Assertions that nursing education is out of step with practice and that academic programs do not meet the needs of employers are common criticisms by health care leaders. Spiraling health care costs, advancing technology, rapidly changing health care systems and regulations have created an urgency to bridge the gap between nursing education and practice. Practitioners and educators must collaborate to prepare nurses with the knowledge and competencies essential to practice in the changing environments. One aim of the national Colleagues in Caring Program (CIC) is designed to bring educators, employers, payers, consumers, and policy makers together to create a nursing workforce prepared to function in the changing systems of health care. The Kansas City CIC project is using both relationship and electronic networking to connect education, practice, health care payers, and regulatory bodies.
A strength of the Kansas City Colleagues in Caring (KC-CIC) project is the long-standing consortium of nurse educators and nurse executives that has sought to solve common problems and achieve mutual goals. To augment the capacity of the consortium to implement the KC-CIC project, consortium membership was expanded beyond hospital-based nurse executives to bring representatives from long-term care, home health, and community-based clinics. Likewise, representatives from managed care firms, state boards of nursing, community and governmental agencies were added. The outcome of reconfiguring the consortium was an enhanced capacity to understand the issues affecting nursing workforce development.
OUTCOMES OF THE COLLABORATION
A primary task of the KC-CIC was to make data and information available to the nursing consortium and community so that evidence-based decisions could be made. The model developed for forecasting workforce supply and demand included several elements intended to provide both quantitative and qualitative information about the current and future workforce in nursing (Figure).
The spirit of collaboration and understanding that evolved among the consortium members has led to some joint projects that have had a positive impact on nursing in the region. The most significant among these achievements has been the enhanced communication system. Communication technology has radically changed the speed and cost of access to information. Thus, the KC-CIC Consortium decided to capitalize on technology to overcome the barriers of cost and timeliness of information in the project. During the second year of the KC-CIC project, a Web site was developed with our technology partner, the Community Resource Network (CRN). Through this Web site, hosted by CRN, the consortium had access to databases (e.g., employers, nursing programs, and professional organizations), project committee rosters and minutes, links to other agencies (e.g., state boards of nursing), a continuing education calendar, and a health careers directory. Although it will continue to be a channel for communication and warehouse for information and data, our vision for the Web site has changed. We now see the Web site as a centralized resource to foster career mobility and lifelong learning for nurses in the region. In addition, in the second phase of the Robert Wood Johnson Foundation project, the plan is to conduct many of the surveys on-line and to make workforce data available on the Web site.
In addition to building the relationship network of nursing leaders from various settings to reduce the gap between nursing education and practice, we have designed an electronic network that includes a virtual center for lifelong learning (CLL), a revised communications center, a data collaborative center, and an employment listing option. Completion of the redesign is expected by July 2000.
Figure. Nursing Workforce Development Model.
Center for Lifelong Learning
Most schools of nursing have as a program outcome that graduates will engage in continuous or lifelong learning. However, it is left up to the individual to locate information about continuing education offerings or academic programs available to meet development needs. Further, those wishing to retool or change career focus have to search through many resources to find information relevant to making the changes. For nurses to remain current and competent, they need to be able to assess their level of competency, compare that information with expected competencies for nursing roles, and have ready access to education programs and experiences to build their professional knowledge and skill base. The KC-CIC Web site will provide that access. Thus, nurses can go to one source to seek information about changing their nursing role or practice setting or to keep current in nursing.
How does the Web site support lifelong learning? Imagine a nurse planning to transition from a long-term care setting into a case management role in a hospital. The nurse will be able to complete a personality inventory and skill inventory online. Competencies for case management will be provided and the nurse may compare current competencies with those expected to practice in case management. The Career Assessment section of the CLL will be linked to two searchable databases. One database lists academic programs in the region. The other is an online calendar of continuing education offerings. Searching the directories may provide the nurse information about programs to be offered in the area on the topic of case management. In some cases, the nurse will be able to register for the program online through electronic links to agencies providing the CE offerings. Additionally, the nurse will be able to connect with the Case Management Association and learn about the local professional network of case managers. The nurse also will be provided information about regulation or certification for the role as appropriate. Finally, by Spring 2000, the nurse will have access to the "Health Care Works" job bank and, therefore, listings of case management positions available in the region. This connection of relationship and electronic networks provides for career mobility and development not possible in traditional models of lifelong learning. The KC-CIC network will provide the infrastructure for retooling of the current workforce in nursing as well as be the point of reference for nurses beginning and planning their careers.
Access to the communications center is key to the success of the KC-CIC project. Through the center, we provide cost effective and efficient communications. We connect to expert resources to provide more complete and accurate information. For example, we electronically link to state agencies such as the Kansas and Missouri State Boards of Nursing, thereby providing direct access to information about requirements for licensure, certification, and other regulations affecting nurses.
One of the more exciting innovations for the KC-CIC Web site is our interactive community event calendar. Consortium members and agencies purchasing the service can access the calendar to determine what events are scheduled over the coming year by participating agencies. Thus, if a school of nursing wants to schedule an event they can do so with some assurance that there is no major competing event on the day they have selected. The event calendar allows us to customize other calendars as well. For example, the Nursing Continuing Education Directory is based on the event calendar infrastructure. As with the event calendar, the continuing education directory has a search engine that enables users to access information quickly about their specific interests for an education program. The directory can be electronically linked to the agency offering the continuing education programs. Therefore, this additional information and registration online is readily available to the nurse making the inquiry.
One of the primary goals of the CIC projects is to make available accurate, timely information for employers and educators. The proposed data center on the Web site will provide employers, educators, policy makers, and others access to data collected in the project. For example, results of employer surveys, academic program surveys, continuing education surveys, focus groups, and the environmental scan will be available. Information will be reported as grouped data to protect proprietary interests of the data partners. As much as possible, we plan to collect, analyze, and report the data online to minimize the cost and work of this initiative. Likewise, the online format will enable us to collect and report data quickly, thereby addressing needs of employers in our region.
Another innovation of the KC-CIC project is "Health Care Works," an online job bank, resume posting, and health careers information center. The potential of "Health Care Works" to meet needs of the new graduates, employers, and nurses seeking career changes is incredible.
It is our goal that the KC-CIC Web site will be the key source of information for nurses in Kansas and Missouri within the next two years. Our technology network provides the foundation for future innovation and cost-savings for participating agencies in the KC-CIC project and others. The technology network is the basis for plans to sustain the work of the project after funding from the Robert Wood Johnson Foundation ends.
IS THE GAP REDUCED?
Both the relationship and electronic networks have contributed to improved communications among the diverse groups represented in the KC-CIC Consortium. These improved communications have greatly enhanced connections between the academic community and the health care employers. Schools are able to make databased decisions regarding academic programs, curricula, and enrollments that will better meet the needs of the health care industry in our region.
Communications between the nursing workforce and the health care employers are being enhanced. We have the beginning infrastructure in place to support lifelong learning and career mobility. The employers have an available forum to communicate their needs for nurses with specialized knowledge and skills. In addition, the nurses will have access to information on strategies to gain needed knowledge and skills for specific positions.
Additionally, the inclusive nature of the consortium has enabled us to address significant problems together and to take a proactive stance in promoting change. Nurse educators, employers, regulators, payers, and other key stakeholders have created this communication infrastructure together rather than in isolation. What has resulted is a system that will better enable us to change rapidly in nursing education to meet the needs of our region for nurses. This system enables the informationage student and nurse to advance his or her professional growth through technology.
To enhance quality patient care, employers and educators are addressing best practices for clinical education, examining new models of cost effective, high quality nursing care, and adopting strategies to reduce costs of duplicated efforts and resources. Finally, the combined relationship and technology networks have created a powerful think tank aimed at meeting the needs of the community for health care and health care providers.
We believe, through the implementation of this project, we have effectively reduced the gap between education, practice, and other health policy-making organizations and this trend will continue.