In 2004, before she was the program director for the Robert Wood Johnson Foundation (RWJF) Interdisciplinary Nursing Quality Research Initiative (INQRI), Mary Naylor, Ph.D., R.N., F.A.A.N., was asked to look at measures that indicated how nurses can affect the quality of health care. She learned that not only were there very few measures, but most of them focused on what nurses did not do, rather than what they did do and their contributions to quality patient care.
That discovery by Naylor, who is Marian S. Ware professor in gerontology at the University of Pennsylvania School of Nursing and director of NewCourtland Center for Transitions and Health, was the impetus for the INQRI program. It generates, disseminates and translates research into how nurses can contribute to and improve the quality of patient care. The INQRI program held its sixth and final Annual Meeting from July 12 to 14 at RWJF.
In welcoming the INQRI grantees, National Advisory Committee members and stakeholders, Lori Melichar, Ph.D., RWJF director, said that thanks in large part to INQRI's work, we know much more about nurses’ contributions to quality of care.
We also know more about what can be done to enhance the contributions of nurses’ to high-quality patient care, added Mark Pauly, Ph.D., INQRI co-director and professor of Health Care Management at the Wharton School at the University of Pennsylvania. Pauly said INQRI has already changed the health care culture, both by raising the profile of nurses’ work and by bringing together researchers from different disciplines to work to improve care.
The focus of this year’s meeting—and the current cohort of INQRI grantees—was translational research and research dissemination. Speakers discussed the importance of sharing INQRI findings with a variety of audiences to improve health and health care in the United States, and the best ways to communicate those findings.
Bruce Vladeck, Ph.D., senior adviser to Nexera, Inc, talked about how people make change, whether in government, science or a health care system. He noted that, as old paradigms start to decay, it’s important to articulate a clear vision for a new paradigm that must then be “normalized.” Vladeck also addressed some of the challenges that change-makers face in the health care system and encouraged the INQRI grantees to find ways to paint a picture of what nurse-led initiatives and programs and changes to nursing policies and procedures will look like. “Develop pilots and prototypes and promote the hell out of them,” he said.
“The Robert Wood Johnson Foundation and INQRI have pointed out the deficiencies in the old health care paradigm, including the fact that we don’t use nurses enough,” said Linda Aiken, Ph.D., R.N., F.A.A.N., a professor of nursing at the University of Pennsylvania and a member of the INQRI National Advisory Committee. “We are presenting a new vision: that nurses can do more to improve health and health care. We have studies that demonstrate what that larger role looks like. I would say that we’re already normalizing nurses’ larger role, too,” Aiken said. “Today, you can’t imagine nurses not having an expanded role in health care.”
Other speakers at the meeting included: Gareth Parry, Ph.D., research scientist at the Institute for Healthcare Improvement, who discussed the importance of a phased-approach to research aimed at quality improvement and evaluation; Susan Dentzer, editor-in-chief of Health Affairs, who walked INQRI grantees through the best ways to craft and convey messages; and Susan Hassmiller, Ph.D., R.N., F.A.A.N., senior adviser for nursing at RWJF. Hassmiller joined Melichar in talking about the Future of Nursing: Campaign for Action and the new research agenda associated with it.
The meeting also included presentations by the principal co-investigators for research teams in INQRI’s cohorts four and five.
The meeting was streamed live on the internet, and included video messages from David Krol, M.D., N.P.H. F.A.A.P., RWJF Human Capital Portfolio team director; Andy Hyman, J.D., RWJF Coverage team director; and Anne Weiss, M.P.P., Quality/Equality team director. INQRI live-Tweeted and blogged the event.
Patricia Dykes, D.N.Sc., M.A., R.N., and Marianne Weiss, D.N.Sc., R.N., both former INQRI grantees, closed the meeting by reflecting on their experiences with the program and discussing how it is contributing to the knowledge about nurses’ contributions to improving health and health care.
“What INQRI tells us to do,” Dykes said, “is to think big, think bold, think beyond.”