Category Archives: Health education
This is part of the June 2014 issue of Sharing Nursing’s Knowledge.
“A registered professional school nurse is the only person [who] has the education, the training, and the skill level to meet the needs of kids in the schools. It’s all about what the kids need and how can they attend schools, be healthy, and learn. Health and education go together: If a child is not healthy, he can’t learn.”
--Sue Buswell, RN, director, Montana Association of School Nurses, Philadelphia Tragedy Highlights Role of School Nurses, Education Week, June 2, 2014
“I quite frankly don’t understand how a school can function without a school nurse. They really are one of the most cost-effective, unrecognized resources in our country.”
--Anne Sheetz, MPH, RN, NEA-BC, director, school health services, Massachusetts Department of Public Health, School Nurses Save, Not Cost Money, New Study Says, Philadelphia Inquirer, May 29, 2014
“And lest we forget: a heartfelt thanks to all nurses, present and past, who are or have served in the military in any capacity, in some cases losing their lives as they tried to save other lives and heal the wounded. And to their families.”
--Jacob Molyneux, BA, MFA, senior editor and blog editor, American Journal of Nursing, Memorial Day Weekend: Thanks to the Nurses Who Served, May 23, 2014
Ruchi S. Gupta, MD, MPH, is an alumna of the Robert Wood Johnson Foundation Physician Faculty Scholars program. She is an associate professor of pediatrics and director of the maternal and child healthcare program at the Northwestern University Feinberg School of Medicine, and an attending physician at the Ann & Robert H. Lurie Children's Hospital of Chicago. Learn more at www.ruchigupta.com.
This past spring, 12 students with asthma at James Hedges Elementary in Chicago’s Back of the Yards neighborhood took hundreds of pictures, filmed video Public Serve Announcements (PSAs), created a website, and rolled out a community intervention to improve asthma conditions. These activities were part of the Student Media-Based Asthma Research Team, or SMART program. We developed this program from a previous pilot program in Chicago’s Uptown neighborhood that empowered students to learn about their asthma and challenged them to create change in their own communities.
As the most common chronic condition in children and the most common cause of school absenteeism, asthma is responsible for 13 million days of school missed each year. Asthma disproportionately affects racial and ethnic minorities, as African Americans and Hispanics/Latino children have significantly higher asthma-related morbidity and mortality rates compared to White children. While evidence-based guidelines for asthma care have been available for 20 years, ethnic minorities have a lower likelihood of receiving or following proper asthma treatment. Across and within racial/ethnic groups, asthma care has been shown to be more effective when it is tailored to the individual community instead of one-size-fits-all intervention.
Have you read “The Swerve,” the Pulitzer Prize-winning book by renowned historian Stephen Greenblatt? In it a canny Renaissance era book hunter discovers and releases knowledge in the form of a medieval, controversial poem lost to posterity. The poem had dwindled down to a single handmade, leather-bound version held behind the vine-covered, ancient walls of an Italian monastery. According to Greenblatt, the unleashing of that book changed everything that came after. That small book with the long poem on the nature of things set in motion forces that challenged the status quo and triggered dramatic, world-wide change—a swerve. The only way that knowledge survived the millennia was because monks trained in hand crafting books had carefully copied the one survivor—and saved it for centuries.
Last week, the Khan Academy, AAMC (Association of American Medical Colleges) and the Robert Wood Johnson Foundation may not have triggered quite such a momentous unleashing—but this powerful collaboration did start something very interesting with potentially significant implications for health care education.
Six libraries in downtown Tucson, Arizona, have some unexpected new employees: public health nurses. In what many believe to be a first-of-its-kind program, Pima County libraries teamed up with the county Health Department to start a jointly-funded “library nurse program.”
Libraries across the country often serve patrons living without shelter, health insurance, medical care or computer access, the Arizona Daily Star reports. As the need for health care and social services has grown in recent years due to a faltering economy and high unemployment, leaders in Pima County were inspired to provide more than just books to their patrons.
Now, five Pima County public health nurses divide the equivalent of one full-time public health nurse position among themselves, working weekdays at six local libraries. The nurses wear stethoscopes so they can be easily identified, but mostly provide health education and referrals to other health care resources in the area rather than actual medical care.
In addition to helping patrons get the health information they need, the program has also reduced the number of 911 calls from the libraries, “partly because nurses trained library staff to recognize when behavioral issues are escalating and to intervene appropriately,” Nurse.com reports.
“If I weren’t here, I think a lot of these individuals would fall through the cracks,” Daniel Lopez, one of the “library nurses” told Nurse.com. “I can open doors for them and they can walk on through. Overall, I think it makes for a healthier Pima County.”
The Robert Wood Johnson Foundation Human Capital Blog is asking diverse experts: What is and isn’t working in health professions education today, and what changes are needed to prepare a high-functioning health and health care workforce that can meet the country’s current and emerging needs? Today’s post is by Mitesh Patel, MD, MBA, a Robert Wood Johnson Foundation Clinical Scholar and senior fellow at the Leonard Davis Institute for Health Economics at the University of Pennsylvania, a member of the AAIM-ACP High-Value, Cost-Conscious Care Curriculum Development Committee, and a practicing physician at the Philadelphia Veteran Affairs Medical Center. He is also the author of Clinical Wards Secrets, a guide for medical students transitioning from the classroom to hospital wards.
Health care costs continue to escalate. Concurrently, the amount of published medical research has increased 10-fold over the last decade. Each of these changes combined with recent health care reform has led to a rapidly evolving health care system. Unfortunately, medical education has been unable to keep pace with these changes.
Health care professionals find themselves searching for ways to deliver better value for their patients. They are looking for an opportunity to become a part of the solution to stemming the rising costs while still providing high-quality, evidence-based care.
The American College of Physicians (ACP), the Accreditation Council for Graduate Medical Education (ACGME), and the Medicare Payment Advisory Commission (MedPAC) have each recognized these deficits among the health care workforce. They’ve called for a restructuring of medical education to address these issues. However, teaching hospitals and medical educators lack a common strategy to accomplish this daunting task. To address these issues, my research team and I studied approaches to transforming medical education to help prepare providers to assess and deliver value-based care for their patients.
To better prepare a high-functioning health and health care workforce, we must start by gaining a better understanding of the problem. In 2009, we published the first study that shed light on this issue on a national scale. We found that among U.S. medical students, less than half felt they were appropriately trained in topics relating to the practice of medicine such as medical economics. In addition, we found that a higher intensity curriculum in health care systems resulted in a payoff, not a tradeoff.
The Robert Wood Johnson Foundation Human Capital Blog is asking diverse experts: What is and isn’t working in health professions education today, and what changes are needed to prepare a high-functioning health and health care workforce that can meet the country’s current and emerging needs? Today’s post is by Miriam Laugesen, PhD, an assistant professor of Health Policy and Management at Columbia University's Mailman School of Public Health and the recipient of a Robert Wood Johnson Foundation Investigator Award in Health Policy Research for a study of Medicare physician payment policies.
When people apply to a program to study health policy, their admissions essay sometimes begins "I always wanted to be a physician, but I realized I wanted to impact more people." Health policy students think in terms of systems, and they are therefore different from front-line health care providers. Whereas a nurse may see the uninsured person with uncontrolled diabetes, the health policy student will connect this to failures of public policy; the patient is nested within clinical, social or organizational environments.
To understand that systemic context, our health policy students first need various 'hard' or technical skills such as program evaluation, epidemiology, and health economics, and it's these skills that employers often look for when hiring our graduates. Without a doubt, technical skills are always valuable.
However, one or two years out, and over the long-term, many of our policy students appreciate the 'soft' skills, such as solving problems, lobbying policy-makers, or building new coalitions. Our policy students learn larger lessons about why things happen, and why policies also fail. They become highly attuned to the framing of advocacy messages. They understand how and why Congress punishes federal agency heads when health policies threaten interests such as tobacco farmers, or why Congress enacts unpopular policies even though legislators want to be re-elected.
Last week was the International Conference on Health in the African Diaspora (ICHAD), which convened experts from a variety of fields to discuss the health and social experience of African descendants in the Western hemisphere. Below, two scholars from the Robert Wood Johnson Foundation Center for Health Policy at Meharry Medical College who attended the conference talk about the experience. Courtney Sinclair Thomas, BS, is a 2011 health policy fellow and doctoral student in the Department of Sociology at Vanderbilt University, and Erika Leslie, MSPH, is a 2012 health policy fellow and doctoral candidate at Vanderbilt University.
Human Capital Blog: Why did you decide to attend the International Conference on Health in the African Diaspora?
Courtney Sinclair Thomas: I decided to attend ICHAD because thus far, my research has been focused on the health of African Americans in the United States. However, I realize that the shared history of the Transatlantic slave trade unites members of the Diaspora in unique ways. I wanted to learn more about the experiences of Blacks from throughout the Diaspora so that I could gain insight into the phenomenon of "race," which has such a significant impact on our health and life chances.
HCB: Please explain the ways that being a descendant of slavery can affect individual, family and population health today.
Sinclair Thomas: Being a descendent of slavery has major impacts on health today. I am interested in social determinants of health, and the experience of slavery has left an entire race at greater risk for many health conditions. This is particularly due to increased chronic stresses, discrimination, and lower social status and access to opportunities.
Last week was the International Conference on Health in the African Diaspora (ICHAD), which convened experts from a variety of fields to discuss the health and social experience of African descendants in the Western hemisphere. Below, two scholars from the Robert Wood Johnson Foundation Center for Health Policy at Meharry Medical College who attended the conference talk about the experience. Helena Dagadu, MPH, is a 2011 health policy fellow and doctoral student in the Department of Sociology at Vanderbilt University, and Tulani Washington-Plaskett, MS, is a Fall 2011 health policy scholar and second-year medical student at Meharry Medical College.
Human Capital Blog: Why did you decide to attend the International Conference on Health in the African Diaspora?
Helena Dagadu: When I met Dr. LaVeist almost two years ago, he shared his idea about ICHAD with me. As he described his vision for the conference, I knew I had to be a part of it. My research and policy interests fit directly with the spirit of ICHAD to both understand and address health disparities among people of African descent. I also attended because this was an opportunity to meet people from different disciplines and gain some insights from their respective perspectives.
An international group of scholars, policy-makers, health workers, health advocates, and journalists are convened in Baltimore, Maryland this week for the International Conference on Health in the African Diaspora (ICHAD), to discuss the health and social experience of African descendants in the Western hemisphere. The theme of ICHAD 2012 is “The Great Scattering: Solving the Puzzle of Slavery, Race, and Contemporary Health in the African Diaspora.”
This afternoon at 3:15 pm EST, @RWJF_HumanCap will be live-tweeting a presentation at ICHAD by Eleanor Fleming, PhD, DDS, of the Centers for Disease Control and Prevention, on “USA Social Determinants of Health and Health Differences between Native and Foreign-born Blacks in the United States.” Fleming is a former scholar at the Robert Wood Johnson Foundation (RWJF) Center for Health Policy at Meharry Medical College.
Click the “read more” link below to see videos from ICHAD co-sponsor Daniel L. Howard, PhD, executive director of the RWJF Center for Health Policy at Meharry Medical College, and ICHAD conference chair Thomas LaVeist, PhD, director of the Center for Health Disparities Solutions at the Johns Hopkins Bloomberg School of Public Health.
On May 10, the Interprofessional Education Collaborative (IPEC) released two groundbreaking reports that recommend competencies for interprofessional health education to promote collaborative, team-based care, and strategies to implement them. This post is the third in a series in which the Robert Wood Johnson Foundation’s (RWJF’s) Human Capital Blog speaks to leaders of this initiative. This interview is with George E. Thibault, M.D., president of the Josiah Macy Jr. Foundation.
Human Capital Blog: What matters most about the report you released on May 10?
George Thibault: The leadership and consensus of the six associations [the American Association of Colleges of Nursing, American Association of Colleges of Osteopathic Medicine, American Association of Colleges of Pharmacy, American Dental Education Association, Association of American Medical Colleges, and Association of Schools of Public Health] representing the schools of the six health professions are powerful and moves this issue into the mainstream. In addition, the public-private partnership of the Health Resources and Services Administration (HRSA) and the foundation world gives it added impetus.
HCB: How do you want to see it used?