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Governor’s Task Force on Nurse Workforce and

Patient Care
Meeting Summary

May 31, 2007

Meeting Participants:
Task Force Members Staff Nurse, Ambulatory Surgical Unit
Sen. Betty Boyd Boulder Medical Center
(D-Lakewood), Senate District 21 Kristy Reuss
Department Head, Department of Health Sciences,
Ned Calonge
Mesa State College
Chief Medical Officer, Colorado Department of
Nancy Smith
Public Health and Environment Dean and Professor
Sue Carparelli Denver School of Nursing
President & CEO, Colorado Center for Nursing Patty Stewart
Excellence Senior Staff Nurse SICU
Ken Cochran Medical Center of Aurora
CNO, Colorado Plains Medical Center Kathy Van Soest
Director TCU & CAIR
CJ Cullinan North Colorado Medical Center
Staff Nurse, Craig Hospital and Julia Temple Long
Term Care Bob Yakely
Vice Speaker, CMS House of Delegates
Colleen Goode
Vice President of Patient Services, University of Participating by Phone
Colorado Hospital Mary Pat DeWald
Eve Hoygaard Staff Nurse, Sexual Assault Nurse Examiner
President, Colorado Nurses Association Integrated Health, Inc.
Nurse Practitioner Family Planning Clinic
Judy Hutchinson Members Absent:
Staff Nurse, Orthopedics, Rep. Jim Kerr
Exempla Lutheran Hospital (R-Littleton) House District 28
Rep. Jack Pommer
Donna Kusuda (D-Boulder) House District 11
Vice President of Quality and Risk Management,
HealthONE Staff:
Kate Mixdorf Chris Adams
Vice President of Nursing/Quality Operations Facilitator
Heart of the Rockies Regional Medical Center The Adams Group
Sharon Pappas Lynn Marie Bell
CNO, Porter Adventist Hospital Project Coordinator
Bernie Patterson The Adams Group

Facilitator: Chris Adams, chris@theadamsgroup.org 1


Project Coordinator: Lynn Marie Bell, bell@theadamsgroup.org
Overview of Key Points and Decisions:
 Governor Bill Ritter addressed the Task Force, highlighting the opportunity
before members to make a substantial contribution to health care in Colorado.
 Draft bylaws were discussed and approved.
 Task Force members shared their perspectives on Items A-H of the Executive
Order.
 The Task Force selected resources with which each member will become
familiar. Members agreed to forward articles and web addresses to the
Project Coordinator for dissemination to all members.
 The Task Force discussed guiding principles for a nurse quality measurement
process. A draft set of principles will be discussed at the next meeting.

Member Perspectives on Items A-H of the Executive Order


Commissioners shared a wide variety of perspectives on the work of the Task Force.
Some perspectives include:
 Public safety should be the highest goal of the task force. We need to find
good solutions that provide appropriate information for patients and contribute
to good health outcomes.
 This effort is part of a broader national effort to select nurse-related care
markers. Other states are watching Colorado.
 It will be important to identify or develop nurse-centered outcomes that are
broadly recognized as being important.
 Each member has an important role to play on the Task Force based on her
or his own experience.
 It is exciting and important that nurses have the opportunity to participate in a
process such as this Task Force, which provides the opportunity for a different
type of conversation than in the Legislature.
 The collaborative process is key to resolving the issues of quality care,
appropriate staffing and patient outcomes.
 We need to put any past history behind us and look at all issues in a fresh
way.
 We need to be careful about how we look at data as the interpretation of facts
can tell different stories.
 We need to provide information that is understandable and applicable to the
lay consumer that will influence patient decisions.
 Nurse satisfaction and the nursing environment are keys to providing quality
care and improving patient outcomes.
 Experienced bedside nurses must play an important role in determining the
quality of the nurse and patient environment.
 We need to consider rural and small hospital perspectives, not just large
urban hospitals.

Facilitator: Chris Adams, chris@theadamsgroup.org 2


Project Coordinator: Lynn Marie Bell, bell@theadamsgroup.org
Comments from Governor Ritter
 Collaboration is key to resolving contentious health care issues.
 This Task Force represents a new approach to resolving issues that the
legislative process has not adequately addressed.
 The task force is doing important work that will complement and inform other
healthcare reform efforts such as the 208 Commission.

Discussion of Ground Rules


Ground Rules for the Task Force were presented and approved. Members requested
additional clarification on how Colorado’s Open Meetings law applies to the Task
Force.

Review of Suggested Data Sources


The Task Force reviewed a list of data sources suggested by task force members
prior to the plenary session. As a result, the following decisions were made:
 The Task Force identified national examples of nurse staffing reporting and
measures (Item B of the EO), including the NQF, NDNQI, AHRQ and JCO
measures.
 The Task Force identified additional resources that it agreed to become
familiar with, including the Hospital Report Card, nurse satisfaction surveys,
and articles by Aiken, Needleman and Buerhaus, among others.
 Members agreed to be responsible for researching specific electronic and/or
hard copies of resources.
 Members will forward resources to the Project Coordinator who will create a
resource library and disseminate resources to all Task Force members.

Presentations to the Task Force


 The Task Force requested presentations or meetings with:
o representatives of The Joint Commission project who are undertaking
a test of nursing sensitive measures developed by the National Quality
Forum. Steven Summer of the Colorado Hospital Association will help
to arrange this.
o the committee that is responsible for the Colorado Hospital Report
Card. Two members of that group, including its chair—Donna Kususda
—are also Task Force members, and will help to arrange this.

Discussion of Guiding Principles for a Quality Measurement Process for


Nursing
 Members discussed the meaning of the Executive Order’s directive to
“develop guiding principles that will lead to a quality measurement process for
nursing."

Facilitator: Chris Adams, chris@theadamsgroup.org 3


Project Coordinator: Lynn Marie Bell, bell@theadamsgroup.org
 Members made many points to be reflected in the guiding principles including:
information must be understandable to the public, the process must be
evidence- and outcome-based, measures must be nationally endorsed and
vetted, the process should be standardized across facilities yet customizable,
and they should reflect acuity. Data collection should be feasible and
economically sound, and it should reflect the bedside environment.

Interaction with the 208 Commission


Governor Ritter asked the Task Force to consider how its mission and scope of
work related to the 208 Commission, which is primarily focused on health care
access and coverage, though it is also reviewing proposals to increase safety
and improve quality. The Task Force agreed that that the work of the two bodies
should coordinate to the extent that it is useful and practical. The Task Force
agreed on two steps regarding the 208 Commission:
 The co-chairs will nominate interested task force members to the 208
Commission's provider task force and rural care task force.
 In July or August, a meeting will be arranged between some task force
members and 208 Commissioners.

Schedule of Next Meetings


 The Facilitator will circulate a date picker program to all members to
reschedule the June, July and September meetings. Task Force members
approved the August 24, October 26, November 30 and December 19th
meeting dates.

Facilitator: Chris Adams, chris@theadamsgroup.org 4


Project Coordinator: Lynn Marie Bell, bell@theadamsgroup.org