The Robert Wood Johnson Foundation Interdisciplinary Nursing Quality Research Initiative (INQRI) will host the next webinar in its “Translating Research Into Practice” series on February 14, 2013.

INQRI investigators Linda Flynn, PhD, RN, FAAN, and Joel Cantor, ScD, will discuss their research and the intervention they designed to increase patient safety by enhancing the leadership and team building skills of nurse managers.

The webinar will be held from 3-4 p.m. EST.

Register for the webinar.
Learn more about Flynn and Cantor’s research.

Lori Melichar, PhD, is a senior program officer at the Robert Wood Johnson Foundation (RWJF). 

The Robert Wood Johnson Foundation’s mission is to improve the health and health care of all Americans. In pursuit of this mission, we seek to improve the quality of care provided in hospitals, ambulatory care centers, public health departments, and other settings where health is enhanced or health care is delivered.

Within the past 15 years, Quality Improvement (QI)—the process-based data-driven approach to improving the quality of a product or service through iterative action-evaluation cycles—has emerged as a promising strategy to accomplish this goal, and RWJF funded several national programs to “demonstrate” the potential of QI to improve health care processes, staff engagement and patient outcomes.  The Foundation’s Pursuing Perfection Program, which had as its goal to help hospital and physician organizations improve patient outcomes dramatically by pursuing perfection in major care processes, employed QI tools such as Plan-Do-Study-Act cycles and improvement collaboratives to accomplish this goal.  Another program, Transforming Care at the Bedside, taught frontline nurses the skills and methods of QI and empowered these staff to engage in activities to transform hospital care.  Paths to Recovery is an RWJF program that used QI processes to improve the systems of care that provided substance abuse treatment. Aligning Forces for Quality  is RWJF’s signature effort to lift the overall quality of health care in targeted communities, reduce racial and ethnic disparities, and provide models for national reform.

Robin Newhouse, PhD, RN, is a grantee of the Robert Wood Johnson Foundation Interdisciplinary Nursing Quality Research Initiative. She is professor and chair, Organizations Systems and Adult Health at the University of Maryland School of Nursing. She is also vice-chair of the Methodology Committee for the Patient-Centered Outcomes Research Institute. This post is part of the "Health Care in 2013" series.

My resolution for the U.S. is to begin the transformation of health care systems to enhance high quality patient-centered care. Despite some improvements, the National Healthcare Quality Report 2011 reveals that health care quality in the U.S. often falls short of expectations—demonstrating geographic and population (minority and low-income) variations. In 2011, the U.S. Department of Health and Human Services (HHS) released the National Quality Strategy (NQS), designed to improve the quality of health care in the U.S. My highest priority for action is the first aim: “Better Care: Improve the overall quality of care, by making health care more patient-centered, reliable, accessible, and safe.” Better care is achievable—with two specific strategies in mind: implementation of evidence-based practices and a focused goal to measure and improve patient-centered outcomes.    

Implementation of Evidence-Based Practices. We have not gone far enough, fast enough. It is time to focus on implementation of evidence-based practices in health care systems. Research studies have continued to exponentially produce results intended to inform health care practices. Identifying and implementing evidence-based practices known to work—but that are underutilized—can go a long way to improve health care processes and quality. Performance measures are an example of one approach to drive system changes. The 2012 NQS Annual Progress Report describes the achievements of the first year’s work, including a focus on clinical and patient-reported outcomes (as close as possible to patient-centered) and development of new patient-centered outcomes.  

Around the country, print, broadcast and online media outlets are covering the groundbreaking work of Robert Wood Johnson Foundation (RWJF) leaders, scholars, fellows and grantees. Some recent examples:

A study led by RWJF Nurse Faculty Scholar Matthew McHugh, PhD, JD, MPH, RN, CRNP, finds that nurses are extremely accurate and reliable assessors of the quality of care in the hospitals in which they work. In the study, nurses’ reports of excellent quality care corresponded with higher levels of patient satisfaction, better scores for processes of care, and better results for patients in the hospital with regard to mortality and failure to rescue. Becker’s Hospital Review and Advance for Nurses are among the outlets to report on the findings. Read more about the study.

New Mexico Business Weekly reports that the RWJF Center for Health Policy at the University of New Mexico has been recognized by the nonprofit Excelencia in Education as one of America’s top programs that is increasing academic opportunities for Latino students.

Jason Farley, PhD, MPH, CRNP, a Nurse Faculty Scholar, spoke to the Baltimore Sun about his research on drug-resistant bacteria and “whether MRSA eradication among people who are HIV positive should focus on the person's entire household, and not just the individual.”

NJ Spotlight reports on the work of the New Jersey Nursing Initiative (NJNI) to help address the state’s nurse and nurse faculty shortage. “The Nursing Initiative’s flagship program, the Faculty Prep Program, comprises 61 nurse scholars (nurses and doctoral-prepared nurses) who have committed to being nurse faculty in New Jersey,” the story reports.

Happy National Nurses Week! The Robert Wood Johnson Foundation (RWJF) has a proud history of supporting nurses and nurse leadership, so this week, the RWJF Human Capital Blog is featuring posts by nurses, including leaders from some of our nursing programs. This post is by Mary Naylor, PhD, RN, FAAN, director of the RWJF Interdisciplinary Nursing Quality Research Initiative program and the Marian S. Ware Professor in Gerontology at the University of Pennsylvania School of Nursing.

Nurses—the largest group of health professionals in the country—have a tremendous impact on health and health care. But despite the immense size and influence of the nursing workforce, we don’t know enough about how nurses can improve the quality and safety of care and reduce costs.

Nurse scientists have been exploring these questions for decades, but large gaps in knowledge remain. Since it was established in 2005, the Interdisciplinary Nursing Quality Research Initiative (INQRI), funded by RWJF, has worked to address those gaps in our knowledge of nursing care.

Over the last seven years, INQRI grantees—teams of nurse scientists and scholars from other disciplines—have conducted groundbreaking research focused on the ways in which nurses affect the quality of care patients receive and how they improve patient care and outcomes.

The interdisciplinary nature of the project has been key to its success; when scholars from multiple disciplines come together to solve problems in nursing care, they generate solutions that are grounded in rigorous evidence, that take into account diverse perspectives, and that use various methodological techniques. In short, interdisciplinary research leads to more robust findings. And more robust findings are more likely to attract investments in nursing resources, which will, in turn, improve health outcomes while reducing costs.

As program leaders, we don’t just talk the interdisciplinary talk; we walk it too.

The U.S. Department of Health and Human Services, Health Resources and Services Administration, has released an infographic for National Nurses Week showing the many ways nurses provide and expand care. Click the read more link to see the infographic.

The results are in! The Robert Wood Johnson Foundation (RWJF) asked you to help choose the most influential research conducted by RWJF grantees in 2011, and the results have been announced. More than 2,200 people from all 50 states, plus the District of Columbia and Puerto Rico, voted.

Among those selected for the “Final 5” Most Influential Research Articles of 2011 was a study led by RWJF Nurse Faculty Scholar Matthew D. McHugh, PhD, JD, MPH, RN, CRNP, an assistant professor at the University of Pennsylvania School of Nursing. McHugh is the only nurse among the finalists.

The study, published in Health Affairs, found that nurses caring directly for patients in hospitals or nursing homes have higher job dissatisfaction and burnout than nurses in other settings. Patient satisfaction levels were also lower in settings in which more nurses were unhappy with their work environments.

“A good place for nurses to work is a good place for patients to receive care,” McHugh says. “Improving the work environment for nurses leads to more satisfied nurses who are more likely to stay in their job. Patients cared for in these environments have better health outcomes and are more satisfied with their care.”

McHugh published the study at the start of his term as an RWJF Scholar. “The Nurse Faculty Scholars program has been great,” he says. “It’s allowed me to expand my focus and move in new directions. I’m doing research that will help explain root causes of racial and ethnic disparities in health outcomes based on where people live, where they get hospital care, and differences in nursing in the hospitals where they receive care.”

The use of electronic health records (EHRs) results in “improved and more efficient nursing care,” according to a study by researchers at the University of Pennsylvania School of Nursing (Penn Nursing). The study, published in the Journal of Nursing Administration, looked at more than 16,000 nurses working at hundreds of hospitals in four states.

Nurses who worked in hospitals with fully implemented basic EHRs reported better quality care and health outcomes for patients than nurses in hospitals without such systems, independent of nurse staffing. Nurses with EHRs were “significantly less likely to report unfavorable patient safety issues, frequent medication errors, and low quality of care,” according to a Penn Nursing statement about the study.

What do you think? Do electronic health records improve care? Do they have any disadvantages? Register below to leave a comment.

Read more about engaging nurses in health information technology.

Susan C. Reinhard, R.N., Ph.D., F.A.A.N., is a senior vice president and directs the AARP Public Policy Institute. She also serves as chief strategist for the Center to Champion Nursing in America, an initiative of AARP, the AARP Foundation and the Robert Wood Johnson Foundation.

As a nurse, health policy expert and as a consumer advocate, I have experienced the many ways that nurses improve patient safety and provide high quality care. One significant way is by ensuring that they are able to put into practice – and continue to build on – the qualities that make them stellar leaders at the bedside and beyond. That is why I was delighted this week when the Leapfrog Group announced that they will include measures of nursing excellence – as exemplified through Magnet status – in their annual hospital survey on quality and patient care.

Leah Binder, Leapfrog’s CEO, shared this announcement at a recent meeting convened by the Center to Champion Nursing in America (CCNA) – an initiative of AARP, the AARP Foundation and the Robert Wood Johnson Foundation (RWJF) – which was very fitting: Leapfrog’s inclusion of nursing excellence in its survey is part of its commitment to the Future of Nursing: Campaign for Action, a collaboration between RWJF and AARP. The campaign aims to implement the recommendations in “The Future of Nursing: Leading Change, Advancing Health,” issued in 2010 by the Institute of Medicine (IOM).

The Campaign is bringing together leaders from all sectors – health care, education, consumer groups, philanthropy and business – to ensure that the report’s vision is met: 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. Leapfrog’s tremendous commitment represents a valuable business perspective on the importance of strong nursing leaders, with the ever-present ultimate goal of improved patient safety.

At the meeting this week, Leah told us that acknowledging hospitals for Magnet status is a big step, because it signifies a hospital’s commitment to nursing excellence as a direct path to better patient care. The designation is very difficult to attain; there are only 386 Magnet hospitals in the U.S. and five in other countries.

Research by the Robert Wood Johnson Foundation (RWJF)-funded Interdisciplinary Nursing Quality Research Initiative (INQRI) team at Marquette University has found that hospitals with more registered nurses working on a unit and fewer R.N. overtime hours have lower rates of patient readmission and fewer post-discharge visits to the emergency department.

Marquette’s Marianne Weiss, D.N.Sc., R.N.; Olga Yakusheva, Ph.D.; and Kathleen Bobay, Ph.D., R.N., N.E.A.-B.C., studied nurse staffing levels, patients’ reports on quality of the discharge teaching process and their readiness for discharge, along with post-discharge readmissions and emergency department visits for 16 medical-surgical units at four hospitals in a single Midwestern health care system. They found that when R.N. non-overtime staffing was higher, the odds of patient readmission were lower, and that when R.N. overtime hours were higher, post-discharge emergency department use was also higher.