The RWJFC and the ION Initiative: Advantages, Action Coalitions of Maryland, and Overcoming Barriers

This article discusses the RWJFC and the ION Initiative, which aimed to transform the nursing profession in the United States. It covers the four main pillars of the initiative, the advantages of the report, and the role of the action coalitions of Maryland. The article also examines the barriers to implementing the initiative and how they can be overcome.

Running head; The RWJFC and the ION Initiative 1
The RWJFC and the ION Initiative
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The year 2008 saw the launch of a two years initiative whose main aim was to assess the
nursing profession in the United States and bring a transformative effect on the future of nursing.
The initiative was launched by the Robert wood Johnson foundation committee (RWJFC)
together with the institute of medicine (IOM) which is today known as the Health and Medicine
Division (HMD). Two years later the initiative referred as the future of nursing; leading change,
advancing health was released by IOM. This paper focuses on the initiative, its advantages and
the role of the action coalitions of Maryland and how they have advanced the goals of the future
of nursing examining the barriers and how the barriers can be overcame.
The RWJFC and the IOM were able to produce an initiative that had four main pillars.
These pillars were set to be a tool of transformation in the nursing practice to produce a more
inclusive and action oriented method of service delivery. According to LoBiondo-Wood, &
Haber, (2017) the decision of forming the committee to focus on the nursing profession was
arrived at due to the fact that the nursing profession has the largest number of healthcare
providers making it the biggest pillar of health in the country. It was also noted that nurses had
the capability of transforming the healthcare sector but were limited by a number of barriers.
These and more other factors saw the formation of the committee that led to the future of nursing
report.
The four pillars of the report included a focus on professional indemnity which outlined
that nurses were to utilize all the education and skills acquired in their respective fields to the
fullest without any limitations. Another pillar saw the improvement of the education system
where it was possible for nurses to acquire higher level of education and skills with ease which
allowed them to increase their knowledge in the profession. This objective was to be realized

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through improving the education systems to make it accommodate these demands (Cronenwett,
et al 2007).
The other main pillar of the initiative was centered on collaborative efforts to unite all
health care providers with the main aim of promoting health services. The initiative urged nurses
to collaborate and cooperate with all healthcare providers such as doctors, clinicians and
nutritionists for the sake of the common good of the patients. This was seen as essential in
reshaping the focus of medical care to be for the best interests of the patients. Lastly, the fourth
objective of the initiative focused on the essence of making good plans and policies that will
foster efficient flow of information, through proper data collection, efficient record keeping and
effective management.
Importance of the report
According to Buerhaus, (2008) as a result of the report, the campaign for action was
initiated in all the states independently in order to arrive at the actions best suited for each
individual state. Several schools and other higher institutions have developed programs and
policies that have favored continuous learning for nurses and other health workers to boost their
skills in the field of health which in turn has increased the quality of health services. In addition
these policies and programs have also improved learning conditions of other students wishing to
advance their studies in different fields too.
The campaign for action has also improved collaboration and co-operation efforts
between different healthcare providers. The increased cooperation and collaboration has in turn
promoted learning and skills acquisition through sharing, common practices and setting goals. To
the larger population, the action plan has also promoted the service delivery through a common

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consciousness in the methods of inquiry and seeking services in the health sector. A greater pool
of advantages that include lowering of mortality rates, reduction of medical errors in diagnosis
and treatment, fewer cases of hospital acquired infections and quick recovery rates of patients are
among the many advantages that can be credited to the report and that have not only benefited
Americans but also people of other nations seeking medical attention in the United States
(Adams, Campbell, & Deming, 2017).
Maryland State Action Coalitions
The state action coalition of Maryland has been the major force behind the transformation
of medication and health care within the state. The action coalition has led to specific goals in the
path of improving health care. Some of the programs already in place include the leadership
development programs, education scholarships and funding opportunities, leadership coalition
summits and conferences and awards to exemplary outstanding individuals (Beauvais, & Kazer,
2017).
The role of the action coalition plan is to aid in realizing the four main goals of the
initiative of the future of nursing report by IOM. The action coalition plan therefore focuses on
advancement of education, leadership, eradication of barriers to medical care and improving
organization of workforce information. The two main initiatives brought up by the action plan in
Maryland are education and diversity. The main objective of the action plan is therefore to
enhance continuous education and promoting diversity and inclusiveness in the health work
force.
Education and diversity initiatives have been essential in advancement of the nursing
profession in various ways. In education for example, measures to promote lifelong learning

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have been put in place. An example is enabling transfer of credits and units from one institution
to another, measures to increase the number of people with doctoral education, sensitizing people
on various certification options to help them further their studies, there has also been increased
progression of best practices lessons that have been acquired in the practice. Finally, there is a
goal to ensure at least 80 percent of BSN educated nurses (National Academies of Sciences,
Engineering, and Medicine. 2016).
In respect to diversity, Maryland has developed strategic plans that have helped to foster
diversity in the state. This has been reflected through inclusiveness I the workforce and good
leadership. The state has also invented standards of measuring and assessing the level of
diversity which helps to respond to the needs of diversity and inclusivity in the state. There have
been several barriers in the place of implementing these strategies. These barriers include non-
compliance by some institutions to develop the relevant policies that favor life log learning.
Altman, Butler, & Shern, (2016) blames the bureaucracy of institutions is another
stumbling block to accessing education, insufficient finances to support implementation of these
initiatives and continued education is also another barrier to realizing these strategies. The
existence of private institutions as opposed to state owned institutions and hospitals has also
hindered implementation of these strategies as they may not actively participate in promoting the
strategies.
According to Wiseman, et al (2017) nursing advocates can however counter these
barriers in the action coalitions by continued sensitization on the need to uphold and adhere to
these strategies even in the private sector, influencing government legislation and policies to

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favor the implementation of these strategies. Seeking government and support from NGOs to
fund education and implementation of these strategies is another way of countering the barriers.

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