Category Archives: LEAP Project

Jun 6 2014
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The Role of Primary Care Providers in Changing the Culture of Care in Communities

The Robert Wood Johnson Foundation’s (RWJF) LEAP National Program is working to create a culture of health by discovering, documenting, and sharing innovations in the primary care workforce. To advance this goal, the program is holding a series of six webinars that highlight best practices. The first webinar addressed the responsibility of health delivery organizations to strengthen community health and the ways primary care providers can address social determinants of health.  It featured leaders from four primary care sites around the country that the LEAP program has deemed exemplars.

Bringing Change to a Low-Income Community in Philadelphia

Patricia Gerrity, PhD, RN, associate dean for community programs at Drexel University and director of 11th Street Family Health Services at Drexel University, discussed the origins and work of her clinic, which is a partnership with the Philadelphia Housing Authority (PHA) that began in 1996. In response to a letter between the University and the PHA, Gerrity worked to gain mutual trust with the aim of improving the residents’ health status.

Getting started wasn’t easy, Gerrity noted.  To achieve some wins, she assigned a public health nursing faculty member from Drexel to each public housing development. The nurse faculty members asked residents about pressing problems—and then became partners in solving them. For instance, residents said car accidents were an issue, so stop signs were put up. Residents wanted to learn CPR, so training was offered. Residents expressed concerns about dog bites, so they worked with Animal Control to remove stray dogs. “We had to have some short term wins to gain trust,” Gerrity said. 

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Apr 17 2014
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Sharing Innovative Practices in Primary Care Delivery

The Robert Wood Johnson Foundation’s LEAP National Program is working to create a culture of health by discovering, documenting, and sharing innovations in the primary care workforce. Across the country, innovative practices have found ways to make care more efficient and effective for both patients and providers, which can lead to improved health outcomes and health savings. The LEAP project has identified and visited practices based in large health systems and rural community clinics ranging from Maine to California, and has brought the sites together in person and via webinars to discuss their innovations.

LEAP stands for The Primary Care Team: Learning from Effective Ambulatory Practices. Over the past six months, the 31 “exemplar sites” have been actively engaged in discussing their workforce best practices. The goal is to allow others across the country to learn from and replicate these innovations, ultimately via a dissemination website.

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Sep 23 2013
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Primary Care on the Front Lines of Innovation

Maryjoan Ladden, PhD, RN, FAAN, is a senior program officer at the Robert Wood Johnson Foundation.

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During a recent visit to my adopted home state of Massachusetts, I took a fresh look at a primary care practice I had previously known only from afar. I was part of the team visiting Cambridge Health Alliance–Union Square Family Health, which is one of 30 primary care practices recognized as exemplar models for workforce innovation by The Primary Care Team: Learning From Effective Ambulatory Practices (LEAP) project. This project, a new initiative of the Robert Wood Johnson Foundation and the MacColl Center at Group Health Research Institute, is studying these 30 practice sites to identify new strategies in workforce development and interprofessional collaboration. The overarching goal of LEAP is to better understand the innovative models that make primary care more efficient, effective, and satisfying to both patients and providers, and ultimately lead to improved patient outcomes.

This site visit took me back to my time as a nurse practitioner at Boston Medical Center, Harvard Vanguard Medical Associates, and Boston’s school-based health centers. This is where my passion for primary care began. As we prepare for millions more Americans to enter the health care system in the coming year, we must identify ways to expand access to primary care, improve the quality of care, and control costs. One important way is by exploring how to optimize the varied and expansive skill sets of all members of the primary care team. This idea has been examined in medical and popular media, but there has been little study of the workforce innovations employed by primary care practices to meet the increasing demands for health care.

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May 16 2013
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Human Capital News Roundup: Oregon’s Medicaid system, ‘healthy’ fast food restaurants, primary care workforce innovation, 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:

RWJF Clinical Scholar Alan Teo, MD, MS, is the lead author of a study that finds the quality of a person’s social relationships influences the person's risk of major depression, regardless of how frequently their social interactions take place. “The magnitude of these results is similar to the well-established relationship between biological risk factors and cardiovascular disease,” Teo told Health Canal. “What that means is that if we can teach people how to improve the quality of their relationships, we may be able to prevent or reduce the devastating effects of clinical depression.”

RWJF recently announced the selection of 30 primary care practices as exemplary models of workforce innovation. The practices will serve as the basis for a new project: The Primary Care Team: Learning from Effective Ambulatory Practices (LEAP). Among them is CareSouth Carolina, the Hartsville Messenger reports. Learn more about the LEAP project and the practices selected for the program.

Low-income Oregonians who received access to Medicaid over the past two years used more health care services, and had higher rates of diabetes detection and management, lower rates of depression, and reduced financial strain than those without access to Medicaid, according to a study co-authored by RWJF Investigator Award in Health Policy Research recipient Amy N. Finkelstein, PhD, MPhil. The study found no significant effect, however, on the diagnosis or treatment rates of hypertension or high cholesterol levels.  Among the outlets to report on the findings: Forbes, the New York Times, the Washington Post Wonk blog, Health Day, and the Boston Globe Health Stew blog. Read more about Finkelstein’s research on the Oregon Medicaid system.

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May 17 2012
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Human Capital News Roundup: Genome sequencing of tumors, Medicare physician fees, cervical cancer among Latinas, and more.

Around the country, print, broadcast and online media outlets are covering the groundbreaking work of Robert Wood Johnson Foundation (RWJF) scholars, fellows and grantees. Some recent examples:

Alejandra Casillas, MD, MPH, an RWJF Clinical Scholar, spoke to New America Media about why Latinas have the highest rates of cervical cancer. Many women don’t go to the doctor as much as recommended because of a cultural belief that their families come first, Casillas says, so raising awareness among men could help encourage more women to get Pap tests.

Healthcare Finance News reports on The Primary Care Team: Learning from Effective Ambulatory Practices (the LEAP Project), a recently launched RWJF initiative designed to make primary care more accessible and effective by identifying practices that maximize the services of the primary care workforce. Learn more about the LEAP Project and read an RWJF Human Capital Blog post about it.

A team led by scientists from the Broad Institute and Dana-Farber Cancer Institute—including RWJF Harold Amos Medical Faculty Development Program alumnus Levi Garraway, MD, PhD—has sequenced the genomes of 25 metastatic melanoma tumors, MediLexicon reports. The first high-resolution views of the genomic landscape are published online in the journal Nature.

RWJF Scholar in Health Policy Research and political scientist Brendan Nyhan, PhD, gave comments to NPR’s Morning Edition about the political landscape, discussing why and how voters reject facts about the political parties or politicians to whom they are loyal. Nyhan’s ongoing research suggests that people may be better able to deal with cognitive dissonance—“the psychological experience of having to hold inconsistent ideas in one's head”—if they are first given an image or ego boost.

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Apr 5 2012
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Human Capital News Roundup: County Health Rankings, a searchable map for defibrillators, encouraging organ donation, and more.

Around the country, print, broadcast and online media outlets are covering the groundbreaking work of Robert Wood Johnson Foundation (RWJF) scholars, fellows and grantees. Some recent examples:

RWJF Executive Nurse Fellows alumna Julie Willems Van Dijk, RN, PhD, was quoted in a number of outlets this week discussing the results of the 2012 County Health Rankings, a joint project of the University of Wisconsin Population Health Institute and RWJF. Coverage included stories in the Fort Worth Star Telegram, San Diego Union-Tribune and Oregon Public Broadcasting. A number of other outlets, including National Public Radio, the Winston-Salem (N.C.) Journal, and the Knoxville (Tenn.) News Sentinel, quoted RWJF President and CEO Risa Lavizzo-Mourey, MD, MBA.

"Work is organized in such a way that it makes it a constant challenge to maintain social and family ties," says RWJF Health & Society Scholars program site director Lisa Berkman, PhD, in "How to Find Happiness at Work," an aptly titled article in U.S. News & World Report. "We do almost nothing in terms of how our work is organized to help families exist. Instead of facilitating that, we in the United States challenge that all the time," she continues. Berkman is partnering with a long-term care services company on what the article describes as a "family-friendly" pilot program for its employees.

For an article on the challenges of achieving a highly educated nursing workforce, NurseZone.com interviewed Jane Kirschling, DNS, RN, an alumna of the Executive Nurse Fellows program, and Linda Aiken, PhD, RN, a 1998 recipient of an RWJF Investigator Award in Health Policy Research. Kirschling observes, "The exciting news is that we have nurses who are actively looking to continue their education," but notes that nursing schools face the challenge of educating enough nurses to meet the nation's growing needs. Read an RWJF Human Capital Blog post about Kirschling's selection as Kentucky's 2010 Nurse of the Year.

A Healthcare Finance News story highlights the role played by Margaret Flinter, APRN, PhD, a 2002 alumna of the Executive Nurse Fellows program. Flinter is co-director of RWJF's new Primary Care Team: Learning from Effective Ambulatory Practices (LEAP) Project. It is designed to identify and study primary care practices that use health professionals and other staff in ways that maximize access to their services. The article quotes Maryjoan Ladden, PhD, RN, FAAN, RWJF senior program officer and an Executive Nurse Fellow alumna herself: "Our system can't produce enough primary care providers over the next couple of years to meet the demand of what we need, so what we're going to have to do is use people more creatively." Read an RWJF Human Capital Blog post about the LEAP Project by Ladden and fellow RWJF Senior Program Officer Nancy Fishman, BSN, MPH.

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Mar 28 2012
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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

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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.

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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.

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Mar 8 2012
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New RWJF Program Will Study How to Use Primary Care Workforce More Effectively

The Robert Wood Johnson Foundation (RWJF) yesterday announced the launch of a new program designed to make primary care more accessible and effective by identifying practices that maximize the services of the primary care workforce.

The Primary Care Team: Learning from Effective Ambulatory Practices (the LEAP Project) will identify primary care practices that use health professionals and other staff in ways that maximize access to their services, so these workforce models can be replicated and adopted more widely. Its goal is to identify and then study the innovative staffing arrangements of up to 30 high-functioning primary care practices.

With millions more Americans poised to enter the health system as the Affordable Care Act is implemented, the new program will identify changes in policy, workforce, culture, education and training related to primary care that can improve the way practices function. “The nation will not be able to train new primary care providers quickly enough to meet the need, so part of the solution must be to use the workforce we have more effectively. This new program will identify ways to do that,” said John Lumpkin, MD, MPH, RWJF senior vice president and director of the Health Care Group.

The LEAP Project will be directed by Ed Wagner, MD, MPH, and Margaret Flinter, PhD, APRN, and the MacColl Center for Health Care Innovation at Group Health Research Institute in Seattle will serve as its national program office. Wagner is director of the MacColl Center and Flinter, a family nurse practitioner by clinical background, is senior vice president and clinical director of the Community Health Center, Inc., a statewide Federally Qualified Health Center in Connecticut and director of its Weitzman Center for Innovation. She is an alumna of the RWJF Executive Nurse Fellows program.

Learn more about the new program here.