Jan 28, 2015, 8:00 AM, Posted by
Aara Amidi-Nouri, PhD, RN, is associate professor of nursing and director of diversity at Samuel Merritt University in Oakland, Calif. She is a Robert Wood Johnson Foundation (RWJF) Executive Nurse Fellow (2014-2017) and has served as a project director for the RWJF New Careers in Nursing scholarship program at Samuel Merritt University since 2009.
Trust. Our health depends on it, and so do our lives.
Our very first stage of personality development as infants starts with trust, according to renowned developmental psychologist Erik Erikson. A newborn’s basic needs—food, shelter, and clothing—are entirely entrusted to a caregiver, one who hopefully recognizes that he or she does not yet have an ability to shiver, sweat, or shed tears.
When caregivers are attuned to babies’ environments and hunger cues, they are able to meet their needs and build their trust in other human beings. When caregivers hold newborns close, they meet their need for love and affection, building trust with every heartbeat and with every breath. We are social beings, dependent on one another. We must trust one another in order to survive. It’s no coincidence that our pennies—our most basic form of currency—are engraved with that very word.
What happens when, instead of building trust, we createmistrust? What happens when we can’t trust our health care system or our health care providers—our own caregivers, the very people who hold our fate and our lives in their hands?
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Dec 22, 2014, 2:58 PM, Posted by
Pooja Mehta, MD, is a generalist obstetrician/gynecologist and a second-year Robert Wood Johnson Foundation (RWJF) Clinical Scholar at the University of Pennsylvania, with support from the Department of Veterans Affairs. Rebekah Gee, MD, MHS, is Medicaid Medical Director for the state of Louisiana, an assistant professor of health policy and management, and obstetrics and gynecology at Louisiana State University and an alumna of the RWJF Clinical Scholars program.*
The theory of disruptive innovation seeks to explain how complicated, expensive systems may eventually be replaced by simpler, more affordable solutions, driven by new entrants into a market who “disrupt” an older, less efficient, and less accessible order.
In the new issue of Current Opinion in Obstetrics and Gynecology, we track the history of the RWJF Clinical Scholars program (CSP) in the field of obstetrics and gynecology, and offer a curated selection of pieces that suggest that our discipline—now peppered with experts in health services research and health policy trained through the CSP—could be teetering at the precipice of an era of such disruptive innovation.
Highlighting the work of nine current and past scholars, among more than 40 Clinical Scholars working in the field of obstetrics and gynecology, this journal issue covers a range of cutting-edge concepts currently being developed and employed to transform our field from the inside out.
Nathaniel DeNicola, MD, (‘11) discusses the potential uses of social media to disseminate and advance new findings and recommendations to broader audiences. Laurie Zephyrin, MD, MBA, (’03) illuminates how efforts to integrate systems, create interdisciplinary initiatives, and how research-clinical partnerships have allowed for rapid organizational and cultural change and have advanced reproductive health care in the Veterans Affairs system.
Elizabeth Krans, MD, (‘09) writes about ways in which new public funding is allowing for disruptive innovation in the delivery of prenatal care—for example, through dissemination of the highly decentralized, patient-driven Centering Pregnancy model. Working from within a city health department, Erin Saleeby, MD, (‘10) writes about how participatory approaches to public health governance can engage community and clinician leaders in the process of redesigning reproductive care and transforming outcomes.
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Dec 2, 2014, 9:46 AM, Posted by
Jon White, AHRQ , Karen DeSalvo, HHS/ONC, Michael Painter
Health primarily happens outside the doctor’s office—playing out in the arenas where we live, learn, work and play. In fact, a minority of our overall health is the result of the health care we receive. If we’re to have an accurate picture of health, we need more than what is currently captured in the electronic health record.
That’s why the U.S. Department of Health and Human Services (HHS) asked the distinguished JASON group to bring its considerable analytical power to bear on this problem: how to create a health information system that focuses on the health of individuals, not just the care they receive. JASON is an independent group of scientists and academics that has been advising the Federal government on matters of science and technology for over 50 years.
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Nov 24, 2014, 1:00 PM, Posted by
Daniel E. Dawes, JD, is a health care attorney and executive director of government relations, health policy and external affairs at Morehouse School of Medicine in Atlanta, Georgia; a lecturer of health law and policy at the Satcher Health Leadership Institute; and senior advisor for the Transdisciplinary Collaborative Center for Health Disparities Research. On December 5, the Robert Wood Johnson Foundation (RWJF) will explore this topic further at its first Scholars Forum: Disparities, Resilience, and Building a Culture of Health. Learn more about it.
With growing diversity relative to ethnicity and culture in our country, and with the failure to reduce or eliminate risk factors that can influence health and health outcomes, it is imperative that we identify, develop, promulgate, and implement health laws, policies, and programs that will advance health equity among vulnerable populations, including racial and ethnic minorities.
Every year, the Agency for Healthcare Research and Quality publishes its National Healthcare Quality and Disparities Report, which tracks inequities in health services in the United States. Since the report was first published in 2003, the findings have consistently shown that while we have made improvements in quality, we have not been as successful in reducing disparities in health care. This dichotomy has persisted, despite the fact that health care spending continues to rise. In fact, health care costs have been escalating at an unsustainable rate, reaching an estimated 17.3 percent of our gross domestic product in 2009, according to the Centers for Medicare and Medicaid Services. Despite these high costs, the delivery system remains fragmented and inequities in the quality of health care persist. The impact of disparities in health status and access for racial and ethnic minorities is quite alarming.
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Nov 21, 2014, 9:00 AM, Posted by
As PIN holds its final national meeting this week, the Human Capital Blog is featuring posts from PIN partners about the program’s legacy of encouraging innovative collaborative responses to challenges facing the nursing workforce in local communities. PIN is an initiative of the Northwest Health Foundation and the Robert Wood Johnson Foundation (RWJF).
The PIN journey with Arkansas Community Foundation and University of Arkansas for Medical Sciences (UAMS), among other partners, has been one of both providence and progress. It was in the fall of 2008 that we were approached by leaders from UAMS with the idea for us to become partners with them in this endeavor.
At first, the idea seemed daunting. Then, after some consideration by our senior leadership, it became an open door for opportunity—an opportunity to leverage the structure and resources of our foundation to complement the expertise of our colleagues and friends at UAMS to address a major issue of mutual concern: the aging population in our state and the significant shortage of adequately prepared nurses to care for that population. Not long into the partnership, our organizations realized this would be a match made in heaven.
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Nov 12, 2014, 1:00 PM, Posted by
Mitesh S. Patel
Mitesh S. Patel, MD, MBA, MS, is an assistant professor of medicine and health care management at the Perelman School of Medicine and the Wharton School at the University of Pennsylvania. He is a staff physician and core investigator at the Center for Health Equity Research and Promotion at the Philadelphia Veterans Administration (VA) Medical Center. Patel is an alumnus of the VA/Robert Wood Johnson Foundation (RWJF) Clinical Scholars Program at the University of Pennsylvania (2012-2014).
Cardiovascular disease is the number one cause of hospitalizations, morbidity and mortality among the veteran population. Building a Culture of Health could address this issue by focusing on individual health behaviors that contribute to risk factors associated with cardiovascular disease such as physical inactivity, diet, obesity, smoking, hyperlipidemia and hypertension.
The current health system is reactive and visit-based. However, veterans spend most of their lives outside of the doctor’s office. They make everyday choices that affect their health such as how often to exercise, what types of food to eat, and whether or not to take their medications.
Connected health is a model for using technology to coordinate care and monitor outcomes remotely. By leveraging connected health approaches, care providers have the opportunity to improve the health of veterans at broader scale and within the setting in which veterans spend most of their time (outside of the health care system). The Veteran’s Health Administration (VHA) is a leader in launching connected health technologies. VHA efforts began in 2003 and included technologies such as My HealtheVet (serving approximately 2 million veterans) and telemedicine (serving about 600,000 veterans).
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