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Bellin Health System and Bellin College Partner to meet the IOM Challenge:

The Institute of Medicine (IOM) 2010 report, The Future of Nursing: Leading Change, Advancing Health, advised that changes in nursing education are necessary in order for current and future generations of nurses to deliver safe, quality, and patient-centered care. Research has consistently demonstrated improved outcomes for patients in organizations with higher percentages of baccalaureate or higher degree prepared nurses. Therefore, the IOM calls for innovative programs that allow for a seamless transition between nursing degree programs. Furthermore, the IOM recommends that by 2020 80% of the nursing workforce be educated at the baccalaureate level and that leaders from academic centers should partner with healthcare organization leaders to facilitate this goal.  Bellin Health System and Bellin College have embraced the charge from the IOM. 

An analysis of the current educational levels of staff was completed. Data on attrition rates, expected retirements, and addition of new RNs were calculated. Utilizing this information, the CNO determined that by elevating 100 existing ADN and Diploma nurses to a BSN level and requiring a retention commitment of 2-4 years, along with mandating any new hire ADNs to have a BSN within 5 years, Bellin would achieve the IOM’s recommendation of 80% of the nursing workforce be BSN or higher by 2020. 

Currently, at least 58% of the over 900 nurses in Bellin Health System have a BSN or higher degree, which is consistent with national statistics.  Within the acute inpatient units, the rate is 62%.  Bellin Health System and Bellin College began collaborating in an effort to achieve the IOM’s BSN recommendation metric. Throughout 2013 and 2014, the Bellin CNO, Bellin College President and several of their professors participated in a series of focus groups at Bellin Health regarding interest in the creation of a BSN completion program. The current ADN and diploma nurses had a high level of interest in participating in a Bellin College BSN completion program. 

Based on feedback from the focus groups and nursing staff, it was determined that tuition assistance covering 70% of the costs would make the program feasible.  It was felt that having them contribute 30% creates incentive to succeed and stay engaged in the program.  The CNO worked with both the Bellin Health and the College CFO to adjust the tuition to a rate that compared more to a state college.  Once this was achieved, the curriculum was built and the accreditation for the 2 year BSN Completion Program was awarded. 

An ROI was calculated, utilizing the cost of turnover and impact the retention of the newly trained BSN would have on the system.  Utilizing the current attrition rate and calculating $50,000 per nurse, the retention requirement would potentially assist the system in decreasing turnover costs by $1,000,000 per 20 nurses retained.  The mandated retention would also come at a time when statistically Bellin will be seeing an increase in retirements, thereby creating a financial win for the organization.  Additionally, Bellin would then have cohorts of 20 nurses that would be completing projects and improvement work on key initiatives within the organization.  This creates a double win: a win for the employee in value- added work, and a win for the organization in that focused energy would be placed on key initiatives.

An application process was created, and the program was set up to accept 20 students annually over the next 5 years to reach a total of 100 students.  Students submit an essay as part of their application packet describing how the BSN degree would impact them and the organization positively.  Information was gathered on their current performance reviews from their leaders, and the leader was required to sign off on the application and validate the student was in good standing. 

The first cohort of 20 nurses was selected by the CNO and Bellin College to begin the innovative project-based RN to BSN curriculum in the fall of 2015. Bellin College professors worked closely with the CNO and her leadership team to craft a 30-credit nursing curriculum that is closely aligned with the BSN Essentials, and strategic direction of the Bellin Health System vision of helping people in the region become the healthiest in the nation. The curriculum is a mix of online and in classroom education. 

Students contribute to Bellin strategic objectives by working on long-term projects that span the curriculum and align the vision of the organization. For example, in the ‘Care Management for Populations’ course, the students work on projects to improve the health and well-being of specific populations by focusing on quality while providing exceptional service and reducing costs. The baccalaureate prepared nurse presents with skills in leadership, interdisciplinary care, and a broad systems approach to client management. Not only will increased knowledge and skills enhance patient care and outcomes, but promote opportunities for the nurse’s continuing education and advanced role specialization. 

The initial cohort has launched and the second cohort will launch in January of 2016.  The feedback so far is overwhelmingly positive!  Students work very closely with their leaders to be sure they are balancing school, work and home.   Our goal is to meet the growing demand for highly-qualified and well-educated nurses who are prepared to meet the dynamic needs and demands of a major health care system.  Through working together and integrating academic and system needs, we are confident that this program will contribute to improved population health outcomes.

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