Background to the Oregon Simulation Alliance Initiative

The current shortages began developing as demand for workers increased and hospitals began adding positions after an earlier period of layoffs. Demand increased further as technological advances created new opportunities for workers. In early 2001, the Northwest Health Foundation issued a report:  Oregon’s Nursing Shortage, A Public Health Crisis in the Making. The report examined the state’s nursing shortage and challenged Oregon to immediately begin developing a coordinated statewide effort to meet both current and future need. The Oregon Nursing Leadership Council (ONLC) responded by developing a strategic plan that included a call for the state’s nurse educators to double nursing program enrollments to ensure an adequate supply of nurses.

By early 2002, the Oregon Workforce Investment Board (OWIB), representatives for Governor Kitzhaber’s Healthcare Initiative, and key stakeholders met to broaden the examination of healthcare workforce shortages to include health occupations across disciplines and to provide targeted solutions to address the shortages. The legislative Interim Task Force on Health Care Personnel coordinated the work of the group’s Steering Committee and three strategy teams: an employment strategy team, a workplace issues team, and an occupational training and education team.  At the same time, the OWIB also created a committee to look at the healthcare workforce shortages.  A synthesis of this work is contained in the report, Healthcare Sector Employment Initiative: Taking “AIMM” at a Growing Crisis.

As an outcome to this report, the Oregon Legislature established healthcare workforce training as a priority and, through a budget note, charged the state’s community colleges and the Oregon Department of Community Colleges and Workforce Development (CCWD) to prioritize training the next generation of the state’s healthcare workforce.

By September of 2002, ONLC’s education committee recommended bringing together private university schools of nursing, public community colleges, and the four-campus system of Oregon Health & Science University School of Nursing. The new initiative, the Oregon Consortium for Nursing Education (OCNE), was developed as a response to the state’s nursing shortage and the ONLC 2001 Strategic Plan.  OCNE’s focus is to increase nursing education capacity and enrollment and prepare program graduates to address rapidly changing healthcare needs.  Developing and using clinical simulation was identified as a strategy to increase clinical opportunities, and to help reach this goal.

In August of 2003, Oregon’s new Chief Executive, Governor Kulongoski, took action to address the healthcare workforce shortages. The Governor appointed a coordinator to work with the Governor’s Office of Education and Workforce Policy to analyze work done under the previous administration and to assess current partnership activities and multi-sector initiatives. The focus was on directing and implementing a coordinated statewide response to healthcare workforce issues. The coordinator was charged with assessing current workforce education across the state, prioritizing previous legislative and government task force recommendations, and helping to develop policy for the Governor’s Healthcare Initiative. One result of this work was input that identified six key elements of the initiative.

The Governor’s Healthcare Workforce Initiative recognized simulation as key to increasing healthcare workforce training capacity by developing additional clinical training “slots” using simulation. A “Statewide Simulation Alliance” was formed to develop a plan to implement this capacity building strategy.

The Oregon Simulation Alliance is an innovative and creative public/private partnership, and multi-sector alliance which serves as a model for other multi-sector initiatives. The Governor’s office coordinated the work of the OSA through 2005 and then the OSA became a nonprofit corporation with a contracted Executive Director.  The OSA is both an advisory group and an oversight committee that combines the strength and expertise of key players in the state. The OSA Governing Council includes representation from state’s community colleges, public and independent four-year colleges and universities, healthcare provider organizations and simulation users.

The group is charged with developing and expanding simulation capacity in all regions of the state for multi-sector, multidisciplinary and interdisciplinary use for healthcare workforce development, including pre- and post-service, career-ladder, and re-entry/refresher programs. The goal is to integrate simulation capacity into healthcare curricula, train and network simulation faculty, and make simulation available over the state’s broadband Internet network fully accessible, and ensure that simulation is affordable for all education and service groups in the state.

To begin integrating simulation into the healthcare training system, the Alliance focused on strategies that included a series of collaborations around the state to distribute simulation statewide and create a network of simulation centers. This “network of networks” is charged with developing shared curricula and simulation scenarios, providing for the training of trainers around the state, and equipping each region with simulation and telecommunications capacity affordable and available to all sectors and healthcare disciplines in the region on a twenty-four hour, seven days per week basis.

The Oregon Simulation Alliance initiative is a targeted Oregon response to address capacity issues, including shortages of clinical sites and faculty, and distance education that brings together statewide partners to work in a new way. This groundbreaking alliance is significant because it provides a new partnership model across sectors and across healthcare disciplines.