Category Archives: Human Capital
Gretchen Hammer, MPH, is executive director of the Colorado Coalition for the Medically Underserved. She works with local and state health care leaders and policy-makers to improve Colorado’s health care system.
Healing is both an art and a science. On one hand, clinicians are intensely driven by the quantifiable, the measurable, and the evidence-based algorithms that lead to accurate diagnosis and treatment as well as allow us to develop new innovations in medicine. However, healing is also an art. Patients are not just a collection of systems that can be separated out and managed in isolation of the whole patient. Each patient and their family has a unique set of values, life experiences, and resources that influence their health and ability to heal. Recognizing the wholeness and uniqueness of each patient is where the art of healing begins.
Empathy is defined as “the ability to understand and share the feelings of another.” It takes presence of mind and time to be empathetic. For clinicians, finding the balance between the necessary detachment to allow for good clinical decision making and empathy can challenging. This balance can be particularly difficult for students and new clinicians.
The Robert Wood Johnson Foundation (RWJF) will host a webinar on Monday, December 2, to present insights and best practices in diversity and inclusion for faculty success at colleges and universities. Through a New Lens will feature a distinguished panel of speakers who discuss lessons and strategies they have developed from their own work in academia. They will share insights and ideas on grants/funding, career development, networking, mentoring, and work-life balance.
The webinar will be held from 2:30-4:00 pm EST. Advance registration is required.
Heather J. Kelley, MA, is deputy director of the Robert Wood Johnson Foundation’s (RWJF) Future of Nursing Scholars program. Prior to this role, she was the program associate for RWJF’s Interdisciplinary Nursing Quality Research Initiative and a former vice president in a political advertising firm.
Three years ago, the Initiative on the Future of Nursing at the Institute of Medicine (IOM) set a revolution in motion with the release of The Future of Nursing: Leading Change, Advancing Health report. Among the bold recommendations offered in the report was the call to double the number of nurses with doctoral degrees by 2020.
RWJF recognizes the valuable contributions that PhD-prepared nurse scientists and researchers make in the lives of patients and families. Their discoveries have the potential to change our health care system. However, as the IOM report suggested, we do not have nearly enough doctorally prepared nurses seeking new solutions to ongoing problems. Currently, less than 1 percent of the nursing workforce has a doctoral degree in nursing or a related field.
SreyRam Kuy, MD, MHS, is an alumna of the Robert Wood Johnson Foundation (RWJF) Clinical Scholars program, and a vascular surgery fellow at the Medical College of Wisconsin.
Gallbladder disease, and specifically gallstones, can present as pain in the upper abdomen, usually after eating fatty foods. More severely, gallstones can progress to an inflammation and infection called cholecystitis or cholangitis, both of which require prompt surgical treatment. Gallbladder disease is an important medical problem as it accounts for $650 billion in health care costs annually in the United States[i], making it the second most costly digestive disease in the country.[ii] With more than 700,000 cholecystectomies (surgeries to remove the gallbladder) performed annually in the United States, gallbladder disease is the number one reason for abdominal surgery in the nation.[i] Cholecystectomies can be done with traditional surgery (open cholecystectomy) or performed minimally invasively (laparoscopic cholecystectomy).
The National Health and Nutrition Examination Survey estimates 6.3 million men and 14.2 million women in the United States have gallbladder disease.[iii] It occurs two times more frequently in women than in men.[i][iv] However, during the reproductive years, women have a four-fold higher prevalence of gallstones than men.[iii] As a result of its disproportionate burden on women, gallbladder disease is a critically important topic in women’s health.
There is currently a lack of consensus on whether a patient’s gender affects how soon they get surgery for cholecystitis, what type of surgery they get (open versus laparoscopic cholecystectomy), and how they do after surgery. My prior work and that of my colleagues has clearly shown that older age negatively impacts how patients do following cholecystectomy.[v] Therefore, to determine whether gender, independent of other factors, affects outcome, we examined a national group of patients hospitalized with cholecystitis over an eight-year period, age-matched to account for the effect of age, and identified gender-based differences in patients hospitalized with cholecystitis. We measured outcomes of women compared with men who underwent cholecystectomy during that admission for cholecystitis, and identified factors associated with outcome.
Foreign-educated and foreign-born health professionals play a vital role in providing patient care in this country, but strategic shifts such as changes in immigration laws may be needed to stabilize the nation’s health workforce, according to a new RAND Corporation study.
The two groups fill important gaps, particularly among primary care physicians, nurses in hospital settings, and other areas with worker shortages, according to findings published in the November issue of Health Affairs.
However, continuing to rely on foreign-educated and foreign-born health workers may reduce incentives for the nation to address problems such as the inadequate supply of primary care physicians. This, in turn, could lead to a less-stable U.S. health care workforce, researchers said.
Human Capital News Roundup: Electronic health records, the widow effect, child safety restraint laws, 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:
Race and economic status are not as important as social network in predicting whether a person will become a victim of a fatal shooting in Chicago, according to a study from Andrew Papachristos, PhD, an RWJF Health & Society Scholars alumnus. “Generally, you can’t catch a bullet from just anyone,” Papachristos told the Chicago Sun Times. “Your relationship with the people involved matters.” The study was also covered by NPR, U.S. News & World Report, and Psych Central, among other outlets.
Most organizations across the United States are in the middle stages of implementing electronic health records, Ann O’Brien, RN, told NurseZone.com. O’Brien is senior director of clinical informatics for Kaiser Permanente and an RWJF Executive Nurse Fellow. “At Kaiser … we have almost three years now of electronic health record data and the ability to actually optimize data and technology to improve care,” she said.
The website Physicians Practice has released its annual Physician Compensation Survey, which for the third straight year shows that a majority of U.S. physicians view the income from their medical practice as “disappointing.” In 2013, 54 percent defined their net income this way, the same number as a year earlier, but 5 percent more than those who took the survey in 2011.
Physicians Practice surveyed 1,474 physicians and staff for the survey, asking about personal income, practice overhead, practice outlook, and other financial issues. For the first time, the survey acknowledged the shift from volume-based reimbursement to value-based reimbursement, asking respondents to share how much of their income is tied to factors other than the number of patients they see.
Thirty-three percent of respondents said a portion of their compensation is tied to value (quality and cost of care provided), with 8.5 percent of that group saying this was the only factor in their pay. Furthermore, 24 percent of respondents said a portion of their compensation was tied specifically to patient satisfaction.
However, productivity remained the dominant factor in physician compensation, with 28 percent of survey respondents saying that their entire compensation package was factored on productivity alone. Another 37 percent said it made up a portion of their annual pay.
This is part of the November 2013 issue of Sharing Nursing's Knowledge.
MTV executives are attempting to mollify nurses and nursing allies who are outraged over a salacious new “reality” television show about a group of young travel nurses in California.
The show, “Scrubbing In” amplifies tawdry aspects of the personal lives of a handful of young nurses and minimizes the important, life-saving work they do, critics say.
The show disrespects “the most respected profession,” said Karen Daley, PhD, RN, FAAN, president of the American Nurses Association.
MTV officials responded with a recent announcement that they would take a number of steps to address the outrage, according to The Truth About Nursing, an advocacy organization that works to improve media portrayals of nurses.
Actions include re-editing some episodes to put a greater emphasis on clinical nursing skills; posting online material to educate visitors about the real reality of nursing education and practice; and airing the show at a less prominent time, potentially slashing viewership.
After the show began airing in October, some nursing organizations called for its cancellation, while others called for a more far-reaching boycott of the channel and its sponsors.
Sheryl Magzamen, PhD, MPH, is an assistant professor in the College of Veterinary Medicine and Biomedical Sciences at Colorado State University and an alumna of the Robert Wood Johnson Foundation (RWJF) Health & Society Scholars program (2007-2009). She recently published two studies exploring the link between early childhood lead exposure and behavioral and academic outcomes in Environmental Research and the Annals of Epidemiology. She discusses both below.
Human Capital Blog: What are the main findings of your study on childhood lead exposure and discipline?
Sheryl Magzamen: We found that children who had moderate but elevated exposure lead in early childhood were more than two times as likely as unexposed children to be suspended from school, and that’s controlling for race, socioeconomic status, and other covariates. We’re particularly concerned about this because of what it means for barriers to school success and achievement due to behavioral issues.
We are also concerned about the fact that there‘s a strong possibility, based on animal models, that neurological effects of lead exposure predispose children to an array of disruptive or anti-social behavior in schools. The environmental exposures that children have prior to going to school have been largely ignored in debates about quality public education.
Researchers at Loyola University Medical Center have conducted the first study of moral distress among nurses in an intensive care unit for burn patients, starting to address “a significant gap” in knowledge about responding to the painful feelings that arise in situations where people can’t act according to their ethical ideals, due to barriers such as lack of time and supervisory support, and policy and legal constraints.
Moral distress has been studied in various populations of health care providers, including neonatal ICU nurses, pediatric ICU nurses, genetic professionals, surgical residents, and medical residents. The Loyola study, published in the September/October issue of the Journal of Burn Care & Research, points out that the impact of moral distress on nurses during the provision of care, particularly in critical care settings, is well documented and can result in a wide variety of reactions, including depression, anxiety, emotional withdrawal, frustration, anger, and a variety of physical symptoms.