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2011 USPHS Scientific & Training Symposium. Nurse Category Day “Creating a Healthy Nation: The Role of Nursing Leadership” Kerry Paige Nesseler, M.S., R.N. Assistant Surgeon General Chief Nurse Officer, USPHS Director, Office of Global Health Affairs Department of Health and Human Services - PowerPoint PPT Presentation

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  • *2011 USPHS Scientific & Training Symposium

    Nurse Category Day

    Creating a Healthy Nation: The Role of Nursing Leadership

    Kerry Paige Nesseler, M.S., R.N. Assistant Surgeon GeneralChief Nurse Officer, USPHSDirector, Office of Global Health AffairsDepartment of Health and Human ServicesHealth Resources and Services Administration

    21 June 2011New Orleans, LA

  • OutlineProposed USPHS Commissioned Corps New Accountability StructureFederal Public Health Nurse Leadership Network Public Health Service Nursing Strategic PlanCommissioned Corps Nurse Officers DemographicsCommissioned Corps Nurse Officers Basic Readiness*

  • USPHS Commissioned Corps New Accountability Structure

    BACKGROUND:

    FY 2011 OMB passback language requested a comprehensive management review of the Commissioned Corps with specific reference to the accountability structure of the Corps.

    The review determined that the current decentralized and complex organizational structure led to fragmented and inconsistent enforcement of policies resulting in reports of suboptimal customer satisfaction.

    The management review recommended that: The Corps streamline the administrative structure from 20 component offices to 10. Unify policy implementation and operations under the Surgeon General with clear points of accountability.Establish a Commissioned Corps Advisory Board under the leadership of the ASH.

  • USPHS Commissioned Corps New Accountability Structure (cont.)

    Proposed Changes:

    The Office of Force Readiness and Deployment, Office of Reserve Affairs, Office of Military Liaison and Veteran Affairs, Office of Commissioned Corps Force Management, and Office of Commissioned Corps Operations will be merged into the newly created Division of Commissioned Corps Personnel and Readiness.

    The Division of Commissioned Corps Personnel and Readiness will include three branches:Recruitment Branch.Assignments and Career Management Branch.Readiness, Deployment, and Ready Reserve Branch.

    The Division of Systems Integration will be established in the OSG.

    The Office of Civilian Medical Reserve Corps and the Office of Science and Communication will be designated as Divisions within the OSG to maintain parallel organizational structure.

  • Proposed New Commissioned Corps Accountability StructureReadiness, Deployment and Ready Reserve Branch (RDRB)Assignments and Career Management Branch (ACMB)Recruitment Branch (RB)DoD TRICARE and TRICARE-Prime RemoteU.S. Coast Guard(USCG)Direct Access (DA)Division of Systems Integration (DSI)Division of Commissioned Corps Personnel and Readiness (DCCPR)Division of Science and Communications (DSC)Division of Civilian Medical Reserve Corps (MRC)Commissioned Corps Advisory BoardOffice of the Assistant Secretary for Health(OASH)Office of the Surgeon General(OSG)

    Deputy Surgeon General

  • Federal Public Health Nurse Leadership Network

  • Federal Public Health Nurse Leadership Network (cont.)Draft Mission:Provide a unified federal public health nursing forumthat facilitates shared communication focused oninnovative and collaborative approaches to improve thehealth and safety of the Nation.

    Draft Vision:A collective and unified federal public health nursing voicethat is recognized and sought-after for consultation andcontributes to current issues and policies that advance theheath, health care workforce, and health care deliverysystems of the Nation.

  • Federal Public Health Nurse Leadership Network (cont.)Draft Goals:Nursing Workforce Discuss the key findings of HRSAs 2008 National Sample Survey of Registered Nurses and their impact on public health nursing Identify existing federal nursing workforce data and discuss strategies to analyze, utilize and improve the data collectedReview the Office of Personnel Management (OPM) processes for recruiting, hiring, and retaining federal nurses and discuss strategies with OPM to meet future federal nursing needs and health needs of the NationDiscuss potential federal nursing involvement and responsibilities in implementing the recommendations of the Institute of Medicine report, The Future of Nursing: Leading Change, Advancing Health

    NetworkingExplore cross agency partnerships and areas for program collaborationsPromote leadership development among federal nursesExplore opportunities for continuing professional education and training for federal nurses Promote a mentoring culture among federal nurses by identifying opportunities for exchange of expertise and knowledgeCoordinate with the Federal Nurses Association (FedNA) to explore partnership possibilities with current nursing organizations

  • Public Health Service Nursing Strategic Plan

    *

    LCDR Sara AndersonLCDR Wanza BaconLCDR Felecia BaileyLCDR Tara DaugereauLCDR Linda EgwimLCDR Amanda HeardLCDR Aisha MixLCDR Tiffany MooreLCDR James PattersonLCDR Michelle RuslavageLCDR Laura WallLT Colleen KerrLT Amy KolwaiteLT Pattama Ulrich LT Belinda RooneyDr. Irene SandvoldMr. Joseph BertulfoMr. Kirk Koyama

    RADM Kerry Nesseler - ChairCAPT Susan Orsega - Vice-ChairCAPT Amy AndersonCAPT Cheryl BordenCAPT Mary LambertCAPT Lynn SlepskiCDR Lori Austin-HansberryCDR Nancy BartoliniCDR Wendy BlockerCDR Philantha BowenCDR Kimberly CrockerCDR Veronica GordonCDR Timothy GruberCDR Lysa HieberCDR Kyong HyonCDR Carmen MaherCDR Dale MishlerCDR Thomas PryorCDR Sophia RussellCDR Amy Webb

  • Public Health Service Nursing Strategic Plan (cont.)Draft Vision:Health outcomes are optimal and health disparities are eliminated for all people through the promotion of wellness and disease prevention efforts

    Draft Mission:To enhance and improve health and safety outcomes through leadership, education and research by providing exceptional culturally competent holistic nursing services to all people

    *

  • Public Health Service Nursing Strategic Plan (cont.)

    *

    COMMITMENT EDUCATION RESEARCH LEADERSHIP COMPASSION EXCELLENCE INTEGRITY

    NURSING

    Draft Values:

  • Public Health Service Nursing Strategic Plan (cont.)

    *COMMITMENT - Fostering a professionally prepared and diverse workforce, capable and ready to respond to existing health priorities, national health initiatives, and emerging and unexpected health threats;EDUCATION - Empowering communities; engaging individuals in health promotion programs, encouraging healthy lifestyle choices to enhance the quality of living throughout the life span;

    RESEARCH - Advancing nursing practice through innovative strategies and cutting edge technologies by means of transferring new knowledge and applying evidence based practices LEADERSHIP - Advocating for change, developing policies that are transforming the national healthcare system in advancing the health of our nation;COMPASSION - Providing culturally competent care through the application of holistic nursing approaches to vulnerable populations focusing on eliminating healthcare disparities among the populace; EXCELLENCE - Supporting initiatives in biomedical research and regulatory science ensuring excellence in safety, quality and performance in regulated products that impact the delivery of care and wellness of the American people;INTEGRITY - Acting with conviction and courage in adherence to the highest standards of ethical and moral principles in the promotion of wellness and disease prevention.

  • *Commissioned Corps Nurse Officers Demographics

  • *

  • *

  • Basic Readiness*

  • OverviewAttaining basic readiness is a requirement for all PHS officers!

    Non-compliance may affect an officers eligibility for promotion, special assignments, and retention in the Commissioned Corps.

  • Nurse Basic Readiness Percentage by Quarter prior to 2011

  • Trends in Readiness 2010-2011Nurse Readiness on 31 March 2010

    Nurse Readiness on 31 March 2011

  • Readiness Trends by RankNurse Officers not meeting readiness standards by Rank as of March 2010

    Nurse Officers not meeting readiness standards by Rank as of March 2011

  • Basic Readiness missing metrics as of March 2011

  • Readiness Status of Nurse Officers by Agency in March 2011

    (50%) (18%) (16%) (5%) (6%) (11%) (7%) (10%) (12%) (9%) (12%)

  • Readiness ExpectationsThe Nursing category will be >98% ready every quarterOur goal is to be 100% Basic ReadyEach nurse officer is personally accountable for being ready--It is YOUR personal responsibilityThe NPAC Readiness Committee is prepared to assist you.To learn more about readiness go tohttp://ccrf.hhs.gov/ccrf/Readiness/Basic_Readiness_Checklist.pdfhttp://ccrf.hhs.gov/ccrf/Readiness_FAQs.pdf

  • *

  • *

  • Contact Information

    Kerry Paige Nesseler, M.S., R.N.Assistant Surgeon GeneralChief Nurse Officer, USPHSDirector, Office of Global Health Affairs Department of Health and Human Services Health Resources and Services AdministrationPhone: (301) 443-2741Fax: (301) 443-2870 Email: [email protected] *

    Good morning fellow nurses, flag nurse officers, VIPs, Professors and Deans,

    Welcome to the 2011 USPHS Scientific and Training Symposium Nurse Category Day. I am honored to be here with you in New Orleans, Louisiana. It has been close to 6 years since the devastating Hurricane Katrina hit New Orleans. Though the effects have been long-lasting, I am very happy to see that New Orleans remains resilient and continues to rebuild this beautiful and historic city they are well on their way to a magnificent recovery.

    Since the 2010 USPHS Scientific and Training Symposium, there have been many exciting and new developments. A lot of really great work has been done over the past year that I am so proud of, and I am excited to share those with you today.

    Today, I will discuss

    The proposed USPHS Commissioned Corps New Accountability StructureThe Federal Public Health Nurse Leadership NetworkPublic Health Service Nursing Strategic PlanCommissioned Corps Nurse Officers DemographicsCommissioned Corps Nurse Officers Basic Readiness**As you may already know, the USPHS Commissioned Corps convened the Commissioned Corps Accountability Structure Working Groups from February to March 2011. The Working Groups were established to advise the Surgeon General on operations and business process outcomes that will facilitate the effective, timely, and efficient implementation of the new accountability structure.

    The three goals were to:

    improve efficiency, effectiveness, performance and customer service for the Commissioned Corps and to the Commissioned Corps stakeholders and partners;

    design a framework to foster a culture of continuous process improvement, including measurable outcomes and accountability; and

    foster the shared vision for the Commissioned Corps accountability structure.

    The Working Groups submitted their final reports to the Office of the Surgeon General on the new accountability structure on 31 March 2011.

    The Proposed Changes for the New Accountability Structure include:

    Merging :- Office of Force Readiness and Deployment, Office of Reserve Affairs, Office of Military Liaison and Veteran Affairs, Office of Commissioned Corps Force Management, and Office of Commissioned Corps Operations into the newly created Division of Commissioned Corps Personnel and Readiness

    The Division of Commissioned Corps Personnel and Readiness will oversee the following three newly created branches:Recruitment BranchAssignments and Career Management BranchReadiness, Deployment, and Ready Reserve Branch

    The Division of Systems Integration will be established

    The current -Office of Civilian Medical Reserve Corps and - the Office of Science and Communication will be designated as Divisions, in order to maintain parallel organizational structure.

    *The chart shown is the proposed New Commissioned Corps Accountability Structure.

    The OSG/USPHS New Accountability Structure is in full development with an expected date of implementation set at 1 July 2011. The position announcement for the Director, Division of Commissioned Corps Personnel and Readiness (DCCPR) was open until 20 May 2011. Two other key position announcements will be opening soon, which are:

    Division of Systems Integration (DSI), and Division of Science and Communications (DSC).

    I encourage well qualified nurses to apply to these critical leadership positions and take an active role in the creation and implementation of the new system. It is important to have nursings voice at the table.

    *The Federal Public Health Nurse Leadership Network is comprised of senior nurse leaders throughout the U.S. Public Health Service (USPHS).

    Recognizing that this is an historic and exciting time for advancing health care, the Group was reconvened in September 2010 to establish a clear and unified vision and coordinated action plan for USPHS nursing leadership, to assist in improving the health and well being of people in our Nation.

    The meeting on 16 September 2010 was well-attended, with representation from non-HHS Agencies, such as - Bureau of Prisons, - United States Marshals Service, - Division of Immigration Health Services, - National Oceanic and Atmospheric Administration, - Uniformed Services University of the Health Services and - all HHS Agencies.

    We had guest speakers representing numerous federal agencies. To name a few, Dr. Wakefield, HRSA Administrator provided opening remarks while Dr. Heinrich (HRSA), Ms. Moody-Williams (CMS) and Dr. Grady (NIH) presented on what impact the Affordable Care Act has on Nursing Workforce Development, Medicare and Medicaid Services and the Nurse Scientist Role respectively.

    Dr. Hassmiller, Senior Advisor at the Robert Wood Johnson Foundation presented the Process and the Implementation Campaign on the Future of Nursing Report and our Acting Deputy Surgeon General at the time, RADM David Rutstein provided an overview of the Public Health Sciences Track, a program that will be utilized to produce highly trained and specialized Officers in the Public Health Service Commissioned Corps to meet the nations shortage of primary care and public health clinicians to serve in high need areas.

    The list of outcomes from September 16 meeting include:Developing a public health nursing plan, a mission and vision, and three or four objectives, Review the recommendations of the IOM report, analyze the evidence, and put it into practice and Meet to review the IOM report and identify how Federal nursing leadership can affect the implementation of that plan

    The second Federal Public Health Nurse Leadership Meeting took place on February third. Dr. Ada Sue Hinshaw, Dean, Graduate School of Nursing, Uniformed Services University of the Health Sciences, provided an overview of the USUHS Graduate School of Nursing while Dr. Linda Burnes Bolton, Vice President and Chief Nursing Officer, Cedars-Sinai Health Systems, Cedars-Sinai Medical Center, spoke on Future of Nursing Report via videoconferencing. Ms. Sandra Haldane, Chief Nurse of the Indian Health Service, provided a presentation on PHS Nursing and Caring for Underserved and Vulnerable Populations.

    The list of deliverables from the February 3rd meeting include:The development of a mission, vision, and three or four objectives and Develop and expand a federal scope of nursing practice.

    The Federal Public Health Nurse Leadership Meeting met for the second time on Thursday, 3 February 2011, 8:30 am 12:30pm, at the Parklawn Building. The group is comprised of senior nurse leaders throughout the U.S. Public Health Service. The purpose of the meeting is to network, establish a clear and unified vision and coordinated action plan for USPHS nursing leadership to assist in improving the health and well being of people in our Nation. Dr. Ada Sue Hinshaw, PhD, RN, FAAN, Dean, Graduate School of Nursing, Uniformed Services University of the Health Sciences, Bethesda, MD; Dr. Linda Burnes Bolton, DrPH, RN, FAAN, Vice President and Chief Nursing Officer, Cedars-Sinai Health Systems, Cedars-Sinai Medical Center, Los Angeles, CA, (videoconference); and Ms. Sandra Haldane, Chief Nurse of the Indian Health Service, were the guest speakers. Dr. Hinshaw presented on the Uniformed Services University Graduate School of Nursings accomplishments, recent initiatives, curriculum and unique mission in providing the Nation with the highest quality advanced practice nurse clinicians, scientists and scholars dedicated to Federal health service. Dr. Burnes Bolton talked about the key messages and recommendations from the Institute Of Medicines Future of Nursing Report and in identifying specific roles and actions for public health leaders to lead changes in improving the Nations health. Ms. Haldane provided an overview about the Indian Health Services unique role in providing nursing care to a specific, underserved and vulnerable population.

    *The Draft Mission and Vision for the group is:

    Draft Mission:Provide a unified federal public health nursing forum that facilitates shared communication focused on innovative and collaborative approaches to improve the health and safety of the Nation.

    Draft Vision:A collective and unified federal public health nursing voice that is recognized and sought-after for consultation andcontributes to current issues and policies that advance the heath, health care workforce, and health care deliverysystems of the Nation.

    *Draft Goals: Nursing Workforce Discuss the key findings of HRSAs 2008 National Sample Survey of Registered Nurses and their impact on public health nursing

    Identify existing federal nursing workforce data and discuss strategies to analyze, utilize and improve the data collected

    Review the Office of Personnel Management (OPM) processes for recruiting, hiring, and retaining federal nurses and discuss strategies with OPM to meet future federal nursing needs and health needs of the Nation

    Discuss potential federal nursing involvement and responsibilities in implementing the recommendations of the Institute of Medicine report, The Future of Nursing: Leading Change, Advancing Health

    NetworkingExplore cross agency partnerships and areas for program collaborationsPromote leadership development among federal nursesExplore opportunities for continuing professional education and training for federal nurses Promote a mentoring culture among federal nurses by identifying opportunities for exchange of expertise and knowledgeCoordinate with the Federal Nurses Association (FedNA) to explore partnership possibilities with current nursing organizations

    *In addition to the Federal Public Health Nurse Leadership Network, a newly created PHS Nursing Strategic Planning Task Force was established in April 2011 to formulate a PHS Nursing Strategic Plan. CAPT Susan Orsega is graciously serving as my Vice-Chair and we are fortunate to have 40 PHS nurses--civilian and Corpswho are participating to develop our Strategic Plan.

    This slide lists the names of members who have been participating in the Task Force. Members represent many agencies, both HHS and Non-HHS, to name a few,

    -Health Resources and Services Administration (HRSA)-National Institutes of Health (NIH)-Food and Drug Administration (FDA)-Indian Health Service (I.H.S) -Centers for Disease Control and Prevention (CDC)

    -Department of Homeland Security (DHS) (Coast Guard and Division of Immigration Health Services)-Department of Justice (DOJ) (Bureau of Prisons & Marshals Service)-Department of Defense (DOD) (Armed Forces and Tricare Management Activity (TMA))

    *Our proposed Draft Vision is:Health outcomes are optimal and health disparities are eliminated for all people through the promotion of wellness and disease prevention efforts

    And

    Our proposed Draft Mission is:To enhance and improve health and safety outcomes through leadership, education and research by providing exceptional culturally competent holistic nursing services to all people*Our Proposed Draft Values are:

    -Commitment-Education-Research-Leadership-Compassion-Excellence -Integrity

    As you can see, these Values make up the word Nursing.

    The next slide will describe each of these values in detail*These description of our values can be considered as the culture of Public Health Service Nursing.

    It encompasses what Public Health Nurses do on a daily basis in improving and advancing the health of American people, which include underserved, vulnerable populations.*The next few slides will discuss the demographics of Commissioned Corps Nurse Officers. I am proud to say that even though we were on a pause last year, as an unintended consequence to the implementation of the Affordable Care Act, our Category remained strong and was not greatly impacted by it.*As you can see from the bar chart, a majority of the nurses are stationed with the - Indian Health Service, - Federal Bureau of Prisons and - Department of Homeland Security, each accounting for 34, 20 and 11% respectively.

    To put these percentages in numbers, 994 out of 1533 nurses are employed by these agencies alone, while the remaining 539 are employed by : - HRSA, - FDA, - CMS, - CDC, - SAMHSA, etc.

    *This chart represents the number of nurses within each temporary grade.

    As you can see, the temporary grade O-4 or LCDR accounts for the highest temporary grade within the nursing category.

    We have a total of five Nurse flag officers, one Rear Admiral Upper Half or O-8, RADM Deborah Parham Hopson and

    four Rear Admiral Lower half or O-7, - RADM Ann Knebel, - RADM Denise Canton, - RADM Clara Cobb and - myself.

    **Referring to the line chart above, you can see that the Nurse Category has done well in ensuring that the Basic Readiness Percentage has been above 93% since the third quarter of 2010.*Looking at these pie charts, there are more nurses who are basic ready in 2011 than there were in 2010.

    However, the number of nurses who are not basic ready also increased in 2011 compared to 2010.

    This could be attributed to the fact that nurses who were under the Exempt status in 2010, fell under the Not Ready status in 2011.

    *As you can see from the 2 bar graphs presented, there is an increase in the number of Nurse Officers who are not Basic Ready, across the board, from LTJG to CAPT.**Slight improvement in Annual Fitness testing and maintaining BLS over the last year.

    *Immunizations, licensures and deployment roles are basically unchanged

    *Completion of On-line courses and keeping medical records up-to-date has gotten worse*Percentage of nurses at individual agencies NOT Basic Ready range from: -as low as 5% at CMS (2 out of 40) to - as high as 50% at ASTDR (1 out of 2).

    -BOP sits at 15.7% not basic ready; -CDC at 14%; -I.H.S at 11%*My expectation is for the Nursing Category to be over 98% Basic Ready every quarter

    Our goal is to achieve 100% Basic Readiness

    I want to iterate that ultimately each nurse officer is responsible and accountable for achieving and maintaining Basic Readiness Status. If you encounter any issues or problems, the NPAC Readiness Committee is available and prepared to help you achieve and maintain Basic Readiness.*