Category Archives: Human Capital
Martin Schiavenato is a PhD, an RN, a nurse scientist, a nurse educator, and an alumnus of the Robert Wood Johnson Foundation (RWJF) Nurse Faculty Scholars program. In January, he also became the subject of a Johnson & Johnson “Day in the Life” video—a video series about the lives of people in various nursing professions.
About 19 in every 100,000 American children under the age of five suffers from an inflammatory illness called Kawasaki Disease (KD) that can cause irreversible damage to the heart. If diagnosed early, it can usually be treated effectively, and children can be returned to health in just a few days. But between 10 and 20 percent of treated patients suffer from a persistent fever, or one that recurs after treatment, and they are at elevated risk of developing coronary artery aneurysms. A new study, led by Robert Wood Johnson Foundation (RWJF) Harold Amos Medical Faculty Development Program Scholar Adriana H. Tremoulet, MD, MAS, and published yesterday in The Lancet, offers new hope for patients with KD.
The symptoms of KD include prolonged fever associated with a rash, swollen neck glands, red eyes, swollen red lips, a condition physicians call strawberry tongue, and swollen hands and feet with peeling skin. Current treatment is infusion of intravenous immunoglobulin (IVIG) and aspirin. The IVIG carries the pooled antibodies from the blood plasma of more than 100,000 donors, and in the KD patient, it decreases the inflammation that causes heart damage. The treatment usually works, but some patients’ IVIG-resistance puts them at greater risk and in need of further treatment.
Tremoulet, a pediatric infectious disease specialist at Rady Children’s Hospital in San Diego, conducted a Phase III trial in which a synthetic antibody called infliximab was added to the standard IVIG and aspirin treatment. While the protocol did not affect the patients’ resistance, it had important positive results. “In our study,” Tremoulet said, “we demonstrated that a single dose of infliximab is safe in children with Kawasaki Disease and that this treatment reduced the inflammation in the body overall as well as in the arteries of the heart faster than just using standard treatment with intravenous immunoglobulin.”
Physician Compensation Patterns Pose Challenges to Efforts to Incentivize Changes in How Care Is Delivered
Salary is the most common type of compensation for physicians in non-solo practice settings, many of whom are paid through a blend of methods, according to a new American Medical Association (AMA) Policy Research Perspectives report that says it provides a “rare glimpse” into how non-solo physicians are paid.
Just over 53 percent of non-solo physicians reported that all or most of their compensation came from salary, while nearly 32 percent said all or most of their compensation was based on personal productivity. The report points out that this breakdown “suggests that it may be difficult to align practice-level incentives that encourage judicious use of resources with physician-level incentives that do not.”
Ideally, the report says, financial and other incentives would encourage physicians to make the best care decisions possible for patients, providing them “the right care, in the right place, and at the right time,” but current incentives often do not encourage that approach.
Sue No, RN, BSN, is a fellow in the Robert Wood Johnson Foundation Nursing and Health Policy Collaborative at the University of New Mexico (2013-2017). She is working toward her PhD in nursing with a concentration in health policy. This post is part of the “Health Care in 2014” series.
Every New Year brings New Year’s resolutions. It is a time for reflection on years past and to develop actionable changes needed for a hopeful and productive new year. Clearly 2014 is no exception. With the New Year already in full swing, I encourage people—yes, this also includes you, Generation Y—to enroll in a health insurance plan and take advantage of the Affordable Care Act’s (ACA) current and new coverage opportunities in an effort to advance our nation’s culture of health.
You might be asking yourself a few questions such as: Who is Generation Y and why are they important? I am happy to provide answers.
The largest generation, Generation Y, or Millennials, consists of young adults born between 1977 and 1994. This important demographic is key to obtaining a sustainable health care exchange system with affordable insurance plans. Healthy Millennials must enroll in the marketplace to offset the high costs acquired by the disproportionate number of Americans with high medical costs. Unfortunately, only a small number of young adults have participated in the health care exchange since open enrollment. This isn’t surprising.
An Interview with Julie A. Fairman, PhD, RN, FAAN, co-director of the Future of Nursing Scholars program, and Nightingale Professor of Nursing and director, Bates Center for the Study of the History of Nursing, at the University of Pennsylvania.
Human Capital Blog: What is the goal of the Future of Nursing Scholars program?
The Robert Wood Johnson Foundation launched the Future of Nursing Scholars program to create a large and diverse cadre of PhD-prepared nurses who are committed to long-term leadership careers that advance science and discovery, strengthen nursing education, and bring transformational change to nursing and health care. It is vitally important that we meet the growing need for PhD-prepared nurses, not only to ensure that we address the shortage of nurse faculty members, but because nurse researchers make valuable contributions to practice and policy. The program will fund schools of nursing to provide scholarships, and it will provide mentoring and leadership development activities to build the capacity of a select group of future nurse leaders. The program’s call for proposals launched this week, and scholars will be selected by the nursing colleges and universities that submit successful program proposals.
HCB: Congratulations on the release of the program’s first call for proposals! As schools begin applying to participate in this program, what would you like them to keep in mind?
Julie Fairman: We are very excited about this program. The major requirement for participation is that research-focused schools of nursing must be ready and able to graduate PhD students in three years. We understand that acquiring a PhD in nursing in three years is not the norm and that many schools have not previously graduated students within that time frame. So, schools are not necessarily ineligible if they have never operated this way, but they will need to provide a thorough description of how they will meet this obligation. We are asking applicant schools to provide information not only about their curricula, but also about their mentoring activities and faculty engagement with research. We also ask that they provide a discussion of interdisciplinary engagement in their institutions, and details about their admission, retention, and graduation of PhD nurses.
Schools that are chosen for the program will be responsible for selecting the scholars who will participate. Schools should select scholars who understand and accept the challenge of completing their PhD degrees in three years. To succeed, the scholars they select will be goal-directed, focused, and committed to long-term academic careers with a focus on science, health policy, and/or innovation. They also should be interested in health policy formulation or in the development of new evidence-based solutions to address health care problems.
This is part of the February 2014 issue of Sharing Nursing’s Knowledge.
“As an ADN-prepared nurse returning to school, I have been confronted with the formidable gap between the current reality of professional nursing and the push to elevate the level and scope of practice in the face of a projected nursing shortage. I have no doubt that higher levels of education, certification, and experience have the potential to create better nurses and in turn safer environments for our patients, but I do have to question whether the infrastructure necessary to support these changes is in place.”
--Eric Deane, RN, Charlottesville, Va., Thoughts on Entry to Practice, Nurse.com, February 10, 2014
“As medical professionals we are recognizing that on a national level, advanced practice nurses [APNs] are part of the solution to the health care access crisis. The only way that patients are going to get the care they need is if all parts of the medical team, including APNs, midwives, physician’s assistants, physicians, and others, come together as partners. It’s not that nurse practitioners are going to replace any other clinicians. That’s not our goal. But advanced practice nurses are extraordinarily well prepared to provide primary care. They are trained in managing multiple types of health problems and in promoting a healthy lifestyle. With the current challenges in patient care, I can only see the role of the nurse practitioner increasing.”
--Ivy Alexander, PhD, APRN, FAAN, clinical professor and director of advanced practice programs, University of Connecticut School of Nursing, An Expanding Role for Nurse Practitioners, Medical Xpress, February 5, 2014
“More needs to be done to help spread awareness [about the Affordable Care Act]. This is one of the things nurses do best. They educate.”
--Mary Wakefield, PhD, RN, FAAN, administrator, Health Resources & Services Administration, Nurses Step Out to Help with ACA Enrollment, Nursezone.com, January 31, 2014
Human Capital News Roundup: Abuse of prescription opioids, thriving singles, smartphone safety nets, 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 suburbs, rural towns, and affluent areas, prescription opioids, such as Oxycontin and Opana, are the most common cause of overdose deaths, Helena Hansen, MD, PhD, writes in a Huffington Post opinion piece. Drug policies that unilaterally curb access to opioids can actually hurt users’ recovery efforts, writes Hansen, an RWJF Health & Society Scholars alumna. The piece was co-authored by Julie Netherland, New York deputy state director, Drug Policy Alliance. It recommends prioritizing public health over punitive responses.
Tina Bloom, PhD, RN, an RWJF Nurse Faculty Scholar, is part of a research team that developed a smartphone app to help domestic violence victims and their friends create safety plans. “This has been so well received by abused women because of the privacy and the chance to learn and weigh information,” Bloom told the Columbia Daily Tribune. “As survivors tell us, the computer doesn’t judge.”
Michigan Daily reports on a recent lecture by RWJF Health & Society Scholars alumnus Patrick Sharkey, PhD, describing his research into how urban violence affects childhood development. Sharkey shared evidence suggesting that children’s exposure to violence in their neighborhoods can negatively affect academic abilities; the conclusion is based on a study he conducted in which children exposed to violence performed significantly lower on a test administered a few days later.
Kentucky Gov. Steve Beshear signed legislation last week that lifts a key limitation on advanced practice registered nurses (APRNs) and increases consumer access to health care.
The new law “allows more flexibility for nurse practitioners to provide accessible health care to Kentuckians,” Beshear said. “Nurse practitioners are a critical part of helping more Kentuckians get the medical care they need quickly and efficiently, and I am proud of the bipartisan effort to serve Kentucky’s health needs.”
In the past, APRNs were only allowed to prescribe medication with a physician’s written consent. The new law removes that requirement for APRNs who have four or more years of experience prescribing medication under a collaborative agreement with a physician or as an independent practitioner in another state, according to the Future of Nursing: Campaign for Action.
Elizabeth Dickson, MSN, RN, is a fellow in the Robert Wood Johnson Foundation (RWJF) Nursing and Health Policy Collaborative at University of New Mexico. Earlier in her career, she worked at a school-based health center (SBHC). This post is part of the “Health Care in 2014” series.
As a public health nurse, I have worked with children in schools for much of my career. From 2009 until 2013, I worked at a SBHC in New Mexico that was located in an alternative high school in southern Albuquerque. Although small, many students at this school came from families of mixed immigration status and had experienced high levels of street violence, alcohol and drug abuse and overdose, suicide, poverty and food scarcity, minimal health care access, and high teen pregnancy rates.
These kids saw and experienced more than many outsiders of the community could have imagined. The SBHC was open one day a week during school hours and employed a staff that included a nurse practitioner, a physician assistant, public health nurses, administrative staff, and mental health counselors. I worked with an incredible team that provided many health services and screenings, including mental health support, in the limited time that we had.
Want to stay on top of the latest news from RWJF? Check out all the ways you can get the latest news delivered to you: