Florida Board Florida Board of Nursingof Nursing

AndAndCommission on Commission on Graduates of Graduates of

Foreign Nursing Foreign Nursing SchoolsSchools

Customer Satisfaction Survey and Analysis of Customer Satisfaction Survey and Analysis of StandardsStandards

Anthony R. JusevitchAnthony R. JusevitchRegulatory Supervisor/ConsultantRegulatory Supervisor/Consultant

Florida Board of NursingFlorida Board of Nursing

BackgroundBackground The Florida Board of Nursing currently has The Florida Board of Nursing currently has

approximately 300 applicants from foreign approximately 300 applicants from foreign schools awaiting permission to take the schools awaiting permission to take the NCLEX. All of these 300 people are waiting NCLEX. All of these 300 people are waiting for the Commission on Graduates of Foreign for the Commission on Graduates of Foreign Nursing Schools (CGFNS) education Nursing Schools (CGFNS) education credentials report. This has become an credentials report. This has become an issue not only with the Florida Board, which issue not only with the Florida Board, which ranks in the top 5 on foreign graduate ranks in the top 5 on foreign graduate applicants, but also with the National applicants, but also with the National Council of State Boards of Nursing.Council of State Boards of Nursing.

CUSTOMER SATISFACTION CUSTOMER SATISFACTION SURVEYSURVEY

This project was initiated This project was initiated by the issues raised by the issues raised between Florida Board of between Florida Board of Nursing (FBON), foreign Nursing (FBON), foreign licensure applicants and licensure applicants and the Commission on the Commission on Graduates of Foreign Graduates of Foreign Nursing Schools (CGFNS).Nursing Schools (CGFNS).

Florida is one of the top Florida is one of the top states for the number of states for the number of foreign trained nurses foreign trained nurses applying to take the applying to take the NCLEX. NCLEX.

Over the past two years Over the past two years there have been numerous there have been numerous meetings, letters, e-mails meetings, letters, e-mails and general and general correspondence between correspondence between the FBON and CGFNS. the FBON and CGFNS.

The guidelines and The guidelines and standards for credentialing standards for credentialing agencies have been set by agencies have been set by the FBON. the FBON.

This project will attempt to This project will attempt to show how well the show how well the objectives have been met objectives have been met and the satisfaction in and the satisfaction in service the applicants have service the applicants have with the FBON and CGFNS.with the FBON and CGFNS.

ObjectivesObjectives Determine the time frame an Determine the time frame an

applicant waits for the Florida Board applicant waits for the Florida Board to receive applicant’s CGFNS to receive applicant’s CGFNS reports. reports.

Find out the countries applicants are Find out the countries applicants are moving to Florida from.moving to Florida from.

Gauge the overall customer Gauge the overall customer satisfaction of the FBON and satisfaction of the FBON and CGFNS.CGFNS.

Determine the level at which CGFNS Determine the level at which CGFNS is living up to its standards.is living up to its standards.

ObjectivesObjectives The survey questions below were sent to a The survey questions below were sent to a

random sampling of 100 of the 300 current random sampling of 100 of the 300 current pending applicants and the pool will be made pending applicants and the pool will be made up of the returned surveys.up of the returned surveys.

The project also shows the following The project also shows the following statistical data on the tie it takes for a CGFNS statistical data on the tie it takes for a CGFNS report to be received by the FBON after the report to be received by the FBON after the licensure application has been received.licensure application has been received.

Percent of applicants waiting and time Percent of applicants waiting and time waiting in 3 month incrementswaiting in 3 month increments

Countries applied from and the percentage Countries applied from and the percentage from eachfrom each

Credentialing Credentialing Agency Performance Agency Performance

StandardsStandards

In addition to meeting criteria in In addition to meeting criteria in Florida Administrative Code Florida Administrative Code 64B9-3.014, the following 7 64B9-3.014, the following 7

standards are desirable criteria standards are desirable criteria for performance and the for performance and the desired compliance rate.desired compliance rate.

Credentialing Credentialing Agency Agency

Performance Performance StandardsStandards

1. Agency provides a full, completed report to the 1. Agency provides a full, completed report to the Board of Nursing Board of Nursing within 90 days receipt of within 90 days receipt of application by credentialing agency via application by credentialing agency via secure methods, including electronic formats.secure methods, including electronic formats.

Compliance rate 90% Compliance rate 90%

2. If applicant information is incomplete, a 2. If applicant information is incomplete, a mechanism is in place mechanism is in place to communicate to communicate status to applicant within the first 30 days and status to applicant within the first 30 days and at least every 90 days. at least every 90 days.

Compliance Rate 90% Compliance Rate 90%

3. Credentialing reports contain summary table 3. Credentialing reports contain summary table with number of with number of theoretical and clinical theoretical and clinical hours in areas of medical, surgical, hours in areas of medical, surgical, pediatric, obstetrics and psychiatry.pediatric, obstetrics and psychiatry.

Compliance Rate 100% Compliance Rate 100%

Credentialing Credentialing Agency Agency

Performance Performance StandardsStandards

4. Credentialing reports contain information on 4. Credentialing reports contain information on completion of completion of specific courses in anatomy & specific courses in anatomy & physiology, sociology , nutrition, physiology, sociology , nutrition, and and pharmacology. If multiple theoretical content is pharmacology. If multiple theoretical content is integrated integrated into course specific detail is provided into course specific detail is provided about the content.about the content.

Compliance Rate 100% Compliance Rate 100%

5. Agency responds to a BON applicant inquiry 5. Agency responds to a BON applicant inquiry within 48 hours within 48 hours via e-mail or phone. via e-mail or phone.

Compliance Rate 90% Compliance Rate 90%

6. Agency Provides quarterly reports within 30 6. Agency Provides quarterly reports within 30 days of end of days of end of quarter to BON on a number of quarter to BON on a number of applications, reports in progress applications, reports in progress and reports and reports completed. completed.

Compliance Rate 100% Compliance Rate 100%

7. Agency provides BON access to credentialing 7. Agency provides BON access to credentialing reports and reports and report status via secure Internet. report status via secure Internet.

The Information Listed Below isThe Information Listed Below isIllustrated in the Charts that Follow:Illustrated in the Charts that Follow:

The service given to and the experience of the The service given to and the experience of the foreign graduates with the Florida Board of foreign graduates with the Florida Board of Nursing and the Commission on Graduates of Nursing and the Commission on Graduates of Foreign Nursing Schools.Foreign Nursing Schools.

The countries the applicants are graduating The countries the applicants are graduating from and the percentage from each country.from and the percentage from each country.

The number of months it takes to get a report The number of months it takes to get a report completed by CGFNS.completed by CGFNS.

Additional fees paid to the FBON and the Additional fees paid to the FBON and the response time for CGFNS to the foreign response time for CGFNS to the foreign applicants.applicants.

0

0.5

1

1.5

2

2.5

3

3.5

4

4.5

Service and Experience to Applicants

BON Service

BON Experience

CGFNS Service

CGFNS Experience

Scale; 1=Very Poor

2=Poor 3=Satisfactory

4= Above Average

5=Excellent

1

0.00%

5.00%

10.00%

15.00%

20.00%

25.00%

30.00%

Percentage of applicants from each country

1

0%

10%

20%

30%

40%

50%

60%

70%

Number of Months Waiting for CGFNS Report

0

5

10

15

20

25

1

Fees to FBON and Response Time for CGFNS

NO Yes N/A

Additional Fees to FBON?

30 Day

90 Day

CGFNS

CGFNS

Phone response from CGFNS

Within 48 Hours

SURVEYSURVEY OUTCOMES OUTCOMES To facilitate the expeditious processing of initial To facilitate the expeditious processing of initial licensure applications by exam candidates graduating licensure applications by exam candidates graduating from foreign schools the Florida Board of nursing has from foreign schools the Florida Board of nursing has taken the following steps:taken the following steps:

1. The FBON has approved two new credentialing 1. The FBON has approved two new credentialing agencies for the agencies for the applicants to use. These measures show applicants to use. These measures show

a. Create a competitive marketa. Create a competitive marketb. Speed up the credentialing of foreign b. Speed up the credentialing of foreign

graduatesgraduatesc. Improve customer service for the FBON and c. Improve customer service for the FBON and

the credentialing the credentialing agencies agenciesd. Save the foreign graduates moneyd. Save the foreign graduates moneye. Allow the FBON to more rapidly determine e. Allow the FBON to more rapidly determine

NCLEX eligibility NCLEX eligibility for the graduates for the graduates

2. The FBON is now offering graduates from Canadian 2. The FBON is now offering graduates from Canadian schooschoo programs were in English to sent their transcripts to programs were in English to sent their transcripts to the FBON and be the FBON and be evaluated for proper credentials by our nursing evaluated for proper credentials by our nursing consultant staff to consultant staff to determine NCLEX eligibility. This measure bypasses determine NCLEX eligibility. This measure bypasses the credentialing the credentialing agencies, agencies, saving the applicants time and money. saving the applicants time and money.

3. Renewed and improved communication with CGFNS 3. Renewed and improved communication with CGFNS providing for a providing for a better avenue to resolve applicant conflict. better avenue to resolve applicant conflict.

It is the FBON’s wish to continue to work closely with It is the FBON’s wish to continue to work closely with CGFNS and the two newly approved credentialing CGFNS and the two newly approved credentialing agencies to reduce response time and to cut down on agencies to reduce response time and to cut down on cost and redundancies. This is all done in an effort to cost and redundancies. This is all done in an effort to improve customer service to the foreign graduates and improve customer service to the foreign graduates and to continue to license quality nurses into Florida and to continue to license quality nurses into Florida and the United States.the United States.

SURVEYSURVEY OUTCOMESOUTCOMES