Mary D. Naylor, R.N., Ph.D., F.A.A.N., national program director for the Robert Wood Johnson Foundation-sponsored Interdisciplinary Nursing Quality Research Initiative (INQRI), received The Baxter International Foundation’s 2009 Episteme Award in November, an honor often described as the nursing profession’s “Nobel Prize.” Naylor was chosen for the award by the Honor Society of Nursing, Sigma Theta Tau International (STTI) in recognition of her research and development of the Transitional Care Model, an innovative evidence-based approach to addressing the needs of high-risk chronically ill elders and their family caregivers.
Naylor accepted the award at a November 3, 2009, session of the STTI biennial convention in Indianapolis, Ind. In addition to wearing several hats with RWJF, she is the Marian S. Ware Professor in Gerontology and director of the New Courtland Center for Transitions and Health at the University of Pennsylvania School of Nursing. She is the 12th national recipient of the award, and the seventh member of the Penn Nursing faculty to receive it.
“There is no question that Mary’s research has made an impact on health care nationally, and we are so pleased that she is being recognized by Sigma Theta Tau,” said Penn Nursing Dean Afaf I. Meleis.
“I’m proud to receive this recognition on behalf of our entire interdisciplinary team,” Naylor said in an interview several weeks after receiving the award. “This award recognizes a body of science that shines a spotlight on the contributions of nurses, working in collaboration with the health care team to improve the care and outcomes of vulnerable, chronically ill adults who are making the difficult transition from hospitals to home.”
“Our approach to knowledge development is also at the heart of the INQRI program,” she explains. “INQRI is designed to advance our understanding of nursing’s influence on quality through rigorous interdisciplinary science. However, the ultimate goal of INQRI is not just to produce evidence. The Episteme award recognized our team’s effort to have impact on clinical practice and health policy—to make a difference in the lives of chronically ill elders and their family caregivers. Similarly, the hallmark of the INQRI program is impact. We are interested in producing evidence that will be useful to a wide range of stakeholders to improve the quality of patient care.”
INQRI teams include both nursing and non-nursing scholars so that the perspective of other disciplines can be brought to bear on the research. Teams have included scholars in economics, sociology and engineering, for example, and the co-director of INQRI, Mark Pauly, Ph.D., of the University of Pennsylvania’s Wharton School, is one of the nation’s leading health economists.
“We are interested in the fresh perspective and new methods that scholars from non-nursing disciplines can bring to nursing science,” Pauly said in a 2007 interview published on the RWJF Web site. “We believe these unconventional partnerships will provide new solutions that will ultimately improve the quality of nursing care. [In addition,] the INQRI leadership team has taken deliberate steps to connect each research team with key stakeholders. As a result, the teams have received specific feedback and modified their research plans based on what they hear from the end-users.”
For example, with funding from the National Institute on Nursing Research, Naylor and her research team have completed three multi-site, randomized clinical trials, testing the effectiveness of the collaborative, nurse-led Transitional Care Model, designed to improve post-hospital discharge outcomes that too often land elderly patients back in the hospital soon after their release. As many as one-third of these re-hospitalizations are considered preventable, so improving outcomes not only improves patients’ quality of life, but reduces health care costs.
The three trials all demonstrated the effectiveness of the approach. Naylor’s research team is now partnering with a major insurance organization and health care plan to translate this model into clinical practice and promote its widespread adoption, and the model has been adopted by the University of Pennsylvania Health System, with local insurers providing reimbursement for their members served.
In 2007, Naylor was named to the inaugural class of Edge Runners by the American Academy of Nursing (AAN). The Edge Runner program is a part of Raise the Voice, an initiative funded by the Robert Wood Johnson Foundation and directed by AAN to recognize practical innovators leading the way in bringing new thinking and new methods to a wide range of health care challenges. Edge Runners have developed care models and interventions that demonstrate significant clinical and financial outcomes.
The Baxter International Foundation’s Episteme Award is given to a nurse who has contributed significantly to nursing knowledge development, application or discovery that results in recognizable and sizable benefit to the public. In the tradition of the Nobel Prize, the award is presented to a person or team for highly significant research.