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Hassmiller highlights what states can learn from California Action Coalition


Susan B. Hassmiller, RN, PhD, FAAN, senior adviser for nursing at the Robert Wood Johnson Foundation, recently traveled to Sacramento, Calif., for a statewide gathering of the California Action Coalition.

Hassmiller is working with state action coalitions around the nation to implement recommendations in the Institute of Medicine’s “Future of Nursing: Leading Change, Advancing Health” report. The report advocates seamless academic progression to help nurses achieve higher levels of education; allowing nurses to practice to the full extent of their education and training; and making nurses full partners with other health professionals in redesigning healthcare in the U.S.

Nearly every state has an action coalition, though as Hassmiller notes, they have made varying progress in achieving their goals. Shortly after her visit to the California Capitol, Hassmiller spoke with about progress made by the California coalition and what others can learn from it.

Q: What progress has the California Action Coalition made?

Hassmiller: California was selected to be part of the Academic Progression in Nursing program. It was one of nine states awarded $300,000 for the first two years. California is ahead of the game in many different aspects. One of the most important things is that it has hired a paid director, Mary Dickow, MPA. In all of the other action coalition states, these are volunteer positions — the directors have other jobs. That puts the California coalition ahead already.

Q: Why is having a paid director so important?

H: Mary has been able to travel all over the state, making sure people understand what the IOM report is about and how they can play a role in implementing it. She worked to bring team leaders from around the state to the University of California, Davis for the statewide gathering, and other town hall meetings in Sacramento. She invites people other than nurses, which is important because nurses can’t do all the things needed to implement the report. She brings in high-level people from places like the California Department of Education and from state legislators’ offices who have influence over what nurses do. These people can make regulatory changes, allocate money, things nurses can’t do.

Q: What are some ways the California coalition is working to implement the IOM report?

H: California is going to have associate degree students start to take classes at California State University schools, creating a partnership with the community colleges and the CSU system for a seamless transition (to a four-year or higher degree). By the time students graduate, they will have a degree from the university. This is a more attractive incentive than giving them the option to opt out after completing requirements for an associate degree.

Q: How does the CAC work with other states?

H: One of the most important things we can do in these coalitions is to hook people up with each other around the country. Mary Dickow is one of our busiest state mentors. Mary is called upon a lot to work with other states to help set up their programs. Most recently I got her hooked up with Alaska, the last state to form an action coalition. They need help figuring out how to start, who are the different stakeholders, how to bring them in. It’s different sitting in Washington, D.C., telling someone how to do this. Mary can talk to people in another state because she’s done all of it.

Q: Which other state coalitions are doing innovative work?

H: Texas is making progress similar to California’s. North Carolina doesn’t have a paid director, but they have very good leadership. You can’t have a leader who just takes over. The best leaders know how to facilitate, to bring people in. That’s what you have in California, in Texas, in North Carolina. But everybody’s doing well in different areas.

Q: What message do you have for nurses working on action coalitions to implement the IOM report?

H: The work of implementing the IOM report is both a marathon and a sprint. It’s going to take a long time to get some of the things we want. There are things we need to do now, and there are things we need to spread out and give ourselves a break. This campaign is not about what’s going to make nurses happy or what is best for nurses. This is about what’s better for patients in this country.

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Cathryn Domrose is a staff writer. Send letters to or post a comment below.

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