Value-Based Payment: What Does It Mean for Nurses?

Among the many lessons that have been reinforced by the SARS-COVID-19 pandemic is the failure of our current fee-for-service health care system to either adequately respond to patient needs or offer financial sustainability. This has enhanced bipartisan interest in moving forward with value-based payment reforms. Nurses have a rich history of innovative care models that speak to their potential centrality in delivery system reforms. However, deficits in terms of educational preparation, and in some cases resistance, to considering cost alongside quality, has hindered the profession's contribution to the conversation about value-based payments and their implications for system change. Addressing this deficit will allow nurses to more fully engage in redesigning health care to better serve the physical, emotional, and economic well-being of this nation. It also has the potential to unleash nurses from the tethers of a fee-for-service system where they have been relegated to a labor cost and firmly locate nurses in a value-generating role. Nurse administrators and educators bear the responsibility for preparing nurses for this next chapter of nursing.

Burnout among academic nursing faculty.

BACKGROUND: Nurse faculty burnout is a growing concern in the United States. There are limited studies exploring the level of burnout in nursing faculty. PURPOSE: To assess the prevalence of burnout among nurse faculty in undergraduate and graduate programs and its relationship with specific demographic and organizational variables. METHODS: A descriptive cross-sectional research design was employed to examine the level of burnout of nursing faculty. An internet-based survey was administered to nursing faculty in over 1000 schools of nursing in the United States. Burnout was measured using the Oldenburg Burnout Inventory. RESULTS: A total of 3556 surveys were returned. Among all participants, most of the sample exhibited moderate levels of burnout, exhaustion, and disengagement. Based on the findings from the OBI, a moderate/high exhaustion level was reported in 85.5 % of participants, while disengagement was moderate/high in 84.9 %, and overall burnout was at moderate/high levels in 85.2 % of the nursing faculty. CONCLUSIONS: The nation's nurse faculty population is experiencing a moderate to high level of burnout, exhaustion, and disengagement. Academic nursing leaders are encouraged to identify ways and take action to reduce faculty burnout and promote faculty wellness and resilience.

From vision to action: Next steps in designing PhD programs of the future.

Declines in PhD enrollment, funding and support for PhD students, and the quality and quantity of the nursing research pipeline has fueled the concern about providing high-quality education in research-focused nursing doctoral programs. To address the challenges and opportunities facing research focused PhD education, the University of Pennsylvania School of Nursing convened an invitational summit, Re-Envisioning Research-Focused PhD Programs of the Future, of research-intensive institutions. Both as a dissemination strategy and as an effort to engage perspectives from other Schools with PhD programs, we presented a summary of the Penn Summit discussion at the AACN Doctoral Education Conference (AACN Doctoral Conference). Focused discussions at both events further identified opportunities for research focused PhD programs, including recruiting undergraduate students, establishing research-focused partnerships, creating clear evaluation methods. AACN Doctoral conference participants also discussed the need to discuss and identify competencies, common subject areas, and financial resources for PhD students and graduates. This synthesis of discussions, considerations, and challenges affecting research-focused doctoral programs of nursing serve as a basis and catalyst for further discussion and action to ensure PhD research focused programs are preparing successful nurse scientists of the future.

Emerging roles for research intensive PhD prepared nurses: Beyond faculty positions.

Research-intensive PhD programs need to prepare nurse scientists to bridge the chasms between research, and practice and policy in an increasingly complex healthcare system. In practice, nurse scientists are critical to building capacity for research, promoting excellence in patient-centered care, and achieving or exceeding national quality benchmarks. Moreover, they provide methodological expertise and insight to address pressing clinical questions. PhD-prepared nurses also leverage their research expertise and practice knowledge to transform health policy in roles as organizational executives and leaders, advocates, and communicators. Re-envisioning nursing PhD curricula is required to ensure that PhD students are capable of not only conducting rigorous and impactful science, but launching careers across sectors of healthcare. Here, we summarize viewpoints of a special session from the October 2019 PhD Summit "Re-Envisioning PhD Programs of the Future" sponsored by the University of Pennsylvania School of Nursing and literature to invigorate thinking about ways to promote career transitions into nontraditional vital positions for nurse scientists. Advancing the health of patients and communities depends on preparing the next generation of nurse scientist to pursue career trajectories outside of traditional academic institutions.

Leadership by collaboration: Nursing's bold new vision for academic-practice partnerships.

In 2016 the American Association of Colleges of Nursing issued a report, Advancing Healthcare Transformation: A New Era for Academic Nursing that included recommendations for more fully integrating nursing education, research, and practice. The report calls for a paradigm shift in how nursing leaders in academia and practice work together and with other leaders in higher education and clinical practice. Only by doing so can we realize the full benefits of academic nursing in this new era in which integration and collaboration are essential to success. In this paper we: 1) examine how academic nursing can contribute to healthcare innovation across environments; 2) explore leadership skills for deans of nursing to advance the goals of academic nursing in collaboration with clinical nursing partners, other health professions and clinical service leaders, academic administrators, and community members; and, 3) consider how governance structures and policy initiatives can advance this work.