Category Archives: Health Policy Fellows
The Robert Wood Johnson Foundation (RWJF) Human Capital Blog published nearly 400 posts this year. As we usher in 2015, we take a look back at our ten most-read 2014 posts.
Why Do Deaths from Drugs Like Oxycodone Occur in Different Neighborhoods than Deaths from Heroin? This in-depth look at the role neighborhoods play in shaping substance abuse patterns was written by RWJF Health & Society Scholars program alumna Magdalena Cerdá, PhD, MPH. She compares neighborhoods that have more fatal overdoses of opiate-based painkillers to neighborhoods in which heroin and cocaine overdoses are more likely to occur, identifying characteristics of each. Her piece generated a larger audience than any other post published on this Blog this year, with more than 22,000 visits.
How Stress Makes Us Sick was written by RWJF Health & Society Scholar Keely Muscatell, PhD. A social neuroscientist and psychoneuroimmunologist, Muscatell shares her research into the physical manifestations of stress, its relationship to inflammation, and ways people may be able to reframe their responses to stress in order to alleviate the physical reactions it can cause. Understanding how stress makes us sick, she blogs, “is of extreme importance to the health and longevity of our nation.”
Misfortune at Birth, which drew the third-largest audience among the posts published on this Blog in 2014, asks whether some premature babies are simply born in the wrong place. It reports on nurse-led research that finds seven in ten black infants with very low birth weights have the misfortune of being born in hospitals with lower nurse staffing ratios and work environments than other hospitals. The blog post was written by Eileen Lake, PhD, RN, FAAN, and Jeannette Rogowski, PhD, based on their study funded by RWJF’s Interdisciplinary Nursing Quality Research Initiative.
Harry J. Heiman, MD, MPH, is an alumnus of the Robert Wood Johnson Foundation (RWJF) Health Policy Fellows program. He practiced clinical family medicine for more than 20 years and is currently director of health policy at the Satcher Health Leadership Institute, Morehouse School of Medicine. On December 5, Heiman will be a panelist when RWJF holds its first Scholars Forum: Disparities, Resilience, and Building a Culture of Health. Learn more.
The importance of place and geography and its impact on health is not a new concept in public health, but one that has been largely overlooked until recently. John Snow’s map of the London cholera outbreak in 1854, a precursor of today’s more sophisticated geo-spatial mapping, reminds us of the powerful impact public health has always had through assessment and intervention at the neighborhood level. Health care not only drains a disproportionate share of our resources, it also gets a disproportionate share of our attention. Access to affordable, quality health care is necessary, but not sufficient. While important and often life-saving to individuals, it is a relatively weak determinant of population health.
A large body of research has demonstrated the importance of health behaviors, with almost half of all deaths attributable to tobacco, diet and sedentary lifestyle, alcohol and substance use, firearms, and sexual behavior. What has not been adequately understood or discussed is the influence of the social and economic environment on health behaviors. People in lower social classes are more likely to have unhealthy behaviors—something that is strongly associated with the lack of available healthy choices and the impact of increased psychosocial stress. The impact of stress is life-long, occurring not only in childhood, but prenatally, leading to what some experts refer to as inherited disadvantage.
RWJF Scholars in the News: Simulating combat conditions for medical and nursing students, enriched maternity care, GMO confusion and more.
Around the country, print, broadcast and online media outlets are covering the groundbreaking work of Robert Wood Johnson Foundation (RWJF) leaders, scholars, fellows, alumni and grantees. Some recent examples:
An article on dcmilitary.com describes a recent training exercise conducted for medical and nursing students at the Uniformed Services University of the Health Sciences (USU). The students cared for “patients” under simulated combat conditions that included mock explosions and casualties, operational problems, and reality-based missions. Arthur Kellermann, MD, MPH, dean of the F. Edward Hébert School of Medicine of USU, noted that while the exercise is focused on enhancing leadership and patient care skills, students are also practicing cultural sensitivity and problem-solving abilities. “All of this is wrapped into an incredibly challenging series of unfolding scenarios,” Kellermann said. “They are constantly being thrown problems. They have to adapt and learn to work with one another in a variety of ways and a variety of combinations.” Kellerman is an alumnus of the RWJF Clinical Scholars and Health Policy Fellows programs. Read more from Kellermann on the Human Capital Blog.
A study by Sara Rosenbaum, JD, examines the challenge of maintaining and coordinating “enriched health care” for pregnant women in California who purchase subsidized coverage from Covered California, the state’s health care exchange, and are also eligible for the state’s Medicaid program (Medi-Cal) and the Comprehensive Perinatal Services Program (CPSP) it offers. Science Daily reports that CPSP makes enriched maternity care available to pregnant women facing elevated health, environmental and social risks due to their economic status. Researchers compared maternity care under the two programs and identified a number of care coordination and integration challenges. Rosenbaum is an RWJF Investigator Award in Health Policy Research recipient.
The following are among the many honors received recently by Robert Wood Johnson Foundation (RWJF) leaders, scholars, fellows, grantees and alumni:
Linda Aiken, PhD, FAAN, FRCN, RN, has won the Institute of Medicine’s Leinhard Award in recognition of her “rigorous research demonstrating the importance of nursing care and work environments in achieving safe, effective, patient-centered, and affordable health care.” The director of the Center for Health Outcomes and Policy Research at the University of Pennsylvania School of Nursing, Aiken serves on the National Advisory Committee of the RWJF Interdisciplinary Nursing Quality Research Initiative and is a research manager for the Future of Nursing National Research Agenda.
A number of RWJF Scholars and Fellows were recently elected to membership in the Institute of Medicine:
- RWJF Clinical Scholars alumni Robert Aronowitz, MD; Patrick Conway, MD, MSc; A. Mark Fendrick, MD; and Mitchell Katz, MD. Aronowitz is also an alumnus of the RWJF Physician Faculty Scholars program, and a recipient of an RWJF Investigator Award in Health Policy Research.
- RWJF Executive Nurse Fellow alumna Margaret Heitkemper, PhD, RN, FAAN.
- RWJF Harold Amos Medical Faculty Development Program alumna Paula Johnson, MD, MPH.
- RWJF Health Policy Fellow Linda Degutis, DrPH, MSN.
- RWJF Investigator Awards in Health Policy Research recipients Mark Hall, JD, and Richard Kronick, PhD.
Deborah E. Trautman, PhD, RN, is the new chief executive officer of the American Association of Colleges of Nursing (AACN) and executive director of the Center for Health Policy and Healthcare Transformation at Johns Hopkins Hospital. She is an alumna of the Robert Wood Johnson Foundation (RWJF) Health Policy Fellows program (2007-2008).
Human Capital Blog: Congratulations on your new position as CEO of AACN! What are your priorities as CEO?
Deborah Trautman: AACN is highly regarded in health care and higher education circles for advancing excellence in nursing education, research, and practice. I am honored to have this unique opportunity to support the organization’s mission and move AACN in strategic new directions. As CEO, I will place a high priority on continuing to increase nursing’s visibility, participation, and leadership in national efforts to improve health and health care. I look forward to working closely with the AACN board, staff, and stakeholders to advocate for programs that support advanced education and leadership development for all nurses, particularly those from underrepresented groups.
HCB: What are the biggest challenges facing nurse education today, and how will AACN address those challenges?
Trautman: Nurse educators today must meet the challenge of preparing a highly competent nursing workforce that is able to navigate a rapidly changing health care environment. As the implementation of the Affordable Care Act continues, health care is moving to adopt new care delivery models that emphasize team-based care, including the medical (health care) home and accountable care organizations.
These care models require closer collaboration among the full spectrum of providers and will impact how health care professionals are prepared for contemporary practice. Nursing needs to re-envision traditional approaches to nursing education and explore how best to leverage the latest research and technology to prepare future registered nurses (RNs) and advanced practice registered nurses (APRNs). Greater emphasis should be placed on advancing interprofessional education, uncovering the benefits of competency-based learning, identifying alternatives to traditional clinical-based education, and instilling a commitment to lifelong learning in all new nursing professionals.
Arthur Kellermann, MD, MPH, an alumnus of the Robert Wood Johnson Foundation (RWJF) Clinical Scholars and Health Policy Fellows programs, is professor and dean of the F. Edward Hébert School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD. He is co-author of the new RAND report, “Redirecting Innovation in U.S. Health Care: Options to Decrease Spending and Increase Value.” Here, he shares recommendations for a brave new world of medical technology.
Americans take justifiable pride in our capacity for innovation. From putting the first men on the moon to developing the Internet, we lead the world in developing innovative technologies. Health care is no exception. The United States holds more Nobel prizes in medicine than any other nation.
Novel drugs, biologics, diagnostics, and medical devices have transformed American health care, but not always for the better.
Some innovations have made a big difference. Combination antiretroviral therapy changed HIV infection from a death sentence to a treatable, chronic disease. Before an effective vaccine was developed, Hemophilus Influenze type b, a bacterial disease, was a major cause of death and mental disability in young children. Today, it is virtually eradicated here and in Western Europe.
The following are among the many honors received recently by Robert Wood Johnson Foundation (RWJF) leaders, scholars, fellows, grantees and alumni:
Emery Brown, MD, PhD, an alumnus of the Harold Amos Medical Faculty Development Program has been elected a member of the National Academy of Sciences.
RWJF Investigator Award in Health Policy Research recipient James Perrin, PhD, is the new president of the American Academy of Pediatrics. He took office on January 1, 2014, beginning a one-year term.
The American Association of Colleges of Nursing (AACN) has named Deborah E. Trautman, PhD, RN, as its new chief executive officer, effective June 16. Trautman, an RWJF Health Policy Fellows program alumna, currently serves as executive director of the Center for Health Policy and Healthcare Transformation at Johns Hopkins Hospital.
The American College of Physicians (ACP), the nation’s largest medical specialty organization, has voted Wayne Riley, MD, MPH, MBA, its president-elect. Riley is a former RWJF senior health policy associate.
Kenneth B. Chance, Sr., D.D.S. has been appointed dean of the Case Western Reserve University School of Dental Medicine and will begin his duties on July 1, 2014. He is an alumnus of the RWJF Health Policy Fellows program, and served on its national advisory committee. His is a current member of the national advisory committee of the RWJF Summer Medical and Dental Education Program.
Have you signed up to receive Sharing Nursing’s Knowledge? The monthly Robert Wood Johnson Foundation (RWJF) e-newsletter will keep you up to date on the work of the Foundation’s nursing programs, and the latest news, research, and trends relating to academic progression, leadership, and other essential nursing issues. Following are some of the stories in the March issue.
Nurses Need Residency Programs Too, Experts Say
Health care experts, including the Institute of Medicine in its report on the future of nursing, tout nurse residency programs as a solution to high turnover among new graduate nurses. Now, more hospitals are finding that these programs reduce turnover, improve quality, and save money. Success stories include Seton Healthcare Family in Austin, Texas, which launched a residency program to help recent nursing school graduates transition into clinical practice. Now, three out of four new graduate nurses make it to the two-year point, and five or six new nurse graduates apply for each vacant position.
Iowa Nurses Build Affordable, Online Nurse Residency Program
Some smaller health care facilities, especially in rural areas, cannot afford to launch nurse residency programs to help new nurses transition into clinical practice. A nursing task force in Iowa has developed an innovative solution: an online nurse residency program that all health care facilities in the state—and potentially across the country—can use for a modest fee. The task force was organized by the Iowa Action Coalition and supported by an RWJF State Implementation Program grant.
RWJF Scholars in the News: Nurse staffing and patient mortality, communicating about vaccines, specialized HIV training for NPs, and more.
Around the country, print, broadcast, and online media outlets are covering the groundbreaking work of Robert Wood Johnson Foundation (RWJF) leaders, scholars, fellows, alumni, and grantees. Some recent examples:
A study led by Linda H. Aiken, PhD, FAAN, FRCN, RN, and covered by CNN.com, finds that hospital nurse-patient ratios and the share of nurses with bachelor’s degrees both have an important impact on patient mortality. Aiken, a research manager supporting the Future of Nursing: Campaign for Action and a member of the RWJF Interdisciplinary Nursing Quality Research Initiative (INQRI) National Advisory Committee, found that increasing a hospital nurse’s workload by one patient increased by 7 percent the likelihood of an inpatient death within 30 days of admission. The same research revealed that a 10-percent increase in the number of nurses with bachelor’s degrees at a given hospital reduces the likelihood of a patient death by 7 percent. Aiken’s study has also been covered by the Guardian, Philly.com, and FierceHealthcare, among other outlets.
Public health messages aimed at boosting childhood vaccination rates may be backfiring, according to a new study led by RWJF Scholars in Health Policy Research alumnus Brendan Nyhan, PhD. Campaigns that use studies, facts, and images of ill children increased fears about vaccine side-effects among some parents, NBC News reports. In fact, messaging that debunked myths about links between vaccines and autism actually made parents less inclined to have their children inoculated. Time magazine online also covered the study.
The Johns Hopkins University School of Nursing has developed a new curriculum that provides specialized HIV training to nurse practitioners, with funding from the Health Resources and Services Administration, Medical Xpress reports. “The design of our program starts with the recognition that HIV care cannot be provided in a silo, that it needs to be integrated holistically into primary care," RWJF Nurse Faculty Scholar Jason Farley, PhD, MPH, said in a statement. Farley is the developer of the curriculum.
Jay Himmelstein, MD, MPH, is a professor of family medicine and community health and chief health policy strategist at the Center for Health Policy and Research at the University of Massachusetts Medical School (UMMS). He serves as a senior advisor to the UMMS Office of Policy and Technology, and is a senior Fellow in health policy at NORC, University of Chicago. Himmelstein is an alumnus of the Robert Wood Johnson Foundation Health Policy Fellows program, where he worked on the health staff of Senator Edward Kennedy. This post is part of the “Health Care in 2014” series.
The nation's attention has focused in recent months on the politics and challenges related to the roll-out of state and federal health insurance marketplaces created by the Affordable Care Act (ACA). Despite website technical woes, significant numbers of Americans have already gained access to affordable insurance plans through the marketplaces and other provisions of the ACA, and it appears likely that the ‘marketplace’ concept will be successful over time in connecting consumers to health insurance and significantly decreasing the ranks of uninsured.
The better functioning marketplaces currently allow consumers to: 1) determine eligibility for subsidized health insurance, 2) use basic online shopping tools to compare and purchase health insurance plans based on four different "metallic tiers" (i.e., the platinum, gold, silver, and bronze tiers), and 3) make side-to-side comparisons between these plans on features such as deductibles, out-of-pocket cost limits, and number and proximity of doctors and hospitals. A few marketplaces also offer information about plan quality, the ability to search for health care providers and hospitals associated with specific plans, and rudimentary ‘cost calculators’ which estimate the total cost of plans inclusive of premiums, deductibles, and out-of-pocket costs.