Category Archives: RWJF Leaders
By Risa Lavizzo-Mourey, MD, MBA, President and CEO, Robert Wood Johnson Foundation
Today’s ruling by the Supreme Court allows the nation to move forward on the road to better health.
The Affordable Care Act, when fully implemented, will expand the number of people with health coverage, introduce strategies for improving the quality of health care, and support plans to make our communities healthier places. For that reason the Robert Wood Johnson Foundation has committed significant resources to help nonprofit organizations, states, communities and the private sector realize the full potential of the law. Today’s ruling by the Supreme Court permits the implementation process to continue in full force, and we look forward to working with everyone who shares our goals to make meaningful improvements in the health and health care of our country.
Improving access to stable, affordable health care is not a partisan issue to us. We’ve been at it for decades, working with people and organizations of all sorts. The Affordable Care Act brings us wonderfully close to achieving that mission. But our ultimate goal of helping Americans lead healthier lives will require more than simply implementing the law. Health care spending continues to rise and crowd out investments in other areas; even for people with insurance, high out-of-pocket costs can be a barrier to accessing care. Furthermore, our health is not just something that comes from the doctor’s office. Community and neighborhood conditions have a significant effect on health. The Affordable Care Act offers ways to address many of these aspects of health, and we will continue to pursue opportunities stemming from the law and elsewhere to improve the health of our nation.
Last summer, in anticipation of the Foundation's 40th anniversary and of her tenth year at the helm, Robert Wood Johnson Foundation (RWJF) President and CEO Risa Lavizzo-Mourey, MD, MBA, took on a challenge of a different sort. Together with her adult daughter, she joined a team climbing to the "Roof of Africa," the summit of Mount Kilimanjaro.
In her 2012 President's Message, Lavizzo-Mourey tells the tale of the trek, and recalls the advice her hiking group leader gave her:
• Measure each pace — Step. Pause. Step. Pause.
• Keep progress slow, but steady.
• Always onward. Always upward.
• Maximize progress. Minimize risk.
• Know your limits.
• Know when to stop / rest so you don’t have to stop / halt.
Lavizzo-Mourey writes, "It wasn’t until I was back on the job in Princeton that I realized these are the same basics RWJF has followed over the past four decades. That’s when it hit me: As we push our philanthropy to higher and higher levels, the one mountain that really matters is the mountain RWJF’s been trying to move all along!"
That mountain, of course, is the challenge of improving health and health care for all Americans, and RWJF has invested $9 billion in the effort over the last four decades. Lavizzo-Mourey continues:
In our practice of philanthropy, this is where the “Kilimanjaro Effect” comes into play. Step by step we progress onward. We may have to “discover the new terrain” and new ways to traverse it. It may take us a generation, or two or three, but we have the will and the means to hang in there until momentum occurs, progress is secured, and evidence confirms that the change we seek is producing positive results. If it is not—well, we have learned the hard way to know our limits, when to step, when to pause, when to stop, suspending the climb for a better route on a better day. Ours is a spirit of resilience and resolve our founder and namesake built into our philanthropic DNA from the very start.
Happy National Nurses Week! Today is National Nurses Day, and the beginning of a week during which we celebrate the contributions of this profession. The week fittingly ends with Florence Nightingale's birthday on Saturday, May 12. The Robert Wood Johnson Foundation (RWJF) has a proud history of supporting nurses and nurse leadership, so this week, the RWJF Human Capital Blog will feature posts by nurses, including leaders from some of the Foundation’s nursing programs. Check back each day to see what they have to say. This post is by Susan B. Hassmiller, PhD, RN, FAAN, RWJF Senior Adviser for Nursing and Director, Future of Nursing: Campaign for Action.
Earlier this month I had the privilege of traveling to Montana to help some of the state’s health care leaders launch the Montana Cooperative to Advance Health Through Nursing. This new state-based Action Coalition is working to advance recommendations from the Institute of Medicine report, The Future of Nursing: Leading Change, Advancing Health.
While I was there, I met with Native American nursing students and their mentors at Montana State University. They are part of the extraordinarily impressive “Caring for Our Own: A Reservation/University Partnership,” known as the CO-OP program. These students come from desperately underserved areas and, after they graduate, they will go back to their reservations to provide culturally-sensitive, urgently needed care.
At the Action Coalition gala, the recipient of the student award told her story, moving many of us to tears. When she was 17, she tried to commit suicide. It was a nurse who saved her life, and convinced her there were things to live for and gifts she had yet to share. She told the audience that the nurse had been her role model through hard times. It had taken her many years and she had overcome many more hardships, she explained, but she will soon graduate and give back in the same way that her role model had given to her.
She and her peers are the kind of strong, dedicated, caring professionals that nursing needs, our health system needs, and patients need. I came home invigorated and encouraged by all the Montanans I had met, and the promise of progress in this state.
Today is National Nurses Day, which begins the celebration of National Nurses Week. We are a diverse profession, serving patients in more ways, more roles and more settings than Florence Nightingale—whose birthday, May 12, concludes National Nurses Week—could have ever imagined.
I am proud to be a nurse, proud of my colleagues working to help patients all over the country, and proud that the Robert Wood Johnson Foundation (RWJF) has a long history of supporting nurses in many roles, from research to practice to leadership and more.
RWJF recently announced the launch of the Academic Progression in Nursing (APIN) initiative, which will help state Action Coalitions in their work to advance the recommendation in the Future of Nursing report that 80 percent of the nursing workforce be prepared at the baccalaureate level by 2020.
I am an associate’s degree nurse. I started my nursing education at a community college, and at that time, I’m not sure I could even have imagined getting to where I am today.
By Jasmine Hall Ratliff, MHA, program officer, Robert Wood Johnson Foundation
In 2010 Grantmakers in Health, an affiliation of health funders across the country, launched the Terrance Keenan Leadership Institute for Emerging Leaders in Health Philanthropy (TK Institute) to commemorate the life and leadership of long-time Robert Wood Johnson Foundation (RWJF) leader Terrance Keenan. The TK Institute was created to nurture the next generation of leaders, build relationships among them, and connect them with established figures in the field.
Terrance Keenan, affectionately called Terry, created and led many RWJF signature funding programs that included the Nurse Faculty Fellowships, Community Care Funding Partners Program and the Interfaith Volunteer Caregivers Program (which later became Faith in Action). (You can read more about Terry here.)
I was fortunate enough to be nominated and then selected to represent RWJF in the inaugural class of the TK Institute. Other participants came from foundations in Massachusetts, Ohio, Missouri, New York, North Carolina, Texas, Washington, DC and California; they worked at community, private and family foundations with assets across all ranges. Though we represented different regions and health priorities, we had many things in common: we were under the age of 40 and had a passion for moving philanthropy forward as a field.
By David Krol, MD, MPH, FAAP, Robert Wood Johnson Foundation Human Capital Portfolio Team Director and Senior Program Officer
For many Americans, a visit to the dentist is a rarity—not by choice, but because their health plans don’t cover dental care, they can’t afford it, or because there is no dentist anywhere near where they live or work. If you’re on Medicare, you know that dental isn’t covered. If you’re part of the VA system, you know that dental benefits are treated differently. If you’re an adult on Medicaid or serve adult patients who are on Medicaid, you know the chances are slim that there’s great coverage for dental care, unless you are lucky to be in a state that still covers it. Why does this happen and what can result?
A study recently released by the Pew Center on the States offers startling data on the scope of the problem and its consequences. In 2009, some 830,000 Americans visited an emergency department for a preventable dental condition. It should be obvious that the emergency department isn’t the best place to seek dental care. The same year, 56 percent of Medicaid-enrolled children got no dental care whatsoever, not even a routine exam. That’s no care even with insurance for it!
Those numbers are alarming for many reasons, but mostly because they reveal a significant public health challenge confronting the nation: Many Americans simply aren’t getting the oral care they need, at any age, including the basic preventive services and education that can detect oral disease in early stages. They are putting their health at risk, and increasing the strain on an already-overwhelmed health care system.
It's Spring and Allergy Season is Upon Us. Is our Primary Care Workforce Ready to Meet Patient Needs?
By Nancy Fishman, BSN, MPH and Maryjoan Ladden, PhD, RN, FAAN. Fishman and Ladden are senior program offers at the Robert Wood Johnson Foundation
Spring is blooming all around us here in central New Jersey and that means nice weather, flowers and a constant search for allergy solutions! For those of us on the Robert Wood Johnson Foundation (RWJF) Human Capital team, this brings up several questions about how to use the primary care workforce more creatively. In this scenario, who in the primary care office could help us with our common allergy symptoms? How would we feel if we went in for a visit and didn’t see a health professional but were instead counseled about common over-the-counter treatments by the medical assistant according to standard protocol?
These are questions that seem practical and every day, but tie back to some basic questions about the primary care workforce and how we could be more creative in using all members of that workforce to improve patient access to care and the value of that care.
At the Robert Wood Johnson Foundation, we are all aware of the shortage of primary care providers – but short of producing a large number of physicians, nurse practitioners and physician assistants this instant – we need to get creative with what we have.
To that end, we are thrilled to be launching a new program to identify those practices that are already creatively using their whole office teams in new ways. This program “The Primary Care Team: Learning from Effective Ambulatory Practices” (LEAP) will first identify and then study sites that have succeeded in providing high quality health care and involving all staff in new and creative ways.
We believe that studying these sites will provide us with insights that we can share with other practices that would like to make changes.
By Risa Lavizzo-Mourey, MD, MBA, President and CEO, Robert Wood Johnson Foundation
Change is a constant in health care. In the face of skyrocketing costs, system fragmentation, health disparities and an aging and sicker population, more care will be delivered in primary care and community/public health sites than in acute- and hospital-based settings. Yet we also face a primary care shortage and the coming infusion of 32 million newly insured people into the system.
To ensure an adequate supply of nurses with the advanced skills and expertise necessary to help bridge the gap while ensuring quality, higher levels of education are imperative. Thus, health care organizations, educational institutions and others are looking intently at the case for advancing nursing education as outlined in the Institute of Medicine (IOM) report The Future of Nursing: Leading Change, Advancing Health. Specifically, the IOM report recommended creating a system that produces more nurses educated at the Bachelor of Science (BSN) level and beyond.
Since its inception, the Robert Wood Johnson Foundation has understood the value of a strong, well-trained health care workforce. And we agree with the IOM report that the nursing profession has the potential to effect wide-reaching changes in the health care system. Further, we concur that an improved education system is necessary to ensure that nurses can continue to deliver safe, quality, patient-centered care required for the 21st century and beyond.
As I recently told NursingOutlookTalk.com, there are a number of things that hospitals and other organizations that employ nurses can do to facilitate education progression. And it is to their benefit to do so.
By Robert Wood Johnson Foundation President and CEO Risa Lavizzo-Mourey, MD, MBA
In March 1966, only two years before he would be assassinated, Martin Luther King Jr. uttered what I consider one of his most profound statements.
“Of all the forms of inequality,” he said, “injustice in health care is the most shocking and inhumane.”
The quotation is never far from my mind. It embodies so much of the work we do at the Foundation—to narrow and then eliminate disparities in health care access, to improve the health of all Americans. But especially every January, as the holiday to honor the civil rights leader again comes around, his words seem to resonate even more. And they mix once again with some very personal memories.
I met Dr. King once. I was 7 years old, and he was in Seattle for the first and last time in his life. After speaking to a big crowd downtown, he and a group of ministers and friends went out to dinner and then came to my house. My mother, a native of Atlanta, had known Martin from childhood. His father had married my parents and buried my grandparents. And now he sat in our living room, and I got to say hello. It was a scene, and a moment, you just don’t forget.
Nearly half a century later, I believe Dr. King would be both cautiously hopeful and deeply distressed over our nation’s health and health care. He would support the significant changes under way to improve access and quality in our health care system, but he would not minimize the significant inequities that endure between Whites and other racial and ethnic groups.
He would urge us all to work harder and push farther to bring about justice in health care. And so we shall.
As we head into 2012, the Human Capital Blog asked Robert Wood Johnson Foundation (RWJF) staff, program directors, scholars and grantees to share their New Year’s resolutions for our health care system, and what they think should be the priorities for action in the New Year. This post is by Susan B. Hassmiller, PhD, RN, FAAN, RWJF senior adviser for nursing.
Since I am responsible for the Future of Nursing: Campaign for Action, my resolution would be to ensure that all of our State Action Coalitions get the help they need from us (the Robert Wood Johnson Foundation and AARP, our national partner) to implement whichever of the Institute of Medicine’s (IOM’s) report on the “Future of Nursing: Leading Change, Advancing Health” they believe makes most sense for their state.
I am humbled by the vast number of people who have come to work on this Campaign because they believe that doing so will make a difference and will indeed improve patient care in this country. And, in continuing to watch their work and supplement their needs, I am struck by the continued fragmentation of our system and vow to do what I can to foster collaboration on the part of health care providers. It really will make a difference for patients when there is true collaboration and teamwork.
Like the IOM report, I do believe that all providers must be able to practice to the top of their education and training and believe it makes the most sense in an era where cost and access issues are paramount. The level of care provided should be dictated by our needs as consumers. If there is a sound cost/benefit quotient based on evidence, that is what we should adhere to. Sometimes it is a family caregiver or a community health worker who will do the trick; sometimes a pharmacist; sometimes a nurse practitioner; and in the case of my mother who has had her life extended for which I am eternally grateful…it was a heart surgeon.
In this new year, this is what I am grateful for!
By Linda Wright Moore
RWJF Senior Communications Officer
Help wanted: Must be available and on call 24/7, year round. No vacations, no days off, no benefits or retirement plan. Base salary: zip. Likely to require taking time off from paid work (without pay) under the Family and Medical Leave Act. Qualified candidates should expect to use own funds, including savings, for expenses. Preferred applicants should have extensive experience in scheduling and arranging transportation to multiple appointments; administration of medications and treatments; and management of complex, chronic and acute conditions. Most importantly, they must be skilled at coordination of care, with capacity to connect with overburdened primary care providers who are too busy to talk, and a bloodhound’s nose for tracking down elusive specialists for consultation, on the rare days they are not in surgery at dawn, out to lunch or gone for the day at 3:45pm. Must agree to forgo taking care of one’s own health (no time for that!) Total commitment is required and will be rewarded with the satisfaction of doing the right thing for someone close to you – even as personal hopes, hobbies and aspirations are stashed in a lock box for which there is no key. WARNING: Rarely do individuals actively seek this position; like life itself, it generally just happens to people. And once it does, beware: you’re not allowed to quit.
If this sounds like your life – then you’re a family caregiver, and now is your time. Mine too. I’m the primary caregiver for my husband, who has been disabled for over a year now.
Here’s some good news: November is not just for turkey, dressing, Pilgrims and pumpkin pie. Along with Thanksgiving, November is National Family Caregivers Month, a time for recognizing and giving thanks for – and to – the 43.5 million family caregivers over age 18 in America, whose unpaid services to support the health needs of family members aged 50 or older were valued at $375 billion in 2007.