Taking Action

The Center to Champion Nursing in America: Mobilizing Consumers and Other Stakeholders

Brenda Cleary and Susan C. Reinhard

“The mission of the Center to Champion Nursing is to assure every American has access to a highly skilled nurse when and where they need one.”

—Center to Champion Nursing in America

The Center to Champion Nursing in America (CCNA) was launched in 2007. Robert Wood Johnson Foundation (RWJF) officials approached AARP’s leaders to discuss a potential collaborative effort among the RWJF, the AARP, and the AARP Foundation. The intent was to bring the consumer voice from a national powerful consumer organization to help galvanize broad-based support for sustainable solutions to seemingly intractable challenges (e.g., the nurse and nurse faculty shortage, and health care delivery). The center would offer substantial potential for the AARP to bring attention to evidence-based nursing models, the contributions of advanced practice nurses, and the need to prepare nurses with the skills needed for the twenty-first century.

At the time of the CCNA’s inception, the AARP had three nurses on its board of directors and had just hired a nurse to lead its public policy think tank: the AARP Public Policy Institute. The timing was ripe to create a new center that could imagine new partnerships with nurses and other stakeholders who care about how people of all ages access high-quality, affordable health care. As a nonprofit, nonpartisan membership organization of about 40 million members, the AARP is dedicated to leading positive social change through research/information, advocacy, and service—consistent with its message: “AARP…The Power to Make it Better.”

The mission of the center is to assure that every American has access to a highly skilled nurse when and where they need one. The goals include the following:

• Increase education capacity to prepare more RNs with skills needed in the twenty-first century.

• Increase the number and diversity of nurses remaining in the profession to serve twenty-first century health care needs.

• Remove barriers that limit nurses’ ability to provide the health care consumers need.

• Increase the influence of nurses in high levels of health care, policy, business, and community decision-making.

The Center to Champion Nursing in America as A Consumer-Driven Force for Change

The CCNA leverages internal influence within the AARP in order to champion nursing solutions as part of changing how the nation delivers health care. For example, the AARP Board of Directors and its National Policy Council consider major strategic initiatives, which successfully promoted transitional care as one of its six major priorities in the health care reform law. The AARP, in collaboration with national nursing organizations, also successfully supported Medicare funding for graduate nursing education as part of health care reform. Through its policy and government relations divisions, the CCNA’s issues are considered in the larger context of consumer priorities. Since the nursing center has a full-time senior legislative representative funded and positioned in AARP’s Government Relations and Advocacy department, priority nursing issues such as increased funding for educational capacity get daily attention. The AARP also contracts the services of a well-known and respected expert consultant in nursing and health care policy at the federal level. Working closely with the nursing community, advocacy staff who focus on nursing issues have made significant progress in advancing policies that provide historically high funding for nursing education, with a focus on graduate preparation to increase the numbers of faculty and Advanced Practice Registered Nurses (APRNs).

The AARP is a large, complex organization, with a vast communications network. To facilitate the integration of messaging related to nursing, the center’s Manager of Communications and Outreach is also part of the Integrated Communications division at the AARP. She works closely with CCNA’s Information and Publications Manager to promote the flow of frequent and timely Web-based communications. The CCNA serves as a clearinghouse for nursing information through a web-based repository of information (issues and evidence-based solutions) for public reference.

Doctorally-prepared nurses serve as the center’s Chief Strategist, Director, and Strategic Policy Advisor. The Strategic Policy Advisor supports the evidence base for both policy analysis and Web-based resources. The center also assists AARP State Offices in addressing nursing issues at the state level, with the primary contact being a Senior Manager for Operations and Integration hired internally through the AARP.

The center leverages external influence in several ways, including the Champion Nursing Council, the Champion Nursing Coalition, and Champion Nursing Teams in 30 states. The center also convenes hill briefings, roundtables, forums, and summits.

The Champion Nursing Council is an advisory group made up of the four organizations of the Tri-Council (American Association of Colleges of Nursing, American Organization of Nurse Executives, American Nurses Association, and the National League for Nursing), along with other major nursing organizations with workforce planning and policy interests. The Champion Nursing Coalition represents the voices of consumers, purchasers, health care delivery systems and providers. Its purpose is to raise awareness about nurses’ roles in health care reform and achieve permanent solutions to the looming crisis of inadequate numbers of nurses with the right skill sets.

Champion Nursing State Teams represented 18 lead states selected in 2008 with 12 teams added in 2009. The work was initiated through two national summits on expanding nursing education capacity that CCNA sponsored in partnership with the RWJF, the U.S. Department of Labor’s Employment and Training Administration, and the U.S. Department of Health and Human Services Health Resources and Services Administration. The CCNA provides ongoing technical assistance (TA) in expanding capacity that relies upon and utilizes the recognized best practices and expertise of the original state teams to help advance and enhance the efforts of newer states. Recently, TA has focused on two learning communities of states already committed to either broadly implementing nursing education redesign or to expanding the use of technology to enhance nursing education. Site visits in 2009 included one to Oregon, featuring the Oregon Consortium for Nursing Education model (Tanner, Gubrud-Howe, & Shores, 2008), and the other to the Smart Hospital Regional Simulation Center at the University of Texas–Arlington. The learning communities also connect via an extranet accessed through the CCNA website. State team leaders reconvened in Washington in 2010. Among states with 2008 and 2009 comparative enrollment data in pre-licensure nursing education programs preparing registered nurses, 71% increased enrollments statewide, despite significant budget cuts.

In 2009, a Capitol Hill briefing was held on nurses’ roles in health care reform and targeted to Hill staff from key committees: Senate Finance; Senate Health, Education, Labor and Pensions; House Ways and Means; and House Energy and Commerce: Health Subcommittee. The briefing was followed later in the year by an AARP/CCNA Solutions Forum, in collaboration with Health Affairs and the RWJF. The solutions forum allowed the CCNA and the AARP to extend the message that the goals of health care reform and economic recovery would not be met unless we build, empower, and deploy a twenty-first century health care workforce. A richly-skilled and effectively integrated nursing workforce offers an essential tool for achieving high-quality health care. The AARP helped to raise the consumer voice around critical needs for more primary and preventive care, chronic care management and care coordination, and transitional care that are core elements of a more effective and efficient health care delivery system, in which nurses play a large role. The forum highlighted five Health Affairs papers on addressing nursing workforce issues as part of health care reform that were released at the event.