Category Archives: RWJF Leaders
By Risa Lavizzo-Mourey, president and CEO, Robert Wood Johnson Foundation
Every year, the American Public Health Association (APHA) annual meeting features some of the best and brightest minds in health and health care. Taking place in Washington, D.C. from October 29 to November 2, it is a cutting edge event that advances critical research, helps shape policy and practice, and stimulates thinking on some of the most pressing health issues of our time. APHA notes that it is the oldest and largest gathering of public health professionals and, in my experience it is easily one of the most influential. I am very proud that, this year, it will feature dozens of Robert Wood Johnson Foundation (RWJF) scholars, fellows, alumni, grantees, staff and others who have been touched by Foundation programs.
Perhaps most exciting is that Melvin D. Shipp, OD, MPH, DrPH, a former RWJF Health Policy Fellow (1989-1990), is beginning his term as president of this prestigious organization. Shipp is dean of The Ohio State University College of Optometry and past president of the Association of Schools and Colleges of Optometry. He will hold the APHA leadership position for two years, and I know he will do great things during that time. At the meeting, Shipp will lead a session on the Health Policy Fellows program, explaining the experience and its impact on participants.
Among the many others from the RWJF “family” who will be featured at the annual meeting are:
By Najaf Ahmad, MPH, Communications Associate, Robert Wood Johnson Foundation Human Capital Portfolio
Walking through Barnes & Noble recently, a book on the “New Arrivals” rack stopped me in my tracks. By now you may know about My Sugar Obsession. So despite being in a rush, I was immediately drawn to Sugar Nation.
Imagine reuniting with a father you haven’t seen in years, finding him in an unrecognizable condition—a “human body in the process of cannibalizing itself”—on death’s door with a missing limb. Author Jeff O’Connell begins with this moving story of how he learned that his estranged father was slowly dying from the ravages of type 2 diabetes.
Despite having learned of his father’s leg amputation weeks earlier, O’Connell—former editor-in-chief at Muscle & Fitness magazine and executive writer at Men’s Health magazine—was certain he had nothing to worry about. He worked out, was lean and appeared healthy. His thin physique didn’t fit the stereotype of someone predisposed to developing type 2 diabetes.
A sobering visit with his doctor shook O’Connell to his core. He was diagnosed with pre-diabetes and headed down the same path as his father. Rather than accepting this fate though, he embarked on a mission to fight back against the enemy lurking within him. In doing so, he unearthed crucial information on how lifestyle factors influence diabetes.
More interestingly, he discovered the troubling manner in which health care providers are (or are not) responding to this burgeoning problem, going so far as to say that many “seem clueless when it comes to diagnosing this disease, let alone treating it.”
Although genes play a prominent role in predisposing someone to type 2 diabetes, lifestyle is a major influence. O’Connell underscores how type 2 diabetes stems from “the sum total of a very long trail of personal choices, made over a lifetime.” We pay a heavy price for our love affair with sugar, as massive quantities from processed foods shock our bodies. It shouldn’t be surprising then that one in three adults in the United States now has a blood sugar abnormality that predisposes them to diabetes-related complications such as heart disease, kidney failure and blindness. Sadly, many do not know they are affected until they develop these complications.
By Susan Hassmiller, PhD, RN, FAAN
RWJF Senior Adviser for Nursing and Director, Future of Nursing: Campaign for Action
Last summer, I took one of the most rewarding trips of my life: a European tour of key sites in the life of Florence Nightingale, the founder of modern nursing and one of the great leaders in improving health and health care worldwide.
So why is it that now, more than a century after Nightingale’s death, nurses are underrepresented in the rooms where we make decisions about how to improve the health care system? Very few of us hold executive-level positions in health care organizations, very few are voting members of health care boards of directors, and very few sit on the editorial boards of health care journals.
We can—and must—change this reality, and our nation’s opinion leaders agree. A 2009 survey conducted by Gallup on behalf of the Robert Wood Johnson Foundation (RWJF) found that an overwhelming majority of opinion leaders—including insurance, corporate, health services, government and industry thought leaders as well as university faculty—want nurses to have more influence in our health care system. The survey captured the feelings of more than 1,500 opinion leaders and was published in a recent edition of the Journal of Nursing Administration.
While opinion leaders said nurses don’t have enough influence over health reform, they did say that nurses have a great deal of influence over key elements of a quality health care system, such as reducing medical errors, improving safety, and improving the quality of patient care.
We nurses also have valuable insights to share. Nurses spend more time providing direct care to patients than other providers, work closely with caregivers and family members, and see patients in their broader social environments. As such, we have a unique understanding of the complex interplay of environment and health, and we have perspectives on health from a variety of settings: the hospital, the clinic, the community and the home.
In addition, nurses are highly valued by the public; nursing is consistently ranked among the most ethical and honest professions by the nation’s adults.
So how do we ensure that nurses’ voices are heard in the rooms where key decisions are made? One key way is to change the perception of nurses. Our Gallup survey found that nurses are not perceived as important decision-makers or revenue generators. When asked how much influence certain groups will have over health reform in the next five-to-10 years, opinion leaders ranked nurses seventh out of seven choices. Dead last.
In short, opinion leaders see us in our traditional—but limited role—as bedside clinicians, but not in more expansive and influential roles as health care leaders.
By Lori Melichar, Ph.D., M.A.
Senior Program Officer, Research and Evaluation, Robert Wood Johnson Foundation
I recently attended a National League for Nursing meeting of top nursing researchers, educators and leaders. Among the purposes of the meeting was to identify gaps in and opportunities to create knowledge to improve nursing education.
While meeting participants discussed several exciting efforts currently underway to improve nursing education, journal editors attending lamented the fact that most of the published research on nursing education innovations is based on single-site studies, making it unlikely to convince faculty to adopt new models of education or change core curriculum. The editors, educators and researchers agreed that research linking teaching methods and curricular content to patient outcomes would bolster efforts to transform patient care in the U.S. Evidence in this area is crucial because curricula are packed, faculty are overworked, change takes effort, and students don't always know what's best for them.
Producing more rigorous evidence is a strategy I often support as a member of the department of research and evaluation at the Robert Wood Johnson Foundation (RWJF). The Research Initiative component of the Campaign for Action, along with the Foundation's Evaluating Innovations in Nursing Education Program, will seek funding for studies of educational innovation over the next couple of years. It occurred to me that a strategy that might be more successful in the goal of quickly transforming nursing education falls out of the Foundation's flagship nursing program, Transforming Care at the Bedside (TCAB).
I was a part of the team from RWJF and the Institute for Healthcare Improvement (IHI) that developed the TCAB program that taught front-line nurses and their managers the skills and methods of continuous quality improvement, and inspired and empowered them to make changes to transform care at the bedside. The idea was that, though evidence should always be considered when it exists, there are things one can try to improve outcomes that matter, without first proving effectiveness.
By David Krol, M.D., M.P.H., F.A.A.P.
RWJF Human Capital Portfolio Team Director and Senior Program Officer
“Everyone has access to quality oral health care across the life cycle.”
That was the vision formed by a varied group of individuals from dentistry, dental hygiene, medicine, public health, nursing, economics, law, social work and philanthropy as they wrote the second of the Institute of Medicine’s reports on oral health, “Improving Access to Oral Health Care for Vulnerable and Underserved Populations.” I had the privilege of being a member of that committee. Our report was released on July 13th, 2011.
Our task was an expansive one. We were asked to:
- Assess the current U.S. oral health system of care;
- Explore its strengths, weaknesses and future challenges for the delivery of oral health care to vulnerable and underserved populations;
- Describe a desired vision for how oral health care for these populations should be addressed by public and private providers (including innovative programs) with a focus on safety net programs serving populations across the lifecycle and Maternal and Child Health Bureau programs serving vulnerable women and children; and
- Recommend strategies to achieve that vision.
Piece of cake right?!
Well, as you might guess, we found numerous, persistent and systemic barriers and challenges that vulnerable and underserved populations face in accessing oral health care. Those barriers include social, cultural, economic, structural, and geographic factors. We also recognized that these barriers contribute to profound and enduring oral health disparities in the United States. Americans who are poor, minority, or have special health care needs suffer disproportionately from dental disease and receive less care than the general population. It’s a sobering reality in that many of us take oral health care for granted or don’t even think about it at all until we are forced to.
By Linda Wright Moore
RWJF Senior Communications Officer
Attending the 36th annual convention of the National Association of Black Journalists (NABJ) last week in Philadelphia provided an opportunity to reflect on the many challenges facing reporters and the news industry in the 21st century. It was also a personal trip down my professional memory lane.
At the start of my career, as a television reporter and anchor, I attended my first NABJ annual meeting in New Orleans in 1983. The organization was small back then – just a few hundred members. We all knew each other by name. Fast forward to 2011, and I was happy to connect with old friends, including founders of the organization.
The group has grown dramatically to 3,000 members, and more than 2,500 people attended the Philadelphia gathering. The profession of journalism and newsgathering has also been transformed in response to tectonic shifts in the way we gather and disseminate information. Consider: “publisher” used to define an institution that had capacity to print a book, newspaper or magazine. Now, it’s anyone with a laptop, an Internet connection and something to say.
But don’t be fooled. The explosive growth of information and ease of access to it do not mean that journalism is a dying craft. In this 21st century age of information overload – where opinion, conjecture and even fiction can masquerade as fact – the ability to find credible, engaging, reliable sources of news and information is more valuable than ever. A free press is still the cornerstone of democracy – enabling us to make informed decisions about political leaders and policies. And we also rely on media to keep us informed about issues and policies affecting every aspect of our lives, including our health and health care.
At the Robert Wood Johnson Foundation (RWJF) booth at the NABJ Career Fair & Exhibition, we provided an array of information about Foundation programs – touching on the work of every team: Childhood Obesity, Coverage, Pioneer, Public Health, Quality/Equality, Vulnerable Populations and Human Capital. We distributed the first edition of the Human Capital Expert Resource Guide, which highlights the work and expertise of selected RWJF scholars, fellows and leaders with a focus on issues of concern to Black and Latino communities. We hope it will be a useful source of experts to interview for reporters developing stories around health and health care issues. Take a look and let us know how we can make future editions more useful for journalists and other researchers.
On July 13, the Institute of Medicine released reports calling for expanded access to oral health care. In this post, Denise Davis, Dr.P.H, M.P.A., an RWJF program officer and the guiding force behind the Robert Wood Johnson Foundation (RWJF) Dental Pipeline program, discusses the consequences of a decade of inaction, the most promising courses at this time of fiscal constraint at the federal and state levels, and invites readers to share their views. See all the posts in this series.
Ten years after the release of the Surgeon General’s report describing the oral health crisis in America, little has changed. This year, in an effort to bring this critical issue back into the spotlight for policy-makers, clinicians and the American public, the Institute of Medicine (IOM), released two reports – one in concert with the National Research Council.
These reports, Advancing Oral Health in America and Improving Access to Oral Health Care for Vulnerable and Underserved Populations, build on the Surgeon General’s report of 2000 highlighting the importance and centrality of good oral health to overall health. The former highlights the need for leadership in this area by the U.S. Department of Health and Human Services and presents a set of organized ideals for creating improvement while the latter provides a vision for oral health access and quality for all Americans.
These reports reiterate where persistent gaps in oral health access and care delivery exist and suggest what organized principles and system-level changes should be adopted to improve the current status of many underserved and vulnerable groups.
Unfortunately, progress in the area of oral health for the most vulnerable within our population is painstakingly slow, as evidenced by the previous decade of inaction. Given the current fiscal constraints at the federal and state levels, it will be critically important to give consideration to the recommendations in these reports while simultaneously looking into other approaches such as foundation studies, creative multi-stakeholder innovative demonstrations, state-level projects, etc. in order to stimulate future progress.
The following is a message from Susan Hassmiller, Ph.D., R.N., F.A.A.N., Robert Wood Johnson Foundation senior adviser for nursing, on The Future of Nursing: Campaign for Action. The Campaign for Action was launched in November 2010 following the release of the Institute of Medicine report “The Future of Nursing: Leading Change, Advancing Health” to implement solutions to the challenges facing the nursing profession, and to build upon nurse-based approaches to improving quality and transforming the way Americans receive health care. Learn more about the Campaign for Action.
A doctor in the desert. A scientist in outer space. A dentist in the Arctic delivering care on cross-country skis. And a family doctor who's taken to city streets with a radical new way to help the sick get well and cut costs at the same time. These are among the inspiring women and men leading what Robert Wood Johnson Foundation President and CEO Risa Lavizzo-Mourey, M.D., M.B.A., calls a “quiet revolution in health and health care.”
In her 2011 President’s Message, released late last week, Lavizzo-Mourey notes that “Americans are approaching what’s being called our ‘coming age of permanent austerity.’ Serious economies, some severe, are likely, triggering long-term and significant changes in our daily lives. At the Robert Wood Johnson Foundation, the expectation and proactive design of change, powered by remarkable people and ideas, is the fundamental currency of our philanthropy…. It’s all about the power of people and ideas.”
In her message, available online, Lavizzo-Mourey shares stories from across the United States, including one about the work of Sanjeev Arora, M.D., a University of New Mexico specialist in liver diseases. Arora’s “Project ECHO” is changing the lives of residents of isolated, rural communities by linking local family physicians together with specialists in virtual “tele-clinics,” forming what Arora calls a “knowledge network.” Says Lavizzo-Mourey of the RWJF-funded effort: “ECHO is an extraordinarily potent global model for the delivery of better, cheaper care to vulnerable and underserved rural and urban populations.”
By Lori Melichar, Ph.D., M.A.
Senior Program Officer, Research and Evaluation, Robert Wood Johnson Foundation
The Robert Wood Johnson Foundation is coordinating a unique, multi-funder initiative to identify, generate, synthesize and disseminate evidence essential to informing efforts to implement the recommendations outlined in the Institute of Medicine (IOM) report, The Future of Nursing: Leading Change, Advancing Health and to contribute to the Campaign for Action’s goal to advance comprehensive change in health care for patients and the country. Melichar is helping coordinate that effort.
The Future of Nursing: Campaign for Action (CFA) has launched an exciting initiative to focus national attention (and funding) on a common research agenda related to the CFA’s vision: that all Americans have access to high-quality, patient-centered care in a health care system where nurses contribute as essential partners in achieving success.
The CFA aims to:
• strengthen nurse education and training;
• enable nurses to practice to the full level of their education and training;
• advance interprofessional collaboration across the health spectrum;
• expand leadership ranks to ensure that nurses have a voice on management teams, in boardrooms and during policy debates; and to
• improve health care workforce data collection.
The Institute of Medicine’s landmark report. The Future of Nursing: Leading Change, Advancing Health offers a blueprint for transforming the nursing profession to enhance the quality and value of U.S. health care in ways that meet future needs of diverse populations—but it doesn’t contain all of the answers. We understand that the national leaders, public agencies, private organizations and individuals who have been called to action through specific recommendations have other priorities that compete for attention, funding and effort. We understand that the major players face uncertainty about the future of health care and their own roles in that future. We also understand the role that politics, with both big and small “Ps,” plays in the positions and behaviors of individuals and powerful organizations.