The Health Professions Education Center (HPEC) is made possible through voluntary support from American Association of Community Colleges (AACC) member colleges with the goal of advancing nursing and allied health advocacy efforts.

December 2011

 Health Professions Education Center Newsletter: Special Edition

Supporting Your Health Professions Education Programs

Do you need to access research, persuasive arguments, or background information to enhance promotion and protection of your community college health professions education programs? HPEC has the assets you seek within a click of your mouse. Surfing through HPEC materials reveals robust resources that easily can be adopted and adapted for the unique local and state health-care workforce and education issues addressed by your institution. This issue of the newsletter provides links to HPEC Web-based materials to assist you in your advocacy efforts, such as the following.

Develop an argument demonstrating how vital your health professions education programs are to your community. Draw on solid reasoning to build your points. For example,

• Since health care is the nation’s largest industry, generating the greatest share of U.S. gross domestic product, health care is key to our community’s economic success. As the predominant educator of the nation’s nursing and allied health professions workforces, community colleges are essential to providing high-value health care, the generator of economic advance. Read more in Community Colleges: Keeping America Healthy and Safe.
• One of the community college’s greatest strengths is its ability to rapidly respond to demands for change and for new types of workers. Read more in the article, “The Role of Community Colleges in Meeting the Nation's Health Workforce Needs.”
• Several recent studies on health-care workforce employment trends help community colleges work with their business partners to develop a better workforce strategy incorporating demand, supply, and education trends specific to the operating environment. While the economic environment faced by new graduates of health-provider education programs is complex, health disciplines showed strong growth. Community colleges are doing their part in preparing workers for their community's health-care jobs. Read the article, “The Recession's Impact on Community College Health-Care Graduates,” in the August 2011 HPEC newsletter.
  

Dispute false claims about the ADN workforce needs in a hospital seeking Magnet Recognition. Shape your challenges drawing on facts, such as these:

• In Magnet-designated organizations, there are minimum educational requirements for nurses in leadership positions. But because the Magnet Recognition Program is silent on minimum requirements for direct care nurses (DCNs,) or “staff nurses,” there are no minimum education requirements for DCNs. Nor are there minimum Magnet requirements for the number or ratio of ADN- or BSN-prepared nurses or specialty-certified nurses.
• Hospitals seeking Magnet designation may not realize that they still need community colleges. Opportunities exist for your institution to partner with those hospitals that may be undergoing the lengthy, rigorous, costly credentialing process of achieving Magnet status. One strategy is to understand the Magnet program’s "5 Model Components" that the applicant must address. Such insight will aid community colleges in demonstrating how ADN education programs directly incorporate key Magnet concepts pertinent to the practice of DCNs in a Magnet organization.
• Understanding the Magnet requirements also will lead to strategies for the community college to creatively work with health-care employer applicants attempting to meet Magnet criteria. Your institution might organize and offer the applicant necessary continuing education for nursing leadership development; or partner with specialty nursing organizations or hospitals to provide certification review courses; or create consortium programs for new graduate or transition-to-specialty training where the didactic content is presented centrally at the college and the clinical orientation takes place at individual hospitals.
• While the Magnet Recognition Program receives high-profile marketing, out of the 5,795 hospitals registered with the U.S. American Hospital Association, only 386 (6.7%) are Magnet-recognized.

For more ideas disputing false claims about the Magnet Recognition Program, read the September 2011 HPEC newsletter.

Draw on the research to dispel the myth that nurses holding a bachelor of nursing degree have better patient outcomes such as lower mortality and failure to rescue rates. Use data to correct the record.

• The AACC policy brief, A Data-Driven Examination of the Impact of Associate and Bachelor's Degree Programs on the Nation's Nursing Workforce, outlines a clear understanding of the evidence contained in the much-discussed Institute of Medicine (IOM report, The Future of Nursing: Leading Change, Advancing Health. In regard to registered nurse (RN) education and outcomes, the brief cites IOM’s report statement that the “causal relationship between the academic degree obtained by RNs and patient outcomes is not conclusive in the research literature."
• In 2008, researchers for the Veterans Administration found no significant association between the proportion of BSN-prepared RNs and patient outcomes. See the HPEC site to access a study by Anne Sales et al., “The Association Between Nursing Factors and Patient Mortality in the Veterans Health Administration,” published in 2008 in Medical Care.
• AACC’s responses to attempts to discredit ADN-education have discerned major flaws in assumptions, methodologies, and conclusions used to support the false assertions. One classic AACC response to an unsound study addressed Linda Aiken et al.’s, “Educational Levels of Hospital Nurses and Surgical Patient Mortality,” published in 2003 in the Journal of the American Medical Association. Your community college can refute incorrect statements using AACC’s October 9, 2003, statement, Associate Degree Nurses Vital to the Nation’s Health Flawed Study Unduly Alarms Public.
• Community colleges have demonstrated that ADN content prepares high-quality nurses. ADN programs educate more than half of new nurses, and RNs credentialed as ADNs pass the same required licensure exam—at the same rate—as do RNs educated in other types of programs. Read AACC’s written testimony supporting ADN programs and graduates, “What, How, and Where We Should Teach."
• A more potent policy option than increasing BSN pathways is one focused on graduate education to generate an adequate supply of advanced practice nurses who serve as nurse educators and primary care providers. RN-to-MSN (master of science in nursing) programs are the true accelerated pathway, as these programs offer ADN-prepared RNs direct enrollment in graduate-level nursing education. This option builds on the foundation of associate degree education and the student's clinical experience to more quickly graduate advanced degree nurses. The expanded scope of practice provides RNs with the competencies necessary for career progression beyond the scope of practice authorized by the RN license as well as with additional earning potential. By promoting seamless academic progression and inventive options such as the RN-to-MSN programs, community college nursing programs can better meet the demands of the communities they serve. Such strategies leverage the community college environment, expert at aligning curriculum to community needs and providing accessible, flexible, high-value courses to allow for individualized learning. Read more about RN-to-MSN programs.

Take advantage of the growing public health education niche to promote your college’s public health education role. Raise the college’s visibility using these initiatives:

• In continuing to address causes that increase the nation’s health-care expenditures, the U.S. Department of Health and Human Services (HHS) focuses on reducing health-risk factors and inequities, as outlined in its objectives of Healthy People 2020. That initiative recently proposed Public Health Infrastructure Objectives that could dramatically increase public health education at the nation’s community colleges. The objective that is of primary significance for community colleges is to “increase the proportion of 2-year colleges that offer public health or related associate degrees and/or certificate programs.” See the 2011 January HPEC newsletter article “Healthy People 2020 Recognizes Community Colleges.”
• HHS also is administering the National Prevention Strategy (NPS), which comprises actions that public and private partners, including higher education institutions, can take to help Americans stay healthy and fit. Examination of the plan provides directions for community college curriculum development and for possible funding and partnership building. For example, two NPS recommendations to the federal government for which community colleges are positioned to take advantage are to (1) support and expand training programs that bring new and diverse workers into the health-care and public health workforce and (2) support health center service delivery sites in medically underserved areas and place primary care providers in communities with shortages. For other ideas, read the July and October 2011 HPEC newsletters.
• A large majority of the current public health workforce has not completed an associate degree or certificate program. Public health practice organizations at the city, county, and state level are increasingly recognizing the need for advancing the education of their employees. The key now is for community colleges to work with public health practitioners to develop general education courses, certificate programs, and associate degrees in public health. See the June 2011 HPEC newsletter to read “Q&A With HHS Official Addresses Community College Role in Public Health Workforce.”
• Public health in general and health departments in particular have a long history of encouraging a diverse public health workforce. The impressive contributions of community colleges to recruit and prepare a diverse student body should be well received by employers in public health. The assistant secretary for health recently released a report, Priority Areas for Improvement of Quality in Public Health (2010), that included improvements such as increased diversity in the education of the public health workforce as a priority area needing attention. Read the June 2011 HPEC newsletter article, “Q&A With HHS Official Addresses Community College Role in Public Health Workforce.”
• Core public health courses offered at community colleges as part of general education should be interchangeable with those offered at 4-year institutions. This is key to the ability to transfer courses to 4-year institutions and to satisfy general education requirements. Core courses such as “public health 101,” “epidemiology 101,” and “global health 101” are increasingly relevant to all college students as they read the newspaper, search the Web, and engage with the public health issues their generation faces, such as AIDS, the impact of aging, and health-care costs. Read more in “Ready for Prime Time: Ramping Up Public Health Education,” published in Community College Journal, April/May 2010.

Formulate a presentation about your college’s unique expertise in tackling health equity issues. Develop your discussion points using various HPEC data and materials:

• Health equity is a national health policy priority, in which community colleges hold considerable expertise and promise for developing the strategies necessary to overcome the health disparities characterizing our communities. Community colleges are the predominant resource ensuring the development of a diverse health-care workforce in all communities of our nation, including those in rural and urban areas that traditionally are underserved. The HPEC brochure, Community Colleges: Keeping America Healthy and Safe, recommends how policymakers can address workforce challenges through community colleges.
• Not only do ADN programs graduate the majority of new RNs, but also they provide the nation’s nursing workforce with its greatest diversity. Recognition of diversity is a critical component of health-care reform’s goal to advance accessible, affordable, quality health care to all. Go to A Data-Driven Examination of the Impact of Associate and Bachelor's Degree Programs on the Nation's Nursing Workforce.
• ADN-prepared RNs are a sound economic and social investment to communities, including those in rural America where unique factors create disparities in health care not found in urban areas. RNs whose initial nursing education is an ADN are the most likely group of RNs to reside in the state in which they were educated: 75.5% (1,037,450) of ADN-prepared RNs compared with 65.2% (616,944) of a group combining BSN-prepared and graduate-degree–prepared RNs reside in the state in which they were educated. Go to the HPEC website to access the National Sample Survey of Registered Nurses.
• In 2008, three quarters (74.8%) of RNs in rural settings received their initial nursing degrees through either an ADN or diploma program, at 57.2% and 17.6% respectively. Clearly, many rural and underserved communities rely on community colleges for their nursing workforce. This was emphasized by an Urban Institute study suggesting that “medical personnel, including nurses, tend to work near where they were trained, so the distribution of support for nursing education matters” and, furthermore, “simply producing more nurses may not be effective in alleviating areas’ shortages if attention is not paid to where the nurses are produced.” Read the 2009 study, Understanding the Nursing Workforce: Public Policy for a Dynamic and Complex Market.

For more information, contact Roxanne Fulcher, director, health professions policy, 202-728-0200, ext. 274.

The American Association of Community Colleges is a national organization representing the nation's close to 1,200 community, junior and technical colleges and their more than 12 million students.