Category Archives: LEAP Project

Dec 8 2014
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Register Now for Tomorrow’s Webinar on Innovations in the Primary Care Workforce

At 4 p.m. ET (1 p.m. PT) tomorrow, Tuesday, December 9, 2014, the Robert Wood Johnson Foundation’s LEAP project will hold a webinar on innovations in the primary care workforce, and the project’s new online resource, the Improving Primary Care Team Guide. To join Tom Bodenheimer, MD, MPH, professor, Family & Community Medicine, University of California San Francisco, Lisa Letourneau, MD, MPH, executive director, Maine Quality Counts, and the LEAP Team for this free webinar, register here

Dec 4 2014
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New Online Resource Provides Tools for Transforming Primary Care

Ed Wagner, MD, MPH, is director emeritus of the MacColl Center for Health Care Innovation. A general internist and epidemiologist, Wagner was founding director of Group Health Research Institute.

Ed Wagner, MD, MPH

Better care. Healthier patients. Happier staff.  A new online resource provides practical, hands-on tools to build better primary care teams that can put those outcomes within reach.

Nationwide, primary care practices are finding that creating more effective practice teams is the key to becoming a patient-centered medical home, improving patients’ health, and increasing productivity. The Improving Primary Care Team Guide (Team Guide) is a free online resource for primary care practices working to do just that. It:

  • Provides hands-on tools and resources that are actionable and measureable
  • Is appropriate for practices at any stage of development
  • Includes modules that enable practices to easily pinpoint relevant topics and areas of interest

The new Team Guide presents practical advice, case studies, and tools from 31 exemplary primary care practices across the country that have markedly improved care, efficiency, and job satisfaction by transforming to a team-based approach. For the last three years, with funding from the Robert Wood Johnson Foundation (RWJF), the LEAP team has identified, studied, and engaged these practices to develop the lessons contained in the Team Guide. 

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Sep 30 2014
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Building the Optimal Primary Care Team

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. Summaries of the first two webinars in the series are available here and here. The third webinar in the series focused on building an effective primary care team. Speakers included leaders from three primary care sites around the country that the LEAP program has deemed exemplars.

LEAP Director Ed Wagner, MD, MPH, began the webinar by framing the question for participants: Patients need multiple forms of contact across a primary care team, he observed. Given that, how does an organization build an effective team? How does an organization go from a collection of employees to a coherent, high-functioning team?

Charles Burger, MD, Medical Director Emeritus at Martin’s Point Health Care in Bangor, Maine, discussed the importance of recruitment and training.

He began by describing the members of Martin’s Point’s teams:  a medical provider, practice administrator, collaborative care nurses, medical assistants, and care team patient service representatives.

The recruiting process is quite rigorous, he explained. “We invite the whole team in reviewing and selecting new team members,” he said. “Really what we are looking for are certain behavioral characteristics.” He said training is similarly rigorous: a six- to eight-week competency-based training period for each new team member, working one-on-one with a trainer and moving steadily through a number of modules. Each new team member moves through each module at his or her own pace, and move on when they demonstrate competence with the material in each module. 

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Aug 27 2014
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Team-Based Interdisciplinary Care

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. (Read a post summarizing the first of the six webinars.) The second of the webinars in the series focused on team-based care for complex cases. Presenters included leaders from four primary care sites around the country that the LEAP program has deemed exemplars.

Managing Care for the Most Complex Patients

Kathy Bragdon, RN, director of care management at Penobscot Community Health Center in Bangor, Maine, discussed the rapid growth of the health center, and went on to describe its system of care management for the most complex patients.

The center relies on a transitions care manager, who shares information back and forth with the hospital and with patients’ medical homes. In addition, the manager meets with patients when they are in the hospital, looking to identify potential barriers to recovery and to provide any needed referrals.

“One of the big roles—we didn’t realize how big—was that a tremendous number of patients had no primary care at the time of admission,” she said. “We worked really closely with the hospitals trying to provide those services and make that linkage to those patients who needed primary care providers.”

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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.

Maryjoan Ladden / RWJF

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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