New IOM Report: The Future of Nursing

In 2010, the Robert Wood Johnson Foundation (RWJF) and the Institute of Medicine (IOM) published The Future of Nursing: Leading Change, Advancing Health, which was the culmination of a two-year initiative designed to transform the nursing profession. Recognizing that nurses have the potential to create significant changes in healthcare, this report advocates for policy makers, government leaders, and health care executives and professionals to use nurses to improve health outcomes and provide this country with affordable, accessible and quality health care.¹

At the Bi-State Nursing Workforce Innovation Center, we are particularly interested in Recommendation #2, which states that we should “expand opportunities for nurses to lead and diffuse collaborative efforts.”^1(p.11) This has always been part of our philosophy at the Center, and we were excited to see this so predominately stated in the IOM report. As leaders conveyed to the participants at the Robert Wood Johnson Alumni meeting, held March 31-April 2 - this is a movement, not a onetime report or event.

The staff of this Center knows all too well operationalizing this report will take all of us and those with whom we collaborate and serve to move this agenda towards adoption and full implementation. Here are just a few of the exciting partnerships and programs the Center is focusing on that support this movement.

• CSI Academies partnering with regional hospitals and schools of nursing to improve outcomes (see the CSI brochure at www.nursinginnovation.org/programs)
• Quality and Safety Education for Nurses (QSEN)² service and academic partnership programs
• Regional Nurse Network (RN²)

Nurses are at the beside every day; they see what happens there, and have first-hand knowledge of the processes and problems associated with daily patient care. Who better than these professionals to address issues of nursing practice and to implement changes to improve patient outcomes? RNs know what needs to be done, but too often are not given the opportunity to make the necessary changes.

The issue of nurses being involved in the quality and safety initiative has already begun to be addressed through programs, such as the Quality and Safety Education for Nurses (QSEN),² Transforming Care at the Bedside (TCAB), the Integrated Nurse Leadership Program (INLP), and our own successful CSI Academy.³ However, we still have a long way to go before nurses are routinely part of creating, implementing and sustaining change projects. Many times, staff nurses simply lack the knowledge of how to accomplish a quality improvement project or how to use data to show that patient outcomes did indeed improve. Without knowledge and guidance, staff nurses’ great ideas may never be realized.

Even before the IOM released this report, the Center staff was teaching nurses the skills to lead improvement efforts. The Clinical Scene Investigator (CSI) Academy was one of our inaugural programs, and our first CSI cohort consisted of staff nurse teams from seven hospitals. We held sessions throughout a 16-month program, and taught these nurses project implementation, data collection and analysis, social entrepreneurship, and more. The teams were responsible for creating and implementing an innovative project on their unit designed to improve a target goal. Each CSI team had a different outcome related to the specific needs of their hospital, and all were able to significantly improve patient and/or staff outcomes.

The Future of Nursing report has numerous recommendations and ideas for transforming nursing care in the 21^st century. The possibilities are nearly limitless, and here at the Center, we look forward to the future. We also are constantly looking for innovative ways for nurses to be involved in redesigning healthcare and improving patient care. This is truly an exciting time to be a nurse.

Get Involved, it’s YOUR movement too!

We would love to hear your thoughts. Please contact us at srlacey@cmh.edu.

Susan Lacey, Director
Karen Cox, Associate Director
Adrienne Olney, Executive Assistant

1. Institute of Medicine. The Future of Nursing: Leading Change, Advancing Health. Washington, DC: National Academies Press; 2010.
2. Quality and Safety Education for Nurses (QSEN). Available at www.qsen.org. Accessed April 19, 2011.
3. Kliger JK, Lacey SR, Olney A, Cox KS, O’Neil E. Nurse driven programs to improve patient outcomes: Transforming Care at the Bedside, Integrated Nurse Leadership Program, and the Clinical Scene Investigator Academy. J Nurs Adm. 2010;40(3):109-114.