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  • Pipeline to Progress – Elms DNP Programs Prepare Nurses for Advanced Roles


    Three years ago, Elms College launched its Doctorate of Nursing Practice program in response to the specific needs of area health systems.
    Now, as the first class of 35 working nurses celebrates their milestone, they’re already making a difference.
    “Baystate Health has 16 incumbent registered nurses from across the health system that graduated this past weekend from the Elms DNP program,” said Patricia Samra, the health system’s senior director of Workforce Planning and interim senior director of Talent Acquisition.
    The 16 traveled two different tracks — six on the Adult Geriatric Acute Care Nurse Practitioner (AGACNP) track, and 10 on the Family Nurse Practitioner (FNP) track — and will sit for board certification and navigate the credentialing process over the summer months.
    “These soon-to-be-certified AGACNP nurse practitioners are exploring job opportunities across the enterprise and will be joining provider teams that serve hospitalized patients in specialty areas such as neurosciences, heart and vascular, critical care, palliative care, and hospital medicine,” Samra noted. “The FNP nurse practitioners will be joining provider teams in primary care, specialty outpatient practices, urgent care, and community health centers.”
    Representatives from Elms began meeting with clinical program teams at Baystate Medical Center and Berkshire Medical Center in 2012 to help the college tailor its DNP program — one of only two in Western Mass., the other being UMass Amherst — and each health system fully funded eight initial scholarships at Elms.
    Kathleen Scoble, dean of the School Nursing at Elms, said the DNP degree is becoming more sought-after in today’s clinical environment, which has become so complex that nurse practitioners need a broader range of knowledge and skills in clinical practice, as well as leadership and organizational expertise.
    “The DNP degree prepares our NP graduates to not only provide advanced clinical care for populations of patients, but to become leaders of care and change in transforming healthcare delivery,” she told HCN.
    National nursing associations have long called for nursing schools to expand their programs due to the rapidly changing healthcare landscape, due to reforms in the system, the aging population, the growing number of patients with complex medical needs, and a broad range of settings in need of nurses with advanced training.
    “These graduates are interviewing now or have already accepted NP positions in primary-care settings to serve patients in rural and underserved areas of Western Massachusetts, in urgent and emergency-care settings, hospital and critical-care units, and specialty clinics such as cardiovascular rehabilitation and palliative care,” said Dr. Andrew Storer, DNP coordinator and associate professor at Elms.
    Priming the Pump
    Nurse practitioners (NPs) are licensed, independent practitioners who practice in ambulatory, acute, and long-term care as primary and/or acute-care providers. They are registered nurses with specialized, advanced education and clinical competency to provide health and medical care for diverse populations in a variety of care settings.
    The family nurse practitioner boasts specialized knowledge and competency to provide comprehensive healthcare for diverse populations across the lifespan, typically in primary care, while adult-gerontology acute-care NPs specialize in managing diverse patients with complex acute and chronic health conditions across the entire adult age spectrum.
    Samra noted that Baystate Health’s (BH) collaboration with the Elms DNP program has assisted in the transformation of  the system’s workforce-planning efforts from standalone programs to a synergized workforce-development pipeline.
    “We have learned a lot during this journey and will continue to refine our pipeline strategies for advanced-practice providers to help BH live its mission to improve the health of the people in our communities every day with quality and compassion,” she told HCN.
    “What is most exciting about this milestone is the quality of the graduates,” she went on. “These new nurse practitioners have proven track records with BH as registered nurses and now present as very strong candidates for advanced-practice roles. Some are aggressively interviewing for current openings, while others are waiting for a specific opportunity to join teams they have worked with in the past as an RN. Regardless of the candidate’s approach, this cadre of future providers offers BH a readily available source of advanced-practice providers for current and future job openings.”
    Berkshire Health Systems is equally satisfied with the pipeline the Elms partnership has cultivated, said Elizabeth Kirby, director of Education at BHS.
    “Berkshire Health Systems recognized several years ago that we would be presented with challenges relative to upcoming physician retirements, especially primary-care providers,” she said. “It was essential, as part of our mission, to assure that the people within our community were still provided with sufficient, well-prepared primary-care providers. A contributor to this solution was the preparation of advanced-practice nurses.”
    The first graduating class produced 13 graduates for Berkshire County, Kirby noted. They were asked to rank their top three choices for employment, and are currently being matched with open positions, in areas including general surgery, emergency care, urology, the pain clinic, hospitalist medicine, and primary care.
    “We felt it was important to assure that both parties have as much information as possible to make an informed decision about possible work location,” she explained. “In some cases, shadowing experiences were set up to allow the NP graduate to have a better sense of the position they would be going into and also help the providers within the department to meet the NP graduate in their new role. We thought this would be helpful since all of these nurses had functioned at a different level previously.”
    Of the 35 inaugural graduates from the Elms DNP program, 23 chose the FNP track, while 12 opted for adult acute gerontology. The class of 2018 currently features 16 in the FNP track and six in the AGACNP track, respectively, while 2019 currently boasts 14 and five in the respective tracks.
    Next Step
    But that’s not all. This fall, Elms will introduce a third DNP track, in Health Systems Innovation and Leadership (HSIL). The program is designed to educate master’s-prepared nurses who are currently practicing in roles such as advanced-practice nurses (nurse practitioners, clinical nurse specialists, nurse midwives, and nurse anesthetists), as well as nurse leaders, nurse managers, and nurse educators.
    The doctoral-prepared nurses will be able to assume a wide variety of leadership roles as indirect- and direct-care providers. The program will examine innovations originating from current business models and evaluate quality initiatives that address complex health needs at the population-health and system levels.
    “Healthcare is fairly new to the science of innovation. Innovation stimulates unique solutions to problems or issues,” said Teresa Kuta Reske, director of the DNP program for the Elms College School of Nursing. “Throughout the DNP HSIL program, the students in healthcare settings will cultivate their innovation through their scholarly DNP capstone project, with the goal of improving quality of care and patient and family outcomes.”
    The new track is designed to blend nursing with other disciplines, such as business, and work with the college’s Center for Entrepreneurship. The graduate business students and the HSIL DNP students will develop skills for collaboration within seminar groups incorporating entrepreneurial approaches to advanced-nursing practices.
    “The DNP HSIL graduate will be a creative thinker and empowered as a doctoral-prepared practice leader for change,” Reske added, “which is the first step in bringing innovation to the forefront.”
    The college will enroll the program’s first students in August to begin studies in September.
    “We are excited to offer this new track in response to nurse practitioners’ and nurse leaders’ requests to acquire a higher level of knowledge and skills in order to lead effective change in healthcare,” Reske said — a good summation of the goal of Elms’ entire DNP program, which continues to prepare nurses for an increasingly complex world of care.

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