Category Archives: RWJF Leaders

Oct 21 2013
Comments

RWJF Scholars & Fellows Speak: What’s a Culture of Health? What Does It Take to Get There?

Linda Wright Moore, MS, is a senior communications officer at the Robert Wood Johnson Foundation (RWJF).

Linda Wright-Moore

Developing a vision for a national “culture of health” has been central to internal discussions at the Foundation, as we’ve engaged in a deliberative process of strategic planning for the future.

For the past year since marking our 40th anniversary, we’ve been asking ourselves where we should set our sights and focus our energies in a rapidly changing world, in order to advance our mission to improve health and health care for all.  Consider: the population is aging, becoming more diverse. Technological advances are transforming how we communicate, how we provide health care, and more. “Big data” is making once tedious and time-consuming calculations and analysis routine. Out of our deliberations—a new vision of the way forward has emerged, presented in the 2013 President’s Message from Risa Lavizzo-Mourey, MD, MBA: "We, as a nation, will strive together to create a culture of health enabling all in our diverse society to lead healthy lives, now and for generations to come."

To begin to informally road test that vision, we posed a question to RWJF grantees and alumni at an RWJF-sponsored reception at the AcademyHealth meeting in Baltimore last summer. In impromptu interviews, we asked, “What is a culture of health? What does it take to get there?

Read more

Oct 15 2013
Comments

A Journey Well Worth Taking

Linda Burnes Bolton, DrPH, RN, FAAN, is vice president for nursing, chief nursing officer, and director of nursing research at Cedars-Sinai Medical Center in Los Angeles. She was vice chair of the Institute of Medicine Commission on the Future of Nursing, and is a trustee of the Robert Wood Johnson Foundation. It has been three years since the Institute of Medicine issued Future of Nursing: Leading Change, Advancing Health.

file

Developing the Institute of Medicine report, Future of Nursing: Leading Change, Advancing Health and working to implement its recommendations has been a magnificent journey. It hasn’t been about nursing, but rather about health and health care. We focus on nursing, because it is one of the keys to improving health and health care. But our success, and the reason people are joining us on this journey, is because the report and its recommendations mean better health for the public and a stronger health care system for the country.

LBurnesBolton_Barros2012

What began as a report has become a groundswell.  It is doing exactly what we hoped it would do, bringing people together to strengthen our health care system. Today a large, multidisciplinary, national movement is engaging nurses, consumers, and other health professionals in local and regional efforts to bring this report to life. There are great examples, for instance, of people from diverse fields coming together to remove practice barriers, physicians saying they believe medicine must be a “team sport,” consumers working to improve care in their communities—and much more.

Read more

Oct 14 2013
Comments

Leading in a Collaborative Environment: A Top 10 List for Getting There

Susan B. Hassmiller, PhD, RN, FAAN, is senior adviser for nursing at the Robert Wood Johnson Foundation, and director of the Future of Nursing: Campaign for Action. Three years ago, the Institute of Medicine issued Future of Nursing: Leading Change, Advancing Health, which supports “efforts to cultivate and promote leaders within the nursing profession—from the front lines of care to the boardroom.” The goal, the report says, is that nurses be full partners, with physicians and other health professionals, in redesigning health care in the United States.

file

The only way to achieve a healthier future for everyone in this country is to work collaboratively toward that goal. Leading in a collaborative environment takes very special skills. To find effective leaders, we must consider the skills, talents, and experience of everyone who aspires to leadership, regardless of their profession.

sue_hassmiller_hz_2_c

In fact, there is no evidence pointing to a single profession as having all requisite leadership skills to get our population to a healthier state. It is truly about the skills, talents, and experience of the whole team, and everyone on the team should be considered a potential leader.

The Institute of Medicine (IOM) report, The Future of Nursing: Leading Change, Advancing Health states that all professions should be equal partners in leading health and health care efforts in this country to assure access, affordability, quality, and a healthier future for all. The IOM committee members who shaped that report made extremely thoughtful recommendations on leadership.

Below, I add my own take, based on experience, about what it takes to lead in a collaborative environment.

Read more

Oct 4 2013
Comments

The Future of Nursing: A Look Back at the Landmark IOM Report

By Harvey V. Fineberg, MD, PhD, president of the Institute of Medicine, and Risa Lavizzo-Mourey, MD, MBA, president and CEO of the Robert Wood Johnson Foundation. This commentary originally appeared on the Institute of Medicine website.

file

Three years ago, the Institute of Medicine (IOM) released its landmark report The Future of Nursing: Leading Change, Advancing Health, made possible by the support of the Robert Wood Johnson Foundation (RWJF). In light of the tremendous need for nurses in health care today and in the future — due to the growing numbers of people with chronic diseases, an aging population, and the need for care coordination — the report provided a blueprint for how to transform the nursing profession. Recommendations put forth by the report committee included removing barriers to practice and care, expanding opportunities for nurses to serve as leaders, and increasing the proportion of nurses with a baccalaureate degree to 80 percent by 2020.1

file

Spurred by the 2010 IOM report, RWJF and AARP partnered to establish the Campaign for Action, an initiative to mobilize action coalitions in all 50 states and the District of Columbia to utilize nurses more effectively in confronting the nation’s most pressing health challenges. Although we have made measurable progress in the past 3 years, we have more work to do to fully realize the potential of qualified nurses to improve health and provide care to people who need it.

Read more

Sep 30 2013
Comments

Making Nurses’ Academic Progression a Reality

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

Maryjoan Ladden / RWJF

There is near-universal agreement among health care stakeholders and experts that the country needs to grow the number of primary care providers. If the health care system is to meet the growing demand for care that will result from the greying of the Baby Boomers and the influx of millions of newly insured Americans, we're going to need a bigger, better-prepared health care workforce.

That’s a point the 2010 Institute of Medicine (IOM) report, The Future of Nursing: Leading Change, Advancing Health, made very clearly with respect to nurses. That landmark report also pointed out that health care is becoming increasingly complex as our understanding of illness grows and as the tools and systems we have available to combat it change and evolve.

Read more

Sep 23 2013
Comments

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.

Read more

Jul 31 2013
Comments

Implementing the Affordable Care Act: Getting Beyond Drama to the Real Deal on Health Reform

Linda Wright Moore, MS, is a senior communications officer at the Robert Wood Johnson Foundation (RWJF).

Linda Wright-Moore

The swirl of controversy and nonstop debate around the Patient Protection and Affordable Care Act  (ACA) is like a play that never ends: Every time you think you’re coming to the finale, another character or plot twist crops up—and the production drags on … and on.

So it goes with the ACA: Last year, the U.S. Supreme Court ruled the new law to be mostly sound, but fudged on the state mandate to expand Medicaid just enough to keep the drama twisting and turning—and to make many poor and uninsured people ineligible for government subsidies.

Meanwhile, repeated attempts to repeal the law—at least 38 to date—have contributed to a jarring statistic: 42 percent of Americans are unaware that the ACA is the law of the land. In light of the lack of knowledge that the health reform law is the law—it’s no surprise that half of the public admits to not having enough information to understand the likely impact of the ACA on themselves and their families.

Read more

Jul 1 2013
Comments

Bold Solutions, Not Tired Turf Battles

Susan B. Hassmiller, PhD, RN, FAAN, is senior adviser for nursing at the Robert Wood Johnson Foundation, and director of the Future of Nursing: Campaign for Action.

sue_hassmiller_hz_1_c

On Thursday, New York Times blogger Pauline Chen, MD, took a fresh look at the disagreements over the services that advanced practice registered nurses should be authorized to provide, reporting on a primary care meeting at which a doctor dared to raise “the unmentionable” topic with his colleagues. The room, she reports, erupted into discord and chaos.

The same divide was documented in a survey reported by the New England Journal of Medicine in May.  It is a terrible shame.  What we need, now more than ever, is open and reasoned conversation within and between health care fields about the best way to provide high quality care and improve our population’s health.

These are challenging times for our health care system. Millions of Americans are about to gain insurance through the Affordable Care Act. Our population is getting older and living with more chronic illnesses. And we have an urgent need to promote prevention, improve quality, and contain costs.

There is no question that we need more physicians and more primary care physicians in particular. There is no question that physicians should treat the sickest patients and those with the most complex health problems.  But there also is no question that we need nurse practitioners to be able to practice to the full extent of their education and training.

Read more

Jun 28 2013
Comments

Expert Discusses New Data on America’s Public Health Nursing Workforce

A report funded by the Robert Wood Johnson Foundation (RWJF) and produced by the University of Michigan Center of Excellence in Public Health Workforce Studies is the first comprehensive assessment of the size, composition, educational background experience, retirement intention, job function and job satisfaction of nurses who work for state and local health departments.

Paul Kuehnert, MS, RN, CPNP, team director of Public Health at RWJF, and an alumnus of the RWJF Executive Nurse Fellows program, discusses the report’s findings.

May 16 2013
Comments

New Survey: Physicians, Nurse Practitioners Disagree on Nurses’ Role in Providing Primary Care

Lori Melichar Gadkari, PhD, MA, is a director at the Robert Wood Johnson Foundation (RWJF), in the Research and Evaluation Unit.

Lori Melichar

Yesterday the New England Journal of Medicine published the results of a study co-funded by the Robert Wood Johnson Foundation, Johnson & Johnson, and the Gordon and Betty Moore Foundation. “Perspectives of Physicians and Nurse Practitioners on Primary Care Practice” finds that 96 percent of nurse practitioners and 76 percent of physicians agreed with the Institute of Medicine report recommendation that “nurse practitioners should be able to practice to the full extent of their education and training.” The new study is authored by Karen Donelan, ScD, EdM, Catherine M. DesRoches, DrPH, Robert S. Dittus, MD, MPH, and Peter Buerhaus, PhD, RN.

When asked how increasing the supply of nurse practitioners would potentially affect the United States health care system, the authors found that the majority of physicians (73%) said increasing the supply of primary care nurse practitioners (PCNPs) would lead to improvements in the timeliness of care. A much smaller majority of physicians (52%) said increasing the supply of PCNPs would lead to improvements in access to care for people in the country. 

However, the new survey found significant disagreement between primary care physicians and PCNPs about whether increasing the supply of PCNPs would improve patient safety and the effectiveness of care, and whether it would reduce costs. There was also a large professional divide about proposed changes to PCNPs’ scope of practice, putting PCNPs in leadership roles, and the quality of care that PCNPs provide.

Read more