Measuring Success in the Campaign for Action using Dashboard Indicators Joanne Spetz, PhD May 28, 2015
What does a Dashboard do? Dashboards provide concise data Dashboards are linked to goals and actions Dashboard are accurate Dashboard have the data you need 2
Design issues How many indicators? How do we organize them? How many are national vs. state? Graphics that are intuitive 3
Key parts of the process Communication Feedback from Strategic Advisory Committee Contacting the State Action Coalitions Sleuthing Where is the data? How good is the data? Feedback Asking for help in defining indicators Asking for data Change Responding to new needs and priorities 4
Design decisions 5-8 top-level indicators Drill-down for additional metrics Organize by domain rather than recommendation 1. Education 2. Practice 3. Interdisciplinary collaboration 4. Leadership 5. Data 5
Content issues Outcomes measures vs. process measures Can we get the exact data we want? What is an acceptable substitute? Does the substitute change the goal? How often can we update the dashboard? 6
Content decisions Focus on current-data outcomes measures at top level Drill down for time trends Additional indicators provides process measures Yearly updates are required 7
Area 1: Education This is one of the easier things to measure IOM recommendations provided explicit benchmarks Percentage of Employed Nurses with a Baccalaureate Degree in Nursing or Higher Degree Total Enrollments in Nursing Doctorate Programs 8
Indicator 1: RNs with Baccalaureates Data issues National Sample Survey of RNs has not been conducted since 2008 (and was only every 4 years) There is no national minimum data set Selected source: American Community Survey Public Use Microdata Sample If nurse has a bachelor s degree, the major field of study is reported Fields of study for graduates degrees are not reported We counted bachelor s in nursing OR graduate degree of any type Data released in fall one year later 9
Additional Education Indicators Number and percent of first-time NCLEX takers with BSNs (Source: NCSBN) Number of RN-to-BSN graduates annually (Source: AACN) Percent of new RN graduates by gender and by race/ethnicity (Source: IPEDS) Collected but not yet reported: Percent of hospitals that have implemented RN Residency programs Share of employers who offer tuition reimbursement Source: RWJF Survey of Nurse Executives This survey has been done only twice 10
Indicator 2: Doctoral Degrees Total Enrollments in Nursing Doctorate Programs Source: AACN Includes both DNP & PhD This is a process measure, because it will take many years to double the number with doctorates Convert to total population with doctoral degrees at some point in the future Small numbers = imprecise estimates in American Community Survey No National Sample Survey of RNs 11
Additional Doctoral Indicators Number of people receiving Nursing Doctoral Degrees (PhD and DNP) annually (Source: AACN) Number of Nurses with Doctorate Degrees (Source: ACS) Diversity of Nursing Doctorate graduates (Source: AACN & IPEDS) 12
Area 2: Practice What aspect of practice to focus on? Advanced practice? Which profession? How could we measure practice of RNs? Initial thought: use the NCSBN ratings of progress toward the NCSBN Consensus Recommendations for APRN Practice These include certification requirements, education program credentialing, etc. Changed to independence of NP practice Whose map to use? NCSBN and AANP did not keep archives of their maps 13
Additional Practice Indicators Number of states that allow Nurse Midwives to practice independently (Source: ACNM/NCSBN) Number of hospitals with Magnet status (Source: American Nurses Credentialing Center) Number of nurse-led clinics (Source: National Nursing Centers Consortium) Number and percent of nurse-managed clinics in underserved areas (Source: National Nursing Centers Consortium geocoded listing of NMCs) 14
Area 3: Interdisciplinary Collaboration How do you measure this????? Percent of required nursing courses that offer clinical or simulation experiences for both entry-level RN students and one or more types of other graduate-level health professional students, for top 10 nursing schools (by US News and World Report rankings) that also have other graduate-level health professions schools. Source: compiled from websites & direct contact with the schools Issue: schools don t always report back to us 15
Additional Collaboration Indicators Number of Articles in Top 10 Health & Health-Services Research Journals co-authored by Nurses & Authors from other Disciplines Source: collected from journals each year Issue: if author does not list his/her RN credential, we can t count them 16
Area 4: Leadership Initial idea: Percent of boards that include an RN for the top 5 of insurance companies, pharmaceutical companies, health care systems (e.g. HCA), and health technology companies Problem: There were none! Now there is one Another idea: Percent of pre-specified leadership positions in government agencies held by RNs nationally Problem: Which agencies? How to collect data? Another idea: Percent of states ACA implementation agency boards/committees with RN membership Problem: Data collection 17
Area 4: Leadership Final idea: Percent of hospital boards with RN members Source: National Health Care Governance Survey Report (AHA) Problem: Survey conducted every 2-3 years Problem: Sample is not 100%, margin of error makes it hard to detect meaningful changes No supplemental indicators 18
Area 5: Data Degree to which States have adopted and/or implemented standardized minimum data sets for nursing supply Source: Forum of State Nursing Centers & new data collection Indicate share of recommended data elements collected in each state Problem: Not all states are in the Forum, data reported to Forum not consistently accurate 19
Additional Data Indicators Number of state nursing boards that participate in the National Council of States Boards of Nursing s NurSys data system Source: National Council of State Boards of Nursing = 43 states in 2012 Number of states that collect race/ethnicity data about their nursing workforce Source: Forum of State Nursing Centers, original data collection 20
Data sharing and dissemination Indicators on the website Graphic display Downloadable PDF Supplemental indicators Dynamic charts displayed using Tableau Need to create: Downloadable Excel file 21