Catherine J. Malone, MBA, DBA(c), is a program associate working in the areas of diversity and nursing for the Robert Wood Johnson Foundation. This is the first in a series of posts looking at diversity in the health care workforce.

As a member of the Robert Wood Johnson Foundation’s (RWJF) Human Capital team leading the group’s diversity efforts and the Foundation’s Diversity Team, I would like to share some of our work in this area. I must start by noting that “diversity” means different things to different people. At RWJF we recognize and value all types of diversity and therefore have a broad definition of the term which is described in the Foundation “Diversity Statement” below:

“Diversity and inclusion are core values of the Robert Wood Johnson Foundation, reflected in our Guiding Principles. We value differences among individuals across multiple dimensions including, but not limited to, race, ethnicity, age, gender, sexual orientation, physical ability, religion and socioeconomic status. We believe that the more we include diverse perspectives and experiences in our work, the better able we are to help all Americans live healthier lives and get the care they need. In service to our mission, we pledge to promote these values in the work we do and to reflect on our progress regularly.”

Michael Painter, JD, MD, is a senior program officer at the Robert Wood Johnson Foundation (RWJF), and an alumnus of the RWJF Health Policy Fellows program. This post originally appeared on the RWJF Pioneering Ideas Blog.

Have you read “The Swerve,” the Pulitzer Prize-winning book by renowned historian Stephen Greenblatt? In it a canny Renaissance era book hunter discovers and releases knowledge in the form of a medieval, controversial poem lost to posterity. The poem had dwindled down to a single handmade, leather-bound version held behind the vine-covered, ancient walls of an Italian monastery. According to Greenblatt, the unleashing of that book changed everything that came after. That small book with the long poem on the nature of things set in motion forces that challenged the status quo and triggered dramatic, world-wide change—a swerve. The only way that knowledge survived the millennia was because monks trained in hand crafting books had carefully copied the one survivor—and saved it for centuries.

Last week, the Khan Academy, AAMC (Association of American Medical Colleges) and the Robert Wood Johnson Foundation may not have triggered quite such a momentous unleashing—but this powerful collaboration did start something very interesting with potentially significant implications for health care education.

Susan B. Hassmiller, PhD, RN, FAAN, is the Robert Wood Johnson Foundation (RWJF) Senior Adviser for Nursing and Director, Future of Nursing: Campaign for Action.

After about a year of planning, we held the Campaign for Action National Summit in Washington D.C. in late February and early March. We brought together more than 200 leaders from state Action Coalitions—nurses, other health leaders, consumers, educators, business leaders and others who are working at the state level to advance nursing and improve health care. These Action Coalition leaders are experts and activists who came to Washington to share innovative ideas for transforming health care and improving health, and to plan for the future. 

The mission of the Campaign for Action and its Action Coalitions, which are in every state and the District of Columbia, is to advance recommendations from the Institute of Medicine’s landmark report, The Future of Nursing: Leading Change, Advancing Health. Those recommendations cover a range of issues, including academic progression, nurse leadership, scope of practice, workforce data collection, diversity, and much more. Our goal, in all this work, is to ensure that nurses can contribute as equal partners in a reformed health care system in order to improve patient care.

We planned the Summit as a nontraditional conference that used a U.N.-style approach. It was designed to allow participants—who are from nursing, medicine, business, health systems, philanthropy, and academia—to learn from each other.

Lori Melichar, PhD, is a senior program officer at the Robert Wood Johnson Foundation (RWJF).

On February 12, the Robert Wood Johnson Foundation launched a new website that can serve as a long-awaited repository for work we have funded over the last 10 years that invests in advancing the science of quality improvement (QI) research and evaluation.  We hope the website also provides the opportunity for researchers and other health care professionals engaged in QI work to access resources and to connect with colleagues with mutual interests.

The launch coincided with a virtual meeting on Advancing the Science of QI Research and Evaluation (ASQUIRE).  The group convened to hear findings from grantees of the Foundation’s Evaluating QI Training Programs Initiative (PQI). 

Meeting participants were tasked with thinking about how the website can best disseminate their work as well as collect, house and spread tools, frameworks, methods and models to assist those doing QI and those evaluating QI efforts. Grantees were joined by experts in QI research, practice and evaluation and a lively discussion (sometimes a debate) ensued. 

Lori Melichar, PhD, is a senior program officer at the Robert Wood Johnson Foundation (RWJF). 

The Robert Wood Johnson Foundation’s mission is to improve the health and health care of all Americans. In pursuit of this mission, we seek to improve the quality of care provided in hospitals, ambulatory care centers, public health departments, and other settings where health is enhanced or health care is delivered.

Within the past 15 years, Quality Improvement (QI)—the process-based data-driven approach to improving the quality of a product or service through iterative action-evaluation cycles—has emerged as a promising strategy to accomplish this goal, and RWJF funded several national programs to “demonstrate” the potential of QI to improve health care processes, staff engagement and patient outcomes.  The Foundation’s Pursuing Perfection Program, which had as its goal to help hospital and physician organizations improve patient outcomes dramatically by pursuing perfection in major care processes, employed QI tools such as Plan-Do-Study-Act cycles and improvement collaboratives to accomplish this goal.  Another program, Transforming Care at the Bedside, taught frontline nurses the skills and methods of QI and empowered these staff to engage in activities to transform hospital care.  Paths to Recovery is an RWJF program that used QI processes to improve the systems of care that provided substance abuse treatment. Aligning Forces for Quality  is RWJF’s signature effort to lift the overall quality of health care in targeted communities, reduce racial and ethnic disparities, and provide models for national reform.

Susan B. Hassmiller, PhD, RN, FAAN, is the Robert Wood Johnson Foundation Senior Adviser for Nursing and Director, Future of Nursing: Campaign for Action. This post is part of the "Health Care in 2013" series.

It is a time of year when we celebrate, reflect and make resolutions.  When I think about the nursing community, there is so much that makes me proud.  I am proud of all the ways nurses care for patients. I am proud of how we are adapting to a fast-changing health care system. I am proud of the ways we work effectively in interdisciplinary teams.  And I am proud of the many ways we organize to make our health care system work, especially for the most vulnerable patients.

Following the heartbreaking tragedy in Newtown, Connecticut, with such devastating loss of life, I was so proud to see that 30 major nursing organizations…and probably more now…came together in one collective voice to advocate to the highest public officials in our land on behalf of all those who need our care. The “call to action” from leading nursing organizations meant that, once again, we took a united stand, as nurses, to proclaim that we care…and we will speak out about what must be done on behalf of the people who put their trust in us. 

This made me proud to be a nurse.  And it makes me proud to know that we are asking nurses to speak out and effect change as part of the Future of Nursing: Campaign for Action.  We are asking that the nursing community come together, not for their own benefit…but on behalf of the people and patients who need nurses the most. 

By Susan B. Hassmiller, PhD, RN, FAAN, Robert Wood Johnson Foundation Senior Adviser for Nursing and Director, Future of Nursing: Campaign for Action.

Those of us who are working to implement recommendations from the Institute of Medicine (IOM) report, The Future of Nursing: Leading Change, Advancing Health, got great news this week when leaders from national organizations representing community college presidents, boards, and program administrators joined with representatives from nursing education associations to endorse a Joint Statement on Academic Progression for Nursing Students and Graduates.  This was a historic moment that will mean greater support for efforts to help nurses advance their education.

Acknowledging the shared goal of preparing a well-educated, diverse nursing workforce, the consensus statement says that nursing students and practicing nurses should be supported in their efforts to pursue higher levels of education. Its endorsing organizations are the American Association of Colleges of Nursing (AACN), the American Association of Community Colleges (AACC), the Association of Community Colleges Trustees (ACCT), the National League for Nursing (NLN), and the National Organization for Associate Degree Nursing (N-OADN).

In addition, Donna Meyer, MSN, RN, the president of N-OADN, an affiliated council of AACC, published a powerful commentary in Community College Times. In it, Meyer voiced support for allowing every associate degree nurse access to additional nursing education and urged employers and others to develop innovative strategies to help associate degree nurses get higher degrees.

All this had special meaning for me, because I started my career at a community college.  It was a terrific experience for me, and I am very proud of that degree. I felt confident and prepared to complete all the tasks required of me when I entered the workforce.

But I quickly realized there was more I wanted – and needed – to know to provide high-quality care for my patients. So I went back to school, and soon felt the increased competence, and confidence, at every turn.

This is part of a series in which Robert Wood Johnson Foundation (RWJF) leaders, scholars, grantees and alumni offer perspectives on the U.S. Supreme Court rulings on the Affordable Care Act.  Susan B. Hassmiller, PhD, RN, FAAN, is the Robert Wood Johnson Foundation Senior Adviser for Nursing and Director, Future of Nursing: Campaign for Action. This post also appears on Off the Charts, the blog of the American Journal of Nursing.

When I heard that the Supreme Court upheld the Affordable Care Act, I immediately thought of my father.  He suffered mightily at the end of his life. Plagued with multiple chronic illnesses, he spent his last year in and out of hospitals.  He received good hospital care, but his health deteriorated every time he left. He simply couldn’t keep track of a growing list of prescriptions, tests and doctor visits.  My father accidentally skipped antibiotics, which led to infections, which landed him back in the hospital. He accidentally skipped blood tests, which landed him back in the hospital. It seemed that every time he came home, he’d land back in the hospital. I lived thousands of miles away and couldn’t be the advocate that he needed.

What he needed was transitional care – he needed a nurse to meet with him during a hospitalization to devise a plan for managing chronic illnesses and then follow him into his home setting. He needed a nurse to identify reasons for his instability, design a care plan that addressed them and coordinate various care providers and services. He needed a nurse to check up on him at home.  Transitional care would have eased his suffering and enabled him to live better.

“Many people see the Supreme Court's ruling as a watershed moment in the history of health care. I have a slightly different view,” Robert Wood Johnson Foundation (RWJF) President and CEO Risa Lavizzo-Mourey, MD, MBA, writes in the Atlantic. “[Last week’s] decision cleared the way for states to go forward in implementing the law and ensuring that people don't die or go bankrupt for a lack of coverage. That will mean a lot of hard work from all parties: states, the federal government, individuals and the private sector. No doubt it was a historic day. But it's not yesterday that is going to define health care in this country. It's what we all do today, tomorrow and every day after.” Read Lavizzo-Mourey’s statement on the Supreme Court’s Affordable Care Act ruling.

Several media outlets spoke to Laura Brennaman, RN, MSN, CEN, a scholar at the RWJF Nursing and Health Policy Collaborative at the University of New Mexico, as she camped outside the Supreme Court to get a seat for the announcement of its ruling. Among them: the Washington Post, CNN’s Political Ticker blog, the Daily Beast, and NurseZone.com. Brennaman, who is an emergency department nurse from Fort Myers, Fla., was also present for the Supreme Court’s oral arguments on the law in March. Read a post her Nursing and Health Policy Collaborative colleague, Lauri Lineweaver, MSN, RN, CCRN-CSC, wrote about the experience.

Other RWJF fellows and program directors were in the news to discuss the Supreme Court ruling on the Affordable Care Act. RWJF Executive Nurse Fellows alumna Juliann Sebastian, PhD, RN, FAAN, dean of the College of Nursing at the University of Nebraska Medical Center, was a guest on KVNO News to discuss how the Affordable Care Act will affect Nebraskans and the challenges associated with implementing the law. Judi Hilman, an RWJF Community Health Leader and executive director of the Utah Health Policy Project, spoke to the Salt Lake Tribune. RWJF Health & Society Scholars program co-director Jo Ivey Boufford, MD, president of the New York Academy of Medicine, gave comments to The Fiscal Times.

Medical News Today reports on the “Community Aging in Place, Advancing Better Living for Elders” (CAPABLE) initiative, led by RWJF Nurse Faculty Scholar Sarah Szanton, PhD, CRNP, MSN. It works to keep at-risk seniors who are on Medicare and Medicaid in their homes and improve their quality of life. Szanton’s project was recently awarded a $4 million Health Care Innovation Award from the U.S. Department of Health and Human Services.

Stephen Black, JD, MTS, a Community Health Leader, was the speaker at a Greater Shelby (Ala.) Chamber of Commerce luncheon, according to a story in the Shelby County Reporter. Black is founder and president of Impact Alabama, which develops and implements service-learning projects for college and graduate students, including an initiative that has provided free, technologically advanced vision screenings for more than 25,000 children in 60 counties throughout Alabama.

By Risa Lavizzo-Mourey, MD, MBA, President and CEO, Robert Wood Johnson Foundation

Today’s ruling by the Supreme Court allows the nation to move forward on the road to better health.

The Affordable Care Act, when fully implemented, will expand the number of people with health coverage, introduce strategies for improving the quality of health care, and support plans to make our communities healthier places. For that reason the Robert Wood Johnson Foundation has committed significant resources to help nonprofit organizations, states, communities and the private sector realize the full potential of the law. Today’s ruling by the Supreme Court permits the implementation process to continue in full force, and we look forward to working with everyone who shares our goals to make meaningful improvements in the health and health care of our country.

Improving access to stable, affordable health care is not a partisan issue to us. We’ve been at it for decades, working with people and organizations of all sorts. The Affordable Care Act brings us wonderfully close to achieving that mission. But our ultimate goal of helping Americans lead healthier lives will require more than simply implementing the law. Health care spending continues to rise and crowd out investments in other areas; even for people with insurance, high out-of-pocket costs can be a barrier to accessing care. Furthermore, our health is not just something that comes from the doctor’s office. Community and neighborhood conditions have a significant effect on health. The Affordable Care Act offers ways to address many of these aspects of health, and we will continue to pursue opportunities stemming from the law and elsewhere to improve the health of our nation.