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Consortium seeks funding for local initiatives

Renewed interest in the nursing shortage, growing out of recent media coverage, is increasing dialogue on its causes and solutions. As those close to the issue know, there is more to the shortage than the high cost of living along America’s Gold Coast and the limited capacity of South Florida’s nursing schools. Yet, as nurse vacancy rates have risen from an average of 8 to 11%, few beyond health facility administrators and nurses themselves have focused on the problem. This growing shortage only becomes evident to other South Floridians when they encounter our healthcare system where, according to the annual state snapshots recently issued by the Agency for Healthcare Research and Quality, health care quality has declined. While few read such government statistical reports, declining quality trends push us inevitably closer to sensational stories about surgery performed on the wrong body part or other avoidable occurrences that can brand a health care facility and a region for years.

Besides measuring how well hospitals fulfill their mission in the community, quality indicators are poised to increasingly impact facility bottom lines. First Medicare and more recently private payers from California to Georgia are using quality data to determine the extent to which facility expenses are reimbursable under pay for performance models. The quality of care rendered at our health care facilities is fundamental to the physical and mental wellbeing of our communities, as well as to the economic vitality of the Region. The fourth largest industry in South Florida, health care generates dollars not only through payments from and on behalf of local residents and seasonal visitors, but also from Central and South Americans, and those from the Caribbean island nations who increasingly come to South Florida for medical procedures. This important international business will go elsewhere if the quality of care in our Region is perceived to be substandard.

The correlation of poor health outcomes with nurse vacancy rates has been well documented by JCAHO and in numerous published academic studies. With quality linked to facility reimbursement and nursing care driving quality indicators, administrators are wise to take a new look at nursing services. Traditionally viewed as overhead to be managed, the new paradigm positions quality nursing care as an important key to maximizing payer reimbursement. Thus the case for building and retaining nursing competency has never been stronger. Recognizing that declining trends in quality can be reversed by increasing the size, quality, and stability of the nurse workforce, we need to strive for a common and comprehensive understanding of the factors that make this shortage a threat to health and well-being throughout South Florida and together call for the funding we need to implement initiatives designed to avert a worsening crisis.

The Nursing Consortium of South Florida, with financial support from the Florman Family Foundation and the Health Foundation of South Florida, has recently issued a white paper on the nursing shortage in our Region. The paper examines nursing workforce trends through a pipeline model that identifies areas of concern that constrict the supply of nurses. It recommends a series of programs designed to extend the productive careers of nurses, cultivate nurse leaders, better leverage our nurse resources to improve staff and patient satisfaction and health outcomes, strengthen the transition of novice nurses from education to practice, expand the pool of qualified nursing faculty in the Region’s institutions of higher education, allocate the limited nursing school educational opportunities to candidates most likely to persist in the profession, and expand the exposure of students in our schools to nursing. The Consortium is actively seeking funding to launch these and other initiatives that will help South Florida maneuver successfully through a nursing shortage that is projected to exceed, in scale and duration, all previous shortages.

The good news is that while much remains to be done, we can celebrate that recent investments have resulted in a stronger asset base of human and physical capital for dealing with this challenge than was in place just five years ago. Our nursing school deans have successfully attracted renowned researcher-educators, developed a variety of academic tracks for second career professionals, expanded enrollment capacity, and raised the funds needed to construct some of the most technologically advanced academic buildings dedicated to nursing education found anywhere in the Nation. The new nursing school buildings at Florida Atlantic University and the University of Miami are of landmark quality, as will be the new nursing building at Florida International University. Having replaced woefully inadequate facilities, these new structures are already contributing to increased faculty productivity and enhanced student learning experiences. Furthermore, greater cooperation among the academic programs at FAU, FIU, UM, Nova Southeastern, and Barry University that prepare nurses and the other health professionals are enriching the academic experiences of Regional college students pursing careers in these fields, providing models for advancing understanding and collaboration across the health professions. These important gains at our public and private institutions of higher education would not have been possible without significant investments by our hospitals and other healthcare providers.

More is needed. The current nursing shortage is not simply a challenge for the profession or for the health care industry. It affects us all, and so the investment must become a front-burner priority for community leaders throughout South Florida. With the right investments, strategically managed, we can preserve our gains and leverage them to enhance the regional capacity to attract, educate, cultivate, and retain a culturally competent and diverse nursing workforce. A nursing workforce aligned with the evolving health care needs of this dynamic South Florida community and able to lead the way to improved regional health and the creation of true centers of excellence in health care.