Category Archives: RWJF Leaders
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.
Human Capital News Roundup: The Affordable Care Act, aging at home, service-learning projects, and more
“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.
Last summer, in anticipation of the Foundation's 40th anniversary and of her tenth year at the helm, Robert Wood Johnson Foundation (RWJF) President and CEO Risa Lavizzo-Mourey, MD, MBA, took on a challenge of a different sort. Together with her adult daughter, she joined a team climbing to the "Roof of Africa," the summit of Mount Kilimanjaro.
In her 2012 President's Message, Lavizzo-Mourey tells the tale of the trek, and recalls the advice her hiking group leader gave her:
• Measure each pace — Step. Pause. Step. Pause.
• Keep progress slow, but steady.
• Always onward. Always upward.
• Maximize progress. Minimize risk.
• Know your limits.
• Know when to stop / rest so you don’t have to stop / halt.
Lavizzo-Mourey writes, "It wasn’t until I was back on the job in Princeton that I realized these are the same basics RWJF has followed over the past four decades. That’s when it hit me: As we push our philanthropy to higher and higher levels, the one mountain that really matters is the mountain RWJF’s been trying to move all along!"
That mountain, of course, is the challenge of improving health and health care for all Americans, and RWJF has invested $9 billion in the effort over the last four decades. Lavizzo-Mourey continues:
In our practice of philanthropy, this is where the “Kilimanjaro Effect” comes into play. Step by step we progress onward. We may have to “discover the new terrain” and new ways to traverse it. It may take us a generation, or two or three, but we have the will and the means to hang in there until momentum occurs, progress is secured, and evidence confirms that the change we seek is producing positive results. If it is not—well, we have learned the hard way to know our limits, when to step, when to pause, when to stop, suspending the climb for a better route on a better day. Ours is a spirit of resilience and resolve our founder and namesake built into our philanthropic DNA from the very start.
Happy National Nurses Week! Today is National Nurses Day, and the beginning of a week during which we celebrate the contributions of this profession. The week fittingly ends with Florence Nightingale's birthday on Saturday, May 12. The Robert Wood Johnson Foundation (RWJF) has a proud history of supporting nurses and nurse leadership, so this week, the RWJF Human Capital Blog will feature posts by nurses, including leaders from some of the Foundation’s nursing programs. Check back each day to see what they have to say. This post is by Susan B. Hassmiller, PhD, RN, FAAN, RWJF Senior Adviser for Nursing and Director, Future of Nursing: Campaign for Action.
Earlier this month I had the privilege of traveling to Montana to help some of the state’s health care leaders launch the Montana Cooperative to Advance Health Through Nursing. This new state-based Action Coalition is working to advance recommendations from the Institute of Medicine report, The Future of Nursing: Leading Change, Advancing Health.
While I was there, I met with Native American nursing students and their mentors at Montana State University. They are part of the extraordinarily impressive “Caring for Our Own: A Reservation/University Partnership,” known as the CO-OP program. These students come from desperately underserved areas and, after they graduate, they will go back to their reservations to provide culturally-sensitive, urgently needed care.
At the Action Coalition gala, the recipient of the student award told her story, moving many of us to tears. When she was 17, she tried to commit suicide. It was a nurse who saved her life, and convinced her there were things to live for and gifts she had yet to share. She told the audience that the nurse had been her role model through hard times. It had taken her many years and she had overcome many more hardships, she explained, but she will soon graduate and give back in the same way that her role model had given to her.
She and her peers are the kind of strong, dedicated, caring professionals that nursing needs, our health system needs, and patients need. I came home invigorated and encouraged by all the Montanans I had met, and the promise of progress in this state.
Today is National Nurses Day, which begins the celebration of National Nurses Week. We are a diverse profession, serving patients in more ways, more roles and more settings than Florence Nightingale—whose birthday, May 12, concludes National Nurses Week—could have ever imagined.
I am proud to be a nurse, proud of my colleagues working to help patients all over the country, and proud that the Robert Wood Johnson Foundation (RWJF) has a long history of supporting nurses in many roles, from research to practice to leadership and more.
RWJF recently announced the launch of the Academic Progression in Nursing (APIN) initiative, which will help state Action Coalitions in their work to advance the recommendation in the Future of Nursing report that 80 percent of the nursing workforce be prepared at the baccalaureate level by 2020.
I am an associate’s degree nurse. I started my nursing education at a community college, and at that time, I’m not sure I could even have imagined getting to where I am today.
By Jasmine Hall Ratliff, MHA, program officer, Robert Wood Johnson Foundation
In 2010 Grantmakers in Health, an affiliation of health funders across the country, launched the Terrance Keenan Leadership Institute for Emerging Leaders in Health Philanthropy (TK Institute) to commemorate the life and leadership of long-time Robert Wood Johnson Foundation (RWJF) leader Terrance Keenan. The TK Institute was created to nurture the next generation of leaders, build relationships among them, and connect them with established figures in the field.
Terrance Keenan, affectionately called Terry, created and led many RWJF signature funding programs that included the Nurse Faculty Fellowships, Community Care Funding Partners Program and the Interfaith Volunteer Caregivers Program (which later became Faith in Action). (You can read more about Terry here.)
I was fortunate enough to be nominated and then selected to represent RWJF in the inaugural class of the TK Institute. Other participants came from foundations in Massachusetts, Ohio, Missouri, New York, North Carolina, Texas, Washington, DC and California; they worked at community, private and family foundations with assets across all ranges. Though we represented different regions and health priorities, we had many things in common: we were under the age of 40 and had a passion for moving philanthropy forward as a field.
By David Krol, MD, MPH, FAAP, Robert Wood Johnson Foundation Human Capital Portfolio Team Director and Senior Program Officer
For many Americans, a visit to the dentist is a rarity—not by choice, but because their health plans don’t cover dental care, they can’t afford it, or because there is no dentist anywhere near where they live or work. If you’re on Medicare, you know that dental isn’t covered. If you’re part of the VA system, you know that dental benefits are treated differently. If you’re an adult on Medicaid or serve adult patients who are on Medicaid, you know the chances are slim that there’s great coverage for dental care, unless you are lucky to be in a state that still covers it. Why does this happen and what can result?
A study recently released by the Pew Center on the States offers startling data on the scope of the problem and its consequences. In 2009, some 830,000 Americans visited an emergency department for a preventable dental condition. It should be obvious that the emergency department isn’t the best place to seek dental care. The same year, 56 percent of Medicaid-enrolled children got no dental care whatsoever, not even a routine exam. That’s no care even with insurance for it!
Those numbers are alarming for many reasons, but mostly because they reveal a significant public health challenge confronting the nation: Many Americans simply aren’t getting the oral care they need, at any age, including the basic preventive services and education that can detect oral disease in early stages. They are putting their health at risk, and increasing the strain on an already-overwhelmed health care system.
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
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.
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.
By Risa Lavizzo-Mourey, MD, MBA, President and CEO, Robert Wood Johnson Foundation
Change is a constant in health care. In the face of skyrocketing costs, system fragmentation, health disparities and an aging and sicker population, more care will be delivered in primary care and community/public health sites than in acute- and hospital-based settings. Yet we also face a primary care shortage and the coming infusion of 32 million newly insured people into the system.
To ensure an adequate supply of nurses with the advanced skills and expertise necessary to help bridge the gap while ensuring quality, higher levels of education are imperative. Thus, health care organizations, educational institutions and others are looking intently at the case for advancing nursing education as outlined in the Institute of Medicine (IOM) report The Future of Nursing: Leading Change, Advancing Health. Specifically, the IOM report recommended creating a system that produces more nurses educated at the Bachelor of Science (BSN) level and beyond.
Since its inception, the Robert Wood Johnson Foundation has understood the value of a strong, well-trained health care workforce. And we agree with the IOM report that the nursing profession has the potential to effect wide-reaching changes in the health care system. Further, we concur that an improved education system is necessary to ensure that nurses can continue to deliver safe, quality, patient-centered care required for the 21st century and beyond.
As I recently told NursingOutlookTalk.com, there are a number of things that hospitals and other organizations that employ nurses can do to facilitate education progression. And it is to their benefit to do so.