Category Archives: Investigator Awards in Health Policy Research

Apr 11 2014
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Academic Progression is Focus of Meeting with Community College, University Nursing Leaders

A year ago this week, the Robert Wood Johnson Foundation (RWJF) convened an unprecedented meeting that brought together diverse leaders from community colleges around the country, the Tri-Council for Nursing, and RWJF’s Academic Progression in Nursing (APIN) initiative, which is fostering collaboration between community colleges and four-year university nursing programs to promote seamless academic progression for nurses. The meeting was organized to address concerns in the community college community about the recommendation in the Institute of Medicine’s (IOM) report, The Future of Nursing: Leading Change, Advancing Health, that 80 percent of the nation’s nurses attain bachelor of science in nursing or higher degrees by the year 2020.

A paper, released today, reports on the proceedings of that meeting, including participants’ shared goal to ensure that community colleges continue their invaluable work to educate a new generation of nurses and diversify the nursing workforce; and to give all nurses opportunities to be lifelong learners who are well-prepared to provide high-quality care and promote health.

The paper includes an addendum that provides news and information about how nursing, health, education, government, business, and other leaders in nine states have made exciting progress in the last year in support of seamless progression for nursing students, as well as for nurses already in the workforce who wish to continue their education.

“While we did not solve every concern, the meeting was tremendously constructive, opening a dialogue, identifying numerous areas of strong agreement, and illuminating issues yet to be resolved,” said John Lumpkin, MD, MPH, senior vice president at RWJF. The Foundation “is determined that last year’s meeting be a beginning for a continuing, constructive dialogue that will advance the goals we all share.”

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Apr 10 2014
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RWJF Scholars in the News: Electronic health records, nurse mentoring, ‘longevity gaps,’ 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:

The California Action Coalition has developed a mentorship program that is helping prepare the next generation of nurses to serve as leaders on health care reform. The state’s mentorship program dovetails with the 2014 leadership focus of the Future of Nursing: Campaign for Action, a national effort backed by RWJF and AARP that is working to transform health care through nursing. “Mentoring is key to strengthening any leader,” Mary Dickow, MPA, tells Nurse Zone. “Having strong mentors in my life helped me think differently and advance. I wouldn’t be where I am today without them.” Dickow is statewide director of the California Action Coalition.

A recent interview in the Atlantic with David Blumenthal, MD, MPP, has generated numerous comments from readers weighing in on the merits of electronic health records (EHRs). Blumenthal is former national coordinator for health information technology at the U.S. Department of Health and Human Services and a recipient of an RWJF Investigator Award in Health Policy Research. He points out in the interview that EHRs offer “substantial” benefits for patients, but notes that in the short-term, providers incur significant costs and that it will take time to make the transition to EHRs. The Atlantic has now published several articles highlighting reader comments, which can be found here, here, and here. FierceEMR published a story about the give-and-take, which notes that many of the commenters who are skeptical about the value of EHRs are physicians.

RWJF Health & Society Scholars program University of Wisconsin-Madison Site Director David Kindig, MD, PhD, appeared on the Kojo Nnamdi Show on Washington, D.C.’s WAMU radio to discuss the “longevity gap,”—the growing gap in life expectancy between the rich and the poor. Kindig and other guests explore how health care reform and policies to address income inequality might affect the gap.

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Apr 3 2014
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RWJF Scholars in the News: Medical debt disparities, nurses providing primary care, technologies that maximize time with patients, 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:

In a study of women diagnosed with breast cancer, RWJF Physician Faculty Scholars alumna Reshma Jagsi, MD, PhD, found that Black and Latina patients were more than twice as likely as White patients to have medical debt and to skip treatments due to concerns about costs. Jagsi tells Reuters that “our findings suggest that racial and ethnic minority patients appear to be more vulnerable, as are those who are too young to qualify for Medicare, those who lack prescription drug coverage, those who reduce their work hours after diagnosis, and those with lower household income at the time of diagnosis.”

Expanding nurse practitioners’ role in primary care could help meet new demands on California’s health care system, as millions of previously uninsured residents gain coverage under the Affordable Care Act, according to Susan Reinhard, RN, PhD, senior vice president of the AARP Public Policy Institute. “We should make sure that the nurse practitioners can use every ounce of their talent for what is needed,” she tells the AARP Bulletin. “Consumers should have a choice of different clinicians who will suit their preferences and their needs.” Reinhard is chief strategist for the Center to Champion Nursing in America, a partnership of AARP, AARP Foundation, and RWJF and co-director of the Future of Nursing: Campaign for Action.

At a recent information technology summit, Ann O’Brien, MSN, RN, an RWJF Executive Nurse Fellow, discussed her work with Kaiser Permanente to leverage new health care technology to maximize nurses’ valuable time providing patient care. O’Brien explains that “you have to look at what can enable small amounts of change,” because saving seconds with each repeated use of rapid sign-on technology, for example, can mean gaining extra minutes in a day for a nurse to provide direct care, FierceHealthIT reports.

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Apr 2 2014
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RWJF Milestones, April 2014

The following are among the many honors received recently by Robert Wood Johnson Foundation (RWJF) leaders, scholars, fellows, grantees and alumni:

Susan B. Hassmiller, PhD, RN, FAAN, RWJF’s senior advisor for nursing and director of its Future of Nursing: Campaign for Action, has been named co-chair of the newly formed External Nurse Advisory Board (ENAB) for the Center for Nursing Advancement (CFNA) at UnitedHealth Group. The goal of the ENAB is to “inform, create and evolve nursing best practices, and advance the nursing profession.”

Angelina Jolie has signed on as executive producer of Difret, a film by RWJF Health & Society Scholars alumna Mehret Mandefro, MD, MSc, AB. The film premiered at the Sundance Film Festival in January, where it won the World Cinema Dramatic Audience Award, then went on to receive the Audience Award at the Berlin International Film Festival in February. The film tells the story of a young Ethiopian girl who challenges the tradition of “telefa,” the practice of abduction in marriage, usually of young girls. Read more about Mandefro’s film.

The American Association of Colleges of Nursing (AACN) has voted Juliann Sebastian, PhD, MSN, its president-elect. Sebastian, an RWJF Executive Nurse Fellows alumna, is dean of the University of Nebraska Medical Center College of Nursing. She will serve as president of AACN from 2016 to 2018. The organization represents more than 740 nursing schools nationwide.

RWJF Scholars in Health Policy Research alumna Jacqueline Stevens, PhD, has been named a 2013 Guggenheim Fellow for the Humanities. Her fellowship is in U.S. History.

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Mar 27 2014
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RWJF Scholars in the News: Cultural barriers to care, medical conspiracies, parenting, 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:

In a Talking Points Memo opinion piece, Harold Amos Medical Faculty Development Program alumna Paloma Toledo, MD, MPH, writes that while the Affordable Care Act holds the promise of greatly increasing access to care, language and cultural barriers could still stand between Hispanic Americans and quality care. Toledo’s research into why greater numbers of Hispanic women decline epidurals during childbirth revealed that many made the choice due to unfounded worries that it would leave them with chronic back pain or paralysis, or that it would harm their babies. “As physicians, we should ensure that patients understand their pain management choices,” she writes.

More than one in three patients with bloodstream infections receives incorrect antibiotic therapy in community hospitals, according to research conducted by Deverick J. Anderson, MD, an RWJF Physician Faculty Scholars alumnus. Anderson says “it’s a challenge to identify bloodstream infections and treat them quickly and appropriately, but this study shows that there is room for improvement,” reports MedPage Today. Infection Control Today, FierceHealthcare, and HealthDay News also covered Anderson’s findings.

People’s health and wellness can be linked to their zip codes as much as to their genetic codes, according to an essay in Social Science and Medicine co-authored by Helena Hansen, MD, PhD. As a result, Hansen argues, physicians should be trained to understand and identify the social factors that can make their patients sick, HealthLeaders Media reports. Hansen is an RWJF Health & Society Scholars alumna.

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Mar 20 2014
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RWJF Scholars in the News: ADHD medication, reconstruction after mastectomy, care for returning veterans, 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:

NBC News reports on a surge in the number of young adult women taking ADHD medication. An RWJF Investigator Award in Health Policy Research recipient, Stephen Hinshaw, PhD, explains that the rise in diagnoses among women in that age group may be evidence of failure to recognize the problem when the women were children. They may not have manifested symptoms as visibly as their male classmates with ADHD did, turning their distress inward rather than misbehaving in class, for example.

“How people with mental disorders are viewed by treatment providers and the general public can have a significant impact on treatment outcomes and the quality of life of clients,” Jennifer Stuber, PhD, and colleagues write in a study reported by Health Canal. The researchers presented vignettes about people with mental health problems to mental health providers and the general public, and compared their reactions. Providers had more positive attitudes, but some held views about the danger such patients might pose in the workplace that the researchers called “concerning.” Stuber is an RWJF Health & Society Scholars alumna.

More women are having breast reconstruction after mastectomies, USA Today reports. As a result of a 1998 federal law, most group insurance plans that cover mastectomies also cover breast reconstruction. Researchers found that the share of women who received reconstruction after mastectomy rose from 46 percent to 63 percent between 1998 and 2007. Author Reshma Jagsi, MD, DPhil, an RWJF Physician Faculty Scholars alumna, says the law could be contributing to the increase. The study was also covered by 9 News (Denver) and WKYC.com (Cleveland), among other outlets.

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Mar 13 2014
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RWJF Scholars in the News: Military suicides, easing the path to a BSN, early clues to lung cancer, 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:

Amid growing attention to suicide rates among members of the military, a new series of studies explores the contributing factors, the New York Times reports. One of the studies, on suicides and accidental deaths, was led by RWJF Scholars in Health Policy Research alumnus Michael Schoenbaum, PhD. He identified a host of risk factors, including demotions, low rank, and previous deployment. However, Schoenbaum did not find evidence to support the contention that relaxed recruitment standards had led to the induction of soldiers more likely to commit suicide. The study was also covered in USA Today, the Wall Street Journal, and the Guardian, among other outlets.

The North Carolina Medical Journal features an article by Polly Johnson, RN, MSN, RN, FAAN, on the Regionally Increasing Baccalaureate Nurses (RIBN) initiative. It provides an economically feasible educational pathway between community colleges and universities so that more North Carolina nursing students can achieve a baccalaureate degree at the start of their careers. RIBN is supported by RWJF’s Academic Progression in Nursing initiative.

In her work as a nurse practitioner in a pediatric ICU, Karin Reuter-Rice, PhD, CPNC-AC, has observed that some children with traumatic brain injuries improve rapidly, while others suffer grave and permanent damage, reports Duke Nursing. As a result, Reuter-Rice, an RWJF Nurse Faculty Scholar, is using her RWJF grant for a multi-year research project to determine what neurological differences account for those dramatically different outcomes. She is exploring whether vasospasm, the sudden contraction of blood vessels in the brain, might play a role.

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Mar 7 2014
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Robert Wood Johnson Foundation Investigator Awardees Selected

The Robert Wood Johnson Foundation (RWJF) Investigator Awards in Health Policy Research  program has selected projects and Investigators as a result of its 2013 application process.  The program provides funding to highly qualified individuals undertaking broad studies of the most challenging health, health care, and health policy issues facing the country. Grants of up to $335,000 are awarded to investigators from a wide range of disciplines.

Eleven individuals have been selected to join the program.  Their eight projects address race, ethnicity, and class in pharmaceutical marketing; mood and behavior disorders in children and adolescents; ethical and policy issues raised by living donor transplantation; resilience and recovery from disasters; and moreGrants to their institutions will be awarded on a rolling basis throughout 2014.

See the full list of newly selected RWJF Investigators.

Mar 6 2014
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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.

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Mar 4 2014
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The Emergency Medical Treatment and Active Labor Act: Past, Present and Future

An interview with Sara Rosenbaum, JD, the Hirsh Professor in the School of Public Health and Health Services at the George Washington University, in Washington, DC, and a Robert Wood Johnson Foundation (RWJF) Investigator Awards in Health Policy Research recipient. She is the author of “The Enduring Role of the Emergency Medical Treatment and Active Labor Act,” published in the December 2013 issue of Health Affairs, which focused on the future of emergency medicine. The interview is part of a series of posts  featuring RWJF Scholars who authored articles in the issue.

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Human Capital Blog: Your article discusses the past, present, and future of the Emergency Medical Treatment and Active Labor Act (EMTALA), adopted in 1986. Could you tell us a little about what moved Congress and the President to create the law, and what its purpose was?

Sara Rosenbaum: The law had several roots. To begin, it was the outgrowth of a good deal of law that came before it, embracing the notion that hospitals should provide emergency care, even without the expectation of payment. So that idea wasn’t unique to EMTALA, but by the early 1970s the expectation that hospitals would provide the community benefit of emergency services had revved up, partly because states had adopted that expectation under their own common law and statutes. So EMTALA was the culmination of a lot of legal precedent. But what prompted passage of the law in 1986 was two things: First, a substantial number of news stories about patient-dumping, particularly in California; and second, on the heels of Medicare payment reform a few years earlier, there was a lot of concern that hospitals would start discharging Medicare patients in an unstable state – sicker and quicker, as the saying went.

HCB: What are the law’s key components?

Rosenbaum: The one everybody knows best is the screening component: If somebody comes to an emergency department and requests an examination, hospitals must examine the patient to determine if there's an emergency medical condition. And if they find one, they must provide stabilization treatment. Or, if the patient has an emergency condition that the hospital is unable to stabilize, it can seek the cooperation of another hospital with more specialized capabilities, and transfer the patient. And then that second hospital has a separate obligation; it can’t just say “no.”

HCB: What’s your sense of how the law operates in the daily life of a hospital?

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