resources Collaboration

52 DNP Council Establish a council at the Johns Hopkins Hospital 40 DNPs across the Hopkins Enterprise Target practice problems Design strategies to improve performance, evaluate outcomes, and develop careers

53 DNP Council Focus on strategic intent Collaborative efforts Collaborative publications Problem solving Identify and mitigate barriers

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55 Your Thoughts?

56 Next Steps Collaborations Translation EBP Publications Consultations

57 Next Steps Planning for next conference Use of social media Self Paced Learning Modules

58 This work was conducted with support of an NSP II award from the Maryland Health Services Cost Review Commission

59 Start-up IMPACT

60 References 1. American Association of Colleges of Nursing. (2004). AACN Position Statement on the Practice Doctorate in Nursing. Washington, D.C. 2. Chang, S., Hughes, D.C., & Chamberlain, R.M. (2008). Works-in-progress: guiding junior scientists through career development applications. Journal of Cancer Education, 23(3): Dennis, K. (1991). Components of doctoral curriculum that build success in the clinical nurse researcher role. Journal of Professional Nursing, 7(3): Institute of Medicine. (2011). The Future of Nursing: Leading Change. Advancing Health. Washington, DC: The National Academies Press 5. Khalsa, D.C. & Pearson, N.J. (2007). Financial support for research training and career development in complementary and alternative medicine from the National Institutes of Health. Journal of Manipulative and Physiological Therapeutics, 30(7): Kirschling, J. (2014). Reflections on the Future of Doctoral Programs in Nursing. AACN Doctoral Education Conference. Naples, Florida. 7. Levy, G.S., Sherman, C.R., Gentile, N.O., Hough, L.J., Dial, T.H., & Jolly, P. (1988).Postdoctoral research training of full-time faculty in academic departments of medicine. Annals of Internal Medicine, 109 (1),

61 References 8. Nolan, M.T., Wenzel, J., Han, H., Allen, J.K., Paez, K.A., Mock, V.. (2008). Advancing a program of research within a nursing faculty role. Journal of Professional Nursing, 24(6): Nolan, S.A., Buckner, J.P., Marzabadi, C.H., & Kuck, V.J. (2008). Training and mentoring of chemists: a study of gender disparity. Sex Roles, 58: Pion, G.M. & Corday, D.S. (2008). The Burroughs Welcome Career Award in the biomedical sciences: challenges to prospects for estimating the causal effects of career development programs. Evaluation and the Health Professions, 31(4): Robinson, B. (2001). The dissertation and beyond: Developing your academic Career. ABNF Journal, 12(1): Rybarczyk, B., Lerea, L., Lund, P.K., Whittington, D., & Dykstra, L. (2011). Postdoctoral training aligned with the academic professoriate. BioScience, 61(9): Stefuriuc, I. (2009). Introduction: Building an academic profile considerations for graduate students embarking on an academic career in political science in Europe. European Political Science, (8), Taleb, N.N. (2012). Antifragile: Things That Gain from Disorder. Random House. New York, NY. 15. Williams, C.A. (1988). Career development of the nurse scientist: The new doctorate faces a postdoctoral. Journal of Professional Nursing, 4(2): 73.