History

The Navigator Program was originally designed by six University of Michigan Executive MBA students, two of whom, Nancy Dunlap (Chief of Staff, Kirklin Clinic) and Mike Waldrum (Chief Operating Officer of UAB) are from Birmingham.  The following information comes from the group’s original report, produced in 2008 outlining how they sought to alleviate what was then a prevalent nursing shortage while supporting impoverished communities around Birmingham.  The outlined program contains three phases.

• The pre-nursing phase:
  • targets disadvantaged primary and secondary school children
  • provides students with nurse mentors
  • promotes nursing career awareness
  • coordinates educational and other related activities
• The nursing phase:
  • targets students who continue to pursue nursing careers post secondary school
  • allocates funding and scholarships to aid students through nursing programs
  • places students with nursing mentors in training environments.
• The post-nursing phase:
  • assists newly graduated nurses with job placement
  • coordinates career advancement opportunities.

The Navigator Program serves as a pipeline to foster the development of underprivileged youths into the rewarding career of nursing.

Health Care Overview

The United States currently faces a nursing shortage crisis that without significant and timely intervention threatens the well-being of our population. HRSA estimates that by 2020 our country will suffer from a shortage of over 1 million nurses. The health and financial implications of this gap are staggering when one considers that nurses constitute the greatest percentage of providers of health care to our society.

The situation in the State of Alabama is similarly grave. In 2020, Alabama is conservatively anticipated to have a shortage 5,300 nurses. This number will likely be even higher should the state enjoy significant economic growth that is now anticipated from industries such as the automotive industry.

Ironically, while Alabama desperately needs more people to pursue careers in nursing, it also has a large population of young men and women in under-privileged, predominantly African-American communities that are in desperate need of access to career opportunities. With those two synergistic needs in mind, a group of six executive MBA students at the University of Michigan partnered with leaders of the University of Alabama at Birmingham (UAB) Health System, UAB School of Nursing, and UAB School of Public Health to develop a practical and sustainable program that will address the nursing shortage by preparing, encouraging, and assisting disadvantaged members of the local, Birmingham community to become future nurses.

Birmingham-Specific Situational Analysis

The nursing shortage is both driving up the cost of health care and is threatening health care quality. In addition to the downturn in the quality of care, our calculation shows that the 23 hospitals in the Birmingham Hoover metropolitan area will suffer a total of over $200 million decreased contribution margin annually by year 2020 if solutions for the nursing shortage are not identified and implemented.

The Birmingham Hoover metropolitan area has a population of 657,229 located within the ninth poorest state in the nation. There are several disadvantaged, predominately African-American communities within Birmingham that are home to many talented young men and women who would benefit from a career in nursing. However, at this time they do not have realistic access to the full array of nursing educational options.

The development and coordination of a Birmingham nursing workforce “pipeline” can help resolve the statewide nursing crisis in addition to aiding underprivileged communities in fighting poverty and improving the health of their own citizens.  Many Birmingham institutions, associations, religious groups, and community groups are already running various successful initiatives that could potentially benefit a nursing pipeline.  However, they require coordination and occasionally some minor adjustments to tailor them for nursing development.

Barriers of Minority Entry into Nursing:

Despite the availability of these existing initiatives, the current state of the nurse development pipeline has a number of barriers that prevent a potentially qualified student from becoming a nurse.  In the pre nursing phase, students lack awareness of nursing as a career option or have many misperceptions about nursing.  They lack affective mentors to assist in their educational and social development.  Some students need additional educational assistance to get their academic achievement to the required level to become a nurse.  In the nursing phase, there is under-representation of African American nurses, minimal mentoring of the nursing students, high drop out rates, and poor coordination between the different nurse educational pathways. In the post nursing phase, the lack of coordination between the different nurse educational pathways prevents interested students from gaining advanced degrees.  This barrier impedes interested and potentially qualified nurses from getting the advanced degrees that are required to become nurse educators or to qualify for career advancement.

Proposal

We propose to create a non profit organization, “The Navigator Program”: This program will optimize the nursing workforce pipeline in Birmingham by coordinating the existing initiatives and by implementing new programs that are needed to overcome the barriers in the existing nurse development pipeline.

These programs with their functions include:

Mentoring: The mentoring function should support students through the different phases of their educational pathway.

Marketing: The marketing function should increase awareness in target population that nursing is an attractive and obtainable profession.

Funding: The funding function should identify and supply financial resources needed for successful completion of nursing studies.

Coordination: The coordination function should identify optimal pathways for students, including articulation, and support transition through the different programs within those pathways.

Job Placement: The job placement function should identify employment opportunities and facilitate placement into the jobs.

Recommendations for the following components of The Navigator Program were specifically addressed by the work group:

• Governance and Organizational Structure
• Marketing Plan
• Mentoring Plan
• Coordination of Educational Initiatives
• Stakeholder Endorsement
• Funding and budget (pro forma)
• Balanced Scorecard for Organizational Self-assessment and Accountability
• Keys to Successful Implementation
• Risk and Mitigation

The Navigator Program is anticipated to result in fifty additional nurses within the first two years. The cost per nurse produced by The Navigator Program is highly competitive with other methods for alleviating the nursing shortage such as importing nursing professionals. However, The Navigator Program will have the additional benefit of supporting development of the local community.