Search Results for: Melichar

May 16 2013
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New Survey: Physicians, Nurse Practitioners Disagree on Nurses’ Role in Providing Primary Care

Lori Melichar Gadkari, PhD, MA, is a director at the Robert Wood Johnson Foundation (RWJF), in the Research and Evaluation Unit.

Lori Melichar

Yesterday the New England Journal of Medicine published the results of a study co-funded by the Robert Wood Johnson Foundation, Johnson & Johnson, and the Gordon and Betty Moore Foundation. “Perspectives of Physicians and Nurse Practitioners on Primary Care Practice” finds that 96 percent of nurse practitioners and 76 percent of physicians agreed with the Institute of Medicine report recommendation that “nurse practitioners should be able to practice to the full extent of their education and training.” The new study is authored by Karen Donelan, ScD, EdM, Catherine M. DesRoches, DrPH, Robert S. Dittus, MD, MPH, and Peter Buerhaus, PhD, RN.

When asked how increasing the supply of nurse practitioners would potentially affect the United States health care system, the authors found that the majority of physicians (73%) said increasing the supply of primary care nurse practitioners (PCNPs) would lead to improvements in the timeliness of care. A much smaller majority of physicians (52%) said increasing the supply of PCNPs would lead to improvements in access to care for people in the country. 

However, the new survey found significant disagreement between primary care physicians and PCNPs about whether increasing the supply of PCNPs would improve patient safety and the effectiveness of care, and whether it would reduce costs. There was also a large professional divide about proposed changes to PCNPs’ scope of practice, putting PCNPs in leadership roles, and the quality of care that PCNPs provide.

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Mar 5 2013
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RWJF Launches a Website to Advance the Science of QI Research and Evaluation

Lori Melichar, PhD, is a director at the Robert Wood Johnson Foundation (RWJF).

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On February 12, the Robert Wood Johnson Foundation launched a new website that can serve as a long-awaited repository for work we have funded over the last 10 years that invests in advancing the science of quality improvement (QI) research and evaluation.  We hope the website also provides the opportunity for researchers and other health care professionals engaged in QI work to access resources and to connect with colleagues with mutual interests.

The launch coincided with a virtual meeting on Advancing the Science of QI Research and Evaluation (ASQUIRE).  The group convened to hear findings from grantees of the Foundation’s Evaluating QI Training Programs Initiative (PQI). 

Meeting participants were tasked with thinking about how the website can best disseminate their work as well as collect, house and spread tools, frameworks, methods and models to assist those doing QI and those evaluating QI efforts. Grantees were joined by experts in QI research, practice and evaluation and a lively discussion (sometimes a debate) ensued. 

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Feb 4 2013
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You’re Invited to a Virtual Meeting on Advancing the Science of Quality Improvement Research and Evaluation

Lori Melichar, PhD, is a director at the Robert Wood Johnson Foundation (RWJF). 

Lori Melichar

The Robert Wood Johnson Foundation’s mission is to improve the health and health care of all Americans. In pursuit of this mission, we seek to improve the quality of care provided in hospitals, ambulatory care centers, public health departments, and other settings where health is enhanced or health care is delivered.

Within the past 15 years, Quality Improvement (QI)—the process-based data-driven approach to improving the quality of a product or service through iterative action-evaluation cycles—has emerged as a promising strategy to accomplish this goal, and RWJF funded several national programs to “demonstrate” the potential of QI to improve health care processes, staff engagement and patient outcomes.  The Foundation’s Pursuing Perfection Program, which had as its goal to help hospital and physician organizations improve patient outcomes dramatically by pursuing perfection in major care processes, employed QI tools such as Plan-Do-Study-Act cycles and improvement collaboratives to accomplish this goal.  Another program, Transforming Care at the Bedside, taught frontline nurses the skills and methods of QI and empowered these staff to engage in activities to transform hospital care.  Paths to Recovery is an RWJF program that used QI processes to improve the systems of care that provided substance abuse treatment. Aligning Forces for Quality  is RWJF’s signature effort to lift the overall quality of health care in targeted communities, reduce racial and ethnic disparities, and provide models for national reform.

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May 11 2012
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Building the Body of Research in the Science of Nursing Care

Happy National Nurses Week! The Robert Wood Johnson Foundation (RWJF) has a proud history of supporting nurses and nurse leadership, so this week, the RWJF Human Capital Blog is featuring posts by nurses, including leaders from some of our nursing programs. This post is by Mary Naylor, PhD, RN, FAAN, director of the RWJF Interdisciplinary Nursing Quality Research Initiative program and the Marian S. Ware Professor in Gerontology at the University of Pennsylvania School of Nursing.

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Nurses—the largest group of health professionals in the country—have a tremendous impact on health and health care. But despite the immense size and influence of the nursing workforce, we don’t know enough about how nurses can improve the quality and safety of care and reduce costs.

Nurse scientists have been exploring these questions for decades, but large gaps in knowledge remain. Since it was established in 2005, the Interdisciplinary Nursing Quality Research Initiative (INQRI), funded by RWJF, has worked to address those gaps in our knowledge of nursing care.

Over the last seven years, INQRI grantees—teams of nurse scientists and scholars from other disciplines—have conducted groundbreaking research focused on the ways in which nurses affect the quality of care patients receive and how they improve patient care and outcomes.

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The interdisciplinary nature of the project has been key to its success; when scholars from multiple disciplines come together to solve problems in nursing care, they generate solutions that are grounded in rigorous evidence, that take into account diverse perspectives, and that use various methodological techniques. In short, interdisciplinary research leads to more robust findings. And more robust findings are more likely to attract investments in nursing resources, which will, in turn, improve health outcomes while reducing costs.

As program leaders, we don’t just talk the interdisciplinary talk; we walk it too.

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Aug 23 2011
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A Model for Transforming Nursing Education

By Lori Melichar, Ph.D., M.A.
Senior Program Officer, Research and Evaluation, Robert Wood Johnson Foundation

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I recently attended a National League for Nursing meeting of top nursing researchers, educators and leaders. Among the purposes of the meeting was to identify gaps in and opportunities to create knowledge to improve nursing education.

While meeting participants discussed several exciting efforts currently underway to improve nursing education, journal editors attending lamented the fact that most of the published research on nursing education innovations is based on single-site studies, making it unlikely to convince faculty to adopt new models of education or change core curriculum. The editors, educators and researchers agreed that research linking teaching methods and curricular content to patient outcomes would bolster efforts to transform patient care in the U.S. Evidence in this area is crucial because curricula are packed, faculty are overworked, change takes effort, and students don't always know what's best for them.

Producing more rigorous evidence is a strategy I often support as a member of the department of research and evaluation at the Robert Wood Johnson Foundation (RWJF). The Research Initiative component of the Campaign for Action, along with the Foundation's Evaluating Innovations in Nursing Education Program, will seek funding for studies of educational innovation over the next couple of years. It occurred to me that a strategy that might be more successful in the goal of quickly transforming nursing education falls out of the Foundation's flagship nursing program, Transforming Care at the Bedside (TCAB).

I was a part of the team from RWJF and the Institute for Healthcare Improvement (IHI) that developed the TCAB program that taught front-line nurses and their managers the skills and methods of continuous quality improvement, and inspired and empowered them to make changes to transform care at the bedside. The idea was that, though evidence should always be considered when it exists, there are things one can try to improve outcomes that matter, without first proving effectiveness.

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Jun 27 2011
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Put Your Research Proposal in Front of a Group of Funders!

By Lori Melichar, Ph.D., M.A.

Director, Robert Wood Johnson Foundation

The Robert Wood Johnson Foundation is coordinating a unique, multi-funder initiative to identify, generate, synthesize and disseminate evidence essential to informing efforts to implement the recommendations outlined in the Institute of Medicine (IOM) report, The Future of Nursing: Leading Change, Advancing Health and to contribute to the Campaign for Action’s goal to advance comprehensive change in health care for patients and the country. Melichar is helping coordinate that effort.

Lori Melichar

The Future of Nursing: Campaign for Action (CFA) has launched an exciting initiative to focus national attention (and funding) on a common research agenda related to the CFA’s vision: that all Americans have access to high-quality, patient-centered care in a health care system where nurses contribute as essential partners in achieving success.

The CFA aims to:

• strengthen nurse education and training;

• enable nurses to practice to the full level of their education and training;

• advance interprofessional collaboration across the health spectrum;

• expand leadership ranks to ensure that nurses have a voice on management teams, in boardrooms and during policy debates; and to

• improve health care workforce data collection.

The Institute of Medicine’s landmark report. The Future of Nursing: Leading Change, Advancing Health offers a blueprint for transforming the nursing profession to enhance the quality and value of U.S. health care in ways that meet future needs of diverse populations—but it doesn’t contain all of the answers. We understand that the national leaders, public agencies, private organizations and individuals who have been called to action through specific recommendations have other priorities that compete for attention, funding and effort. We understand that the major players face uncertainty about the future of health care and their own roles in that future. We also understand the role that politics, with both big and small “Ps,” plays in the positions and behaviors of individuals and powerful organizations.

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