Appendix A
Data Sources and Methods
The Committee for Assessing Progress on Implementing the Recommendations of the Institute of Medicine (IOM) Report The Future of Nursing: Leading Change, Advancing Health was asked to assess the changes in the field of nursing and peripheral areas over the past 5 years resulting from that report. The role of AARP and Robert Wood Johnson Foundation (RWJF) Future of Nursing: Campaign for Action (the Campaign) was considered in assessing these field changes. The committee also was asked to assess the Campaign’s progress in meeting its stated goals and to identify areas that should be emphasized over the next 5 years to help the Campaign fulfill the recommendations of The Future of Nursing.
To respond to its charge, the committee examined data from a variety of sources. These sources included a literature review on actions taken and progress made toward implementing the recommendations of The Future of Nursing, reports and information provided by the Campaign documenting its activities and progress, public input obtained through a series of workshops and meetings, and written public comments on aspects of the study charge. The study was conducted over a 12-month period.
DESCRIPTION OF THE STUDY COMMITTEE
The study committee comprised 12 individuals with expertise in nursing and health professions education and practice, health services research, health policy, workforce data, health systems, economics, and communications. See Appendix C for biographical sketches of the committee members. The committee convened for four 2-day meetings in April, May, July, and August 2015.
LITERATURE REVIEW
Several strategies were used to identify literature relevant to the committee’s charge. First, a reference search for The Future of Nursing: Leading Change, Advancing Health conducted in SCOPUS and Web of Science yielded more than 1,600 journal articles and books that cite the report. A LexisNexis news search for the report’s title resulted in more than 900 articles. A LexisNexis search for the report’s title within the Congressional Record, the Federal Register, law reviews, federal and state cases, and legislative history also was conducted. A separate LexisNexis search of congressional records, committee reports, statutes, state administrative codes, bills, and registers was carried out using keywords from each of the eight recommendations of The Future of Nursing. A more extensive search of bibliographic databases, including MEDLINE and SCOPUS, was conducted to identify additional articles on relevant topics from peer-reviewed journals. The keywords used in searches included nurse, registered nurse, advanced practice registered nurse, APRN, nurse practitioner, nurse anesthetist, nurse midwife, nonphysician practitioners, nonphysician provider, federal funding, Centers for Medicare & Medicaid Services, Medicare, Medicaid, Center for Medicare & Medicaid Innovation, reimbursement, payment model, care delivery model, health information technology, primary care, ambulatory care, National Council of State Boards of Nursing, third party payer, insurer, scope of practice, practice authority, clinical privileges, admitting privileges, conditions of participation, medical staff, Federal Employee Health Benefits, Federal Trade Commission, regulations, state regulations, entrepreneurship, business, Health Resources and Services Administration, Community Health Accreditation Program, transition to practice, nurse residency, nurse fellowship, graduate medical education, accreditation, evaluation, competencies, baccalaureate, BSN, associate degree, ADN, master’s, MSN, doctorate, PhD, DNP, academic pathway, academic progression, RN-to-BSN, ADN-to-BSN, higher education, articulation agreement, tuition reimbursement, scholarship, loan forgiveness, financial support, second-degree, returning student, interprofessional education, interprofessional collaboration, interprofessional training, health professions education, faculty, recruitment, enrollment, vacancy, education funding, diversity, lifelong learning, continuing education, continuing competency, clinical competency, performance competency, professional development, faculty development, leadership, leadership development, leadership positions, leadership education, management position, National Health Care Workforce Commission, health workforce data, health workforce statistics, minimum data set, data collection, data standards, workforce projections, nursing supply, and nursing demand.
Staff sorted through approximately 2,100 articles, reports, issue briefs, and other documents and pieces of information to identify those relevant to the committee’s charge and created an EndNote database. In addition, committee mem-
bers, Campaign staff, meeting participants, and members of the public submitted articles and reports on these topics.
PUBLIC MEETINGS
The committee hosted three public workshops to obtain additional information on specific aspects of the study charge. These meetings were held on May 28, July 27, and July 28, 2015. Subject-matter experts were invited to present information and recommendations for the committee’s consideration. The workshops brought together stakeholders and leaders from the areas of health professions education and training, policy and regulation in care delivery, provider and organizational efforts in care delivery, and health workforce data to discuss the efforts, successes, and barriers related to implementing the recommendations of The Future of Nursing. Specific topics included
- working toward and achieving a more highly educated nursing workforce, including the development and implementation of models of academic progression, and implications for education and health care delivery;
- development and evaluation of nurse residency programs for registered nurses (RNs) and advanced practice registered nurses (APRNs);
- recruitment and retention of a diverse nursing workforce;
- impacts of health care system changes and culture change on health care delivery; and
- information and data available for assessing health professions education, training, and demand to inform workforce policy.
Speakers included leaders from health professions associations, health delivery organizations, health insurance organizations, higher education, academia and research, government agencies, health professions education and training accrediting agencies, and more.
The committee also held open forums at each workshop at which members of the public were encouraged to provide testimony on topics related to the study charge. Agendas for the three public meetings are presented in Boxes A-1 through A-3.
BOX A-1
PUBLIC SESSION AGENDA
20 F Street NW Conference Center
20 F Street NW
Washington, DC 20001
Thursday, May 28, 2015
|
9:00 a.m. |
Welcome and Introductions |
|
|
Stuart Altman, Ph.D., Chair, Committee for Assessing Progress on Implementing the Recommendations of the Institute of Medicine Report The Future of Nursing: Leading Change, Advancing Health; and Sol C. Chaikin Professor of National Health Policy, The Heller School for Social Policy and Management, Brandeis University |
|
9:15 a.m. |
The Future of Nursing: Campaign for Action Research, Data, and Evaluation |
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|
The goal of this session is for the committee to gain a better understanding of the data and information that have been identified by the Future of Nursing: Campaign for Action relating to progress on implementing The Future of Nursing report’s recommendations and on the Campaign activities. |
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Moderator: Karen Donelan, Sc.D., Ed.M., Senior Scientist in Health Policy, Mongan Institute for Health Policy, Massachusetts General Hospital Institute for Technology Assessment, Massachusetts General Hospital |
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Panelists: |
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Kate Locke, M.P.H., Associate Director of Evaluation, TCC Group |
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Mary D. Naylor, Ph.D., R.N., FAAN, Marian S. Ware Professor in Gerontology, and Director of the NewCourtland Center for Transitions and Health, University of Pennsylvania School of Nursing |
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Jared Raynor, M.S., Director of Evaluation, TCC Group |
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Joanne Spetz, Ph.D., Director, Health Workforce Research Center, and Associate Director for Research Strategy, Center for the Health Professions, University of California, San Francisco |
|
10:15 a.m. |
Health Professions Education and Training Stakeholders |
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Moderator: George Thibault, M.D., President, Josiah Macy Jr. Foundation |
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Panelists: |
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Marsha Howell Adams, Ph.D., R.N., CNE, FAAN, ANEF, President, National League for Nursing, and Dean and Professor, University of Alabama in Huntsville College of Nursing |
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Mary Beth Bigley, Dr.P.H., M.S.N., APRN, Director, Division of Nursing and Public Health, Bureau of Health Workforce, Health Resources and Services Administration |
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Eileen T. Breslin, Ph.D., R.N., FAAN, Dean and Professor, University of Texas Health Science Center at San Antonio, School of Nursing, and President, American Association of Colleges of Nursing |
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Jennifer Butlin, Ed.D., Executive Director, Commission on Collegiate Nursing Education |
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Donna Meyer, M.S.N., R.N., Chief Executive Officer, Organization for Associate Degree Nursing |
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Mary Lou Rusin, Ed.D., R.N., ANEF, Chair, Accreditation Commission for Education in Nursing |
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Thomas J. Snyder, M.B.A., President, Ivy Tech Community College, representing the American Association of Community Colleges |
|
11:30 a.m. |
BREAK FOR LUNCH |
|
12:30 p.m. |
Delivery of Care Stakeholders: Policy and Regulation |
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Moderator: Bob Phillips, M.D., M.S.P.H., Vice President for Research and Policy, American Board of Family Medicine |
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Panelists: |
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Maryann Alexander, Ph.D., R.N., FAAN, Chief Officer, Nursing Regulation, National Council of State Boards of Nursing |
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Humayun J. Chaudhry, D.O., MACP, President and Chief Executive Officer, Federation of State Medical Boards |
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Janet Heinrich, Dr.P.H., R.N., Senior Advisor, Center for Medicare & Medicaid Innovation, Centers for Medicare & Medicaid Services |
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Mary E. Picerno, R.N., Chief Nursing Officer, Cigna |
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George Zangaro, Ph.D., R.N., FAAN, Director, National Center for Health Workforce Analysis, Health Resources and Services Administration |
|
1:45 p.m. |
Delivery of Care Stakeholders: Health Care Organizations and Providers |
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Moderator: Cynthia Barginere, D.N.P., R.N., FACHE, Vice President, Chief Nursing Officer, Rush University Medical Center |
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Panelists: |
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Linda Burnes Bolton, Dr.P.H., R.N., FAAN, Vice President, Nursing; Chief Nursing Officer; and Director of Nursing Research, Cedars-Sinai Medical Center, and President, American Organization of Nurse Executives (by phone) |
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Pamela F. Cipriano, Ph.D., R.N., NEA-BC, FAAN, President, American Nurses Association |
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Catherine M. Dower, J.D., Director, National Nursing Research and Policy, Kaiser Permanente |
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Kenneth P. Miller, Ph.D., F.N.P.-C, FAAN, FAANP, President, American Association of Nurse Practitioners |
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Steven E. Weinberger, M.D., FACP, Executive Vice President and Chief Executive Officer, American College of Physicians |
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Robert L. Wergin, M.D., FAAFP, President, American Academy of Family Physicians |
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3:00 p.m. |
BREAK |
|
3:15 p.m. |
Public Testimony |
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Members of the public who register in advance will have 3 minutes to provide public comment on progress toward implementation of The Future of Nursing report’s recommendations, and successes and barriers to moving the recommendations to reality. |
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Brenda Cleary, Health Care Consultant |
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Mary Sue Gorski, Consultant, Center to Champion Nursing in America |
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Francie Halderman, Board of Directors Chair-Elect, American Holistic Nurses Credentialing Corporation |
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Kristin Jimison, Director of Communications, Virginia Nurses Association |
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Tara Koslov, Deputy Director, Office of Policy Planning, Federal Trade Commission |
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Susan Kosman, Chief Nursing Officer, Aetna |
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Ruth Lubic, Founder, Developing Families Center |
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Linda MacIntyre, Chief Nurse, American Red Cross |
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Sheila Melander, President, National Organization of Nurse Practitioner Faculties |
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Erica Mobley, Director of Communications and Development, The Leapfrog Group |
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Susan Moyer, Assistant Program Director, Colorado Center for Nursing Excellence |
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Frank Purcell, Senior Director, Federal Government Affairs, American Association of Nurse Anesthetists |
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4:15 p.m. |
ADJOURN OPEN SESSION |
BOX A-2
PUBLIC SESSION AGENDA
National Academy of Sciences Building
2101 Constitution Avenue, NW
Room 125
Washington, DC 20418
Monday, July 27, 2015
|
9:00 a.m. |
Welcome and Introductions |
|
|
Stuart Altman, Ph.D., Chair, Committee for Assessing Progress on Implementing the Recommendations of the Institute of Medicine Report The Future of Nursing: Leading Change, Advancing Health; and Sol C. Chaikin Professor of National Health Policy, The Heller School for Social Policy and Management, Brandeis University |
|
9:15 a.m. |
Toward a More Highly Educated Nursing Workforce |
|
|
Moderator: Jack Needleman, Ph.D., FAAN, Professor of Health Policy and Management, Fielding School of Public Health, University of California, Los Angeles |
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Panelists: |
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Rhonda Anderson, R.N., FAAN, FACHE, Chief Executive Officer, Cardon Children’s Medical Center (by phone) |
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Darlene Curley, M.S., R.N., FAAN, Executive Director, Jonas Center for Nursing and Veterans Healthcare |
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Linda C. Lewis, M.S.A., R.N., NEA-BC, FACHE, Executive Vice President and Chief ANCC Officer, American Nurses Credentialing Center (ANCC), and Director, ANCC Magnet Recognition Program® |
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Terri E. Weaver, Ph.D., R.N., FAAN, Dean and Professor, University of Illinois at Chicago College of Nursing (by phone) |
|
10:15 a.m. |
BREAK |
|
10:30 a.m. |
Models of Academic Progression |
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Moderator: Paula Gubrud, Ed.D., R.N., FAAN, Associate Professor, Oregon Health & Science University School of Nursing |
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Panelists: |
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Catherine Alicia Georges, Ed.D., R.N., FAAN, Professor and Chairperson of Nursing, Lehman College |
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Tina Gerardi, M.S., R.N., CAE, Deputy Director, Academic Progression in Nursing (APIN) |
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Jean Giddens, Ph.D., R.N., FAAN, Dean, Virginia Commonwealth University School of Nursing |
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Beth Hagan, Ph.D., Executive Director, Community College Baccalaureate Association |
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Jenny Landen, R.N., M.S.N., FNP-BC, Dean, School of Fitness Education; School of Health, Math, Computer Science, Engineering and Science, Santa Fe Community College |
|
11:30 a.m. |
Nursing Education and Workforce Data |
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Moderator: Ed Salsberg, M.P.A., Director, Health Workforce Studies, George Washington University Health Workforce Institute and School of Nursing |
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Panelists: |
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Maryann Alexander, Ph.D., R.N., FAAN, Chief Officer, Nursing Regulation, National Council of State Boards of Nursing |
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David Auerbach, Ph.D., Deputy Director for Research and Cost Trends, Massachusetts Health Policy Commission |
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Patricia L. Moulton, Ph.D., President, National Forum of State Nursing Workforce Centers, and Executive Director, North Dakota Center for Nursing |
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Marsal P. Stoll, Ed.D., M.S.N., Chief Executive Officer, Accreditation Commission for Education in Nursing |
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Deborah E. Trautman, Ph.D., R.N., Chief Executive Officer, American Association of Colleges of Nursing |
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George Zangaro, Ph.D., R.N., FAAN, Director, National Center for Health Workforce Analysis, Health Resources and Services Administration (by phone) |
|
12:30 p.m. |
LUNCH |
|
1:15 p.m. |
Toward Establishing Nurse Residency Programs |
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Moderator: Carmen Alvarez, Ph.D., R.N., CRNP, CNM, Assistant Professor, Department of Community-Public Health, Johns Hopkins University School of Nursing |
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Panelists: |
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Margaret Flinter, APRN, Ph.D., FAAN, c-FNP, Senior Vice President and Clinical Director, Community Health Center, Inc. |
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Stuart Gilman, M.D., M.P.H., Director, Advanced Fellowships and Professional Development, Office of Academic Affiliations, U.S. Department of Veterans Affairs |
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Debra McElroy, M.P.H., R.N., Senior Director, Nursing Leadership, University HealthSystem Consortium |
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Benjamin Murray, M.P.A., Director of Accreditation Services, Commission on Collegiate Nursing Education |
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2:15 p.m. |
Recruiting and Retaining a Diverse Nursing Workforce |
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Moderator: Ed Salsberg, M.P.A., Director, Health Workforce Studies, George Washington University Health Workforce Institute and School of Nursing |
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Panelists: |
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Adriana Perez, Ph.D., R.N., ANP-BC, FAAN, Assistant Professor, College of Nursing and Health Innovation, Arizona State University |
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Norma Martinez Rogers, Ph.D., R.N., FAAN, Professor, Family and Community Health Systems, University of Texas Health Science Center at San Antonio |
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Deborah Washington, Ph.D., R.N., M.S., Director of Diversity for Patient Care Services, Massachusetts General Hospital, and Co-Chair, Diversity Steering Committee, Future of Nursing: Campaign for Action (by phone) |
|
3:15 p.m. |
ADJOURN |
BOX A-3
PUBLIC SESSION AGENDA
National Academy of Sciences Building
2101 Constitution Avenue, NW
Room 125
Washington, DC 20418
Tuesday, July 28, 2015
|
9:00 a.m. |
Welcome and Introductions |
|
|
Stuart Altman, Ph.D., Chair, Committee for Assessing Progress on Implementing the Recommendations of the Institute of Medicine Report The Future of Nursing: Leading Change, Advancing Health; and Sol C. Chaikin Professor of National Health Policy, The Heller School for Social Policy and Management, Brandeis University |
|
9:15 a.m. |
Impact of Health Care System Changes on the Culture of Care Delivery |
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Moderator: Richard A. Berman, M.H.A., M.B.A., Professor, Institute for Advanced Discovery & Innovation, University of South Florida |
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Panelists: |
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Nancy Gagliano, M.D., Chief Medical Officer, CVS/MinuteClinic, and Senior Vice President, CVS Health |
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Gerri Lamb, Ph.D., R.N., FAAN, Associate Professor and Director for the Center for Advancing Interprofessional Practice, Education and Research, Arizona State University College of Nursing and Health Innovation; Chair, American Interprofessional Health Collaborative (AIHC); and Liaison, Arizona Nexus Innovation Incubator to the National Center for Interprofessional Practice and Education |
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Scott W. Lamprecht, D.N.P., APRN, FNP-BC, R.N., Chief Clinical Educator and Family Nurse Practitioner, Complete Medical Consultants (by phone) |
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Diane Skiba, Ph.D., FACMI, ANEF, FAAN, Professor and Specialty Director, Health Care Informatics, University of Colorado College of Nursing |
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Julie A. Sochalski, Ph.D., FAAN, R.N., Associate Professor of Nursing; Interim Associate Dean for Academic Programs, University of Pennsylvania School of Nursing |
|
10:30 a.m. |
BREAK |
|
10:45 a.m. |
Roundtable on Culture Change in the Health Professions and Health Care Delivery |
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Moderator: George E. Thibault, M.D., President, Josiah Macy Jr. Foundation |
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Panelists: |
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Lawrence “L.B.” Brown, Pharm.D., Ph.D., FAPHA, Associate Dean of Student Affairs, and Professor of Pharmacoeconomics and Health Policy, Chapman University School of Pharmacy, and President, American Pharmacists Association |
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Rebecca S. Etz, Ph.D., Associate Professor, Family Medicine and Population Health, and Co-Director, Ambulatory Care Outcomes Research Network, Virginia Commonwealth University School of Medicine |
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Thomas Graf, M.D., National Director for Population Health, The Chartis Group |
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Diana J. Mason, Ph.D., FAAN, R.N., President, American Academy of Nursing, and Rudin Professor of Nursing, Hunter College-Bellevue School of Nursing, City University of New York |
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Josef Reum, Ph.D., M.P.A., Professor Emeritus, Milken Institute of Public Health, George Washington University |
|
12:00 p.m. |
Public Testimony |
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Stephanie Ahmed, President, Massachusetts Coalition of Nurse Practitioners |
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Britney Broyhill, Nurse Practitioner Fellowship Director, Center for Advanced Practice, Carolinas HealthCare System; and Founding Board Member, Association of Post Graduate APRN Programs (APGAP) |
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Marci Farquhar-Snow, Nurse Practitioner, Program Director, Cardiology NP Fellowship, Mayo Clinic |
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Renee Franquiz, Doctor of Nursing Practice student, University of Maryland |
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Ann Kurth, Professor, New York University College of Nursing |
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Ruth Lubic, Founder, Developing Families Center |
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Frank Purcell, Senior Director, Federal Government Affairs, American Association of Nurse Anesthetists |
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Diana Ruiz, Medical Center Health System (video) |
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Elaine Ryan, Vice President, Government Affairs, AARP |
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Susan Stone, President, Frontier Nursing University |
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1:00 p.m. |
ADJOURN |
