Nurses: Answering America’s Biggest Question

In the New York Times and other national media, America’s looming shortage of doctors predicted under the Affordable Care Act is front-page news. But the question of how to fill an anticipated gap between growing patient needs and the number of healthcare providers has long had an apparent answer: Advanced practice nurses. As established in the Future of Nursing report from the Institute of Medicine, nurses can and should meet the increasing demand for safe, high-quality, patient-centered, and equitable healthcare services under healthcare reform. It is effective and more cost-efficient to grow the population of advanced practice nurses (APRNs) for primary care roles than physicians, with APRNs achieving the same health outcomes.

Penn Nursing, in partnership with the University of Pennsylvania Health System, will set the course to increase the number of APRNs – and therefore the base of primary care providers – in the United States. With great pride and excitement, Ralph Muller, CEO of the University of Pennsylvania Health System, and I have announced the Graduate Nurse Demonstration project.

The Graduate Nurse Demonstration, supported by the Centers for Medicare & Medicaid Services (CMS), is a national program to educate more APRNs -- nurse practitioners, clinical nurse specialists, nurse anesthetists, and nurse midwives -- who can meet the increasing healthcare demands and needs of the U.S. populations.
 Five hospitals are partnering with accredited schools of nursing and non-hospital community-based care settings as clinical sites for APRN education. The Hospital of the University of Pennsylvania, the largest clinical site for Penn Nursing, is among the hospitals selected. The leaders for this ground-breaking demonstration project are Dr. Linda Aiken, who directs the Penn Nursing Center for Health Outcomes and Policy Research, and Dr. Victoria Rich, chief nurse executive of the University of Pennsylvania Medical Center, in collaboration with many others from schools of nursing and healthcare systems in Pennsylvania.

  

In the past, the cost of clinical training has limited the ability of hospitals and other healthcare providers to accept more APRN students for clinical training. In the Graduate Nurse Education Demonstration, CMS will provide the partner hospitals with payments of up to $50 million annually over four years to cover the clinical training and preceptorship of APRNs as part of the demonstration. Payments to the participating hospitals will be linked directly to the number of additional APRNs the hospitals and their partners are able to train as a result of their participation in the demonstration.

The significance of receiving this major support is multifold:

• First, and foremost, the project is based on research by our School of Nursing investigators.
• Second, we are proud that the successful request for funding was led by our own Dr. Aiken and her colleagues in Penn Nursing’s Center for Health Outcomes and by Dr. Rich, a Penn Nursing alumna who is our school’s assistant dean of clinical practice.
• Third, this demonstration project, if successful, sets the stage for support from CMS for graduate nursing education in the future.
• Fourth, the production of this monumental proposal was supported by both Penn Nursing and Penn’s Perelman School of Medicine.
• Fifth, the proposed project was made possible through the collaboration of many schools of nursing in the Southeastern Pennsylvania Deans and Directors Association.

We are proud of all the collaborations that led to the success and funding of this pioneering demonstration project, we are grateful to have the support, and we are looking forward to fully supporting the implementation of this important initiative.

And now the work begins.