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Oct 31 2014
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An Anthropological Approach to Medicine

Theresa Yera is a senior at the State University of New York (SUNY) at Buffalo. A project of the Robert Wood Johnson Foundation (RWJF), the Institute for Health, Health Care Policy and Aging Research, and Rutgers University, Project L/EARN is a 10-week summer internship that provides training, experience and mentoring to undergraduate college students from socioeconomic, ethnic and cultural groups that traditionally have been underrepresented in graduate education.

Theresa Yera

When I applied to the 2014 Project L/EARN cohort, I was seeking exposure to anthropological research that would lead me into a career of public health service. I wanted to pursue L/EARN because of my strong interest in anthropology and medicine. My previous experience in health care included studying for the Emergency Medical Technician (EMT) examinations, volunteering as a Campus Health Educator (CHE), and participating in qualitative and quantitative research projects for almost three years.

The training as an EMT introduced me to patient and health care provider interaction and raised questions on streamlining the process. It also trained me to think critically and quickly, sharpen my leadership skills, and develop interview questions. Patients complained of many chronic and acute health problems that stemmed from their health behaviors and environment. The CHE initiative led me to value a community approach for health problems. In CHE, I worked to end racial disparities in organ donation and increase awareness of the need for organ donation and a healthy lifestyle. I met many individuals with personal stories that explained why they either did or did not want to donate.

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Oct 31 2014
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RWJF Milestones, October 2014

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:

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Oct 30 2014
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Curricular Innovation at Nursing Schools

With so many aspects of the nation’s health care system undergoing significant change, many of the nation’s nursing schools have implemented curricular innovations aimed at ensuring that new nursing graduates are fully prepared for the challenges they’ll face in practice. These include working collaboratively in teams, providing evidence-based care, managing chronic conditions, coordinating complex care, and promoting a culture of health—and much more transformation lies ahead.

According to the latest issue of Charting Nursing’s Future, the Robert Wood Johnson Foundation’s (RWJF) issue brief series focused on the future of nursing, most clinical nursing education programs still emphasize hospital-based care, as they have for decades, even though much care has shifted to community settings. This results in a widening gap between clinical nursing education and the 21st-century competencies nurses need.

The brief highlights curricular innovations at a number of nursing schools around the nation, including re-sequencing of the curriculum, using a “concept-based” approach, a “coach model” supporting an online baccalaureate (BSN) degree, new types of academic/practice partnerships, and more. Increasingly, nursing schools are restructuring their students’ clinical experiences, embracing:

  • Simulation, using actors posing as patients, complex high-fidelity mannequins, or virtual reality. A newly released and eagerly awaited study by the National Council of State Boards of Nursing (NCSBN) offers powerful support for the trend toward simulation. It found no differences in licensure pass rates or other measures of overall readiness for practice between new graduates who had traditional clinical experiences and those who spent up to 50 percent of their clinical hours in simulation.

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Oct 30 2014
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RWJF Scholars in the News: Scapegoating EHRs, Ebola fears, children fighting 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:

In an article published in Healthcare IT News, David Blumenthal, MD, MPP, writes that health care providers may be too quick to blame Electronic Health Records (EHR) for medical errors. Blumenthal notes that EHRs are still imperfect and that improvements will take time, but argues: “There is no going back in the electronic health information revolution. No physician or hospital, however loud their complaints, has ever thrown out their EHR and returned to paper. The dissatisfaction with the technology will recede as EHRs improve, and as a new generation of young clinicians, raised in the electronic world, populates our health care system.”  Blumenthal is president of The Commonwealth Fund, former National Coordinator for Health Information Technology, and an RWJF Investigator Award in Health Policy Research recipient.

In a blog published by the Washington Post’s “Monkey Cage,” Shana Gadarian, PhD, and her co-author write that Ebola anxiety, while potentially misplaced and harmful, is likely to have an impact on whom Americans trust to handle the disease and what kinds of policies they will support to fight it. The authors have studies society’s reactions to small pox and H1N1 flu. “In general we find that anxiety makes people more supportive of government playing an expansive role in protecting them during a health crisis ... we think our study and the current Ebola outbreak both emphasize that people will rally around experts and increase their support for policies that fight the contagion, even if they hurt civil liberties. Let us hope that the U.S. health system is ultimately worthy of the confidence the public has in it.” Gadarian is an RWJF Scholars in Health Policy Research alumna.

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Oct 29 2014
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Primary Care and the Next Phase of Health Care Reform

Michael Hochman, MD, MPH, is medical director for innovation at AltaMed Health Services, the largest independent federally qualified health center in the United States. AltaMed has enrolled more than 30,000 Southern Californians in Medi-Cal and Covered California, the state health care exchange. Hochman is an alumnus of the Robert Wood Johnson Foundation (RWJF) Clinical Scholars program at the University of California, Los Angeles, and the U.S. Department of Veterans Affairs. Martin Serota, MD, is AltaMed’s chief medical officer.

Michael Hochman Michael Hochman

Although the dust is still settling, most indicators suggest that the first wave of national health care reform was a success, particularly in California.  More than 8 million Americans enrolled in commercial health plans under the Affordable Care Act, surpassing targets set by the Obama administration. Many more will qualify for plans under Medicaid expansion. As leaders at a community health center that serves a large population of low-income patients—many of whom currently lack coverage—we could not be happier about the new opportunities for our patients.

Martin Serota Martin Serota

But we also know that the work is far from complete. Health care reform will only be a success if coverage expansion results in improvements in quality and efficiency, and better health for the population. As we know from the Massachusetts experience, it took time and a lot of effort for these benefits to ensue. Only now, several years after health care reform began in Massachusetts, are residents of the state starting to reap the benefits.

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Oct 29 2014
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Patients Pleased With Care from Physician Assistants

Physician assistants (PAs) received high marks from patients in a recent survey conducted by Harris Poll for the American Academy of Physician Assistants (AAPA). Among 680 Americans (out of more than 1,500 surveyed) who have interacted with a PA in the past year, 93 percent see PAs as part of the solution to the nation’s shortage of health care providers; 93 percent regard PAs as trusted health care providers; and 91 percent agree that PAs improve health outcomes for patients.

“The survey results prove what we have known to be true for years: PAs are an essential element in the health care equation and America needs PAs now more than ever,” AAPA President John McGinnity, MS, PA-C, DFAAPA, said in a news release. “When PAs are on the health care team, patients know they can count on receiving high-quality care, which is particularly important as the system moves toward a fee-for-value structure.”

The AAPA points out that more than 100,000 PAs practice medicine in the United States and on U.S. military bases worldwide. A typical PA will treat 3,500 patients in a year, the association says, conducting physical exams, diagnosing and treating illnesses, ordering and interpreting tests, prescribing medication, and assisting in surgery.

Read more about the AAPA survey.

Oct 28 2014
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Health Care Workers Primed to Lead Global Response to Ebola

Timothy Landers, PhD, CNP, and Jason Farley, PhD, MPH, CRNP, are Robert Wood Johnson Foundation (RWJF) Nurse Faculty Scholars. In his work, Landers focuses on the epidemiology and prevention of antibiotic-resistant infections, including the use of hand hygiene as a means of prevention. Farley evaluates treatment outcomes in multi-drug resistant infections including tuberculosis (TB) and Methicillin-Resistant Staphylococcus aureus (MRSA) in patients with HIV, with a focus on sub-Saharan Africa.

Timothy Landers Timothy Landers

The recent outbreak of Ebola virus in West Africa is a stark reminder that we live in a globally connected world and that outbreaks can occur without warning. As infection prevention specialists, we are acutely aware of the risks health care workers face in caring for the public, both now and in times of relatively less chaos.

The good news is that despite media reports, nurses, physicians, infection prevention specialists and other health care workers are in an ideal position to lead the global response to this disease.

Our experience with measures to address hospital-acquired infections—isolation precautions, hand hygiene, contact tracing and public health measures—are also the same methods necessary to contain the spread of Ebola.  

Jason Farley (smaller) Jason Farley

Building on experience addressing these infections, along with recognition of the differences in Ebola virus transmission, the Centers for Disease Control & Prevention (CDC) regularly updates the guidelines and is currently recommending enhanced versions of isolation precautions, including enhanced standard precautions, contact precautions, and droplet precautions. 

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Oct 28 2014
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New Cohort of RWJF Nurse Faculty Scholars

Twelve talented early-career nurse faculty have been selected as the seventh cohort of Robert Wood Johnson Foundation (RWJF) Nurse Faculty Scholars. The award is given to individuals who show outstanding promise as future leaders in academic nursing.

Each scholar receives a three-year $350,000 award to pursue research, leadership training in all aspects of the faculty role, and mentoring from senior faculty at his or her institution. The scholars chosen this year are using their grants to study a range of issues, from pediatric asthma to dementia care to health literacy to HIV treatment to the use of technology to improve access and outcomes for rural and uninsured individuals.

At a time when many schools of nursing are turning away qualified applicants because they do not have the faculty to teach them, RWJF’s Nurse Faculty Scholars program is helping more junior faculty succeed in, and commit to, academic careers. The program also is strengthening the academic productivity and overall excellence of nursing schools by developing the next generation of leaders in academic nursing.

Read more about the 2014 and final cohort of RWJF Nurse Faculty Scholars.

Oct 27 2014
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Eight Peers, One Family

Swet Patel is a sophomore at the College of New Jersey, majoring in psychology. He is a graduate of Project L/EARN, a 10-week summer internship that provides training, experience and mentoring to undergraduate college students from socioeconomic, ethnic and cultural groups that traditionally have been underrepresented in graduate education. Project L/EARN is a project of the Robert Wood Johnson Foundation (RWJF), the Institute for Health, Health Care Policy and Aging Research, and Rutgers University.  

Swet Patel

On May 27, 2014, I finally ended my teens and entered my 20s. But I will forever remember this date as more than just my birthday. This was the first day of Project L/EARN.

Like my peers entering the program, I expected to gain research exposure that would be a great résumé booster. Little did I know I would gain so much more than just research experience. Although the 10-week program was intensive, and at some points it made me question why I was doing it, I never imagined I would be able to achieve so much in such a short period of time. I realized after seeing the fruits of my labor—the poster, the oral presentation, and the paper—that this program was beyond worth it.

Project L/EARN boosted my confidence. I actually feel like a researcher. And it was truly remarkable that I was able to meet such diverse individuals from a wide range of fields during the guest lecture series. I learned a great deal from these esteemed professionals regarding the different aspects of health care. The networking the program provided gave me lifelong relationships that I will forever cherish.

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Oct 24 2014
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Working Together to Draw More Nurses to Public Health

Patricia Drehobl, MPH, RN, is associate director for program development at the Centers for Disease Control & Prevention (CDC). She is an alumna of the Robert Wood Johnson Foundation (RWJF) Executive Nurse Fellows program (2007-2010).

Patricia Drehobl

Human Capital Blog: CDC is engaging in new partnerships with the American Association of Colleges of Nursing (AACN) to promote public health nursing. How did the new collaboration come about?

Pat Drehobl: CDC has funded some national academic associations for many years, including the Association of Schools of Public Health, the Association of Prevention Teaching and Research, and the Association of American Medical Colleges. We recognized the need to include nursing representation because nursing is the largest discipline in the public health workforce. We added AACN as a partner in 2012 when we developed our funding opportunity announcement to work with academic partners.

HCB: Why did CDC decide to reach out to the nursing community in 2012?

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