Field of Work: Aligning the training of physicians and nurse practitioners with the demands of 21st-century clinical practice.
Problem Synopsis: In the 1990s, managed care became one of the dominant forces in health care. Physicians and nurse practitioners (NP's) were expected to know how to manage patients' health, often within a fixed budget. Although care was increasingly taking place in outpatient settings, physicians continued to receive most of their training in hospitals rather than in ambulatory care centers. They also received little training in preventive care, or in interprofessional collaboration.
According to Allan Arbeter, M.D. of Philadelphia's Albert Einstein Healthcare Network, "Our patients and families don't always understand all we have to offer in terms of education, and how much they can affect their own health. The single biggest turning point for patients is when they really understand our relationship with them and their relationship with their chronic condition."
Synopsis of the Work: Partnerships for Quality Education (PQE) (April 1999 through January 2009), was initially funded by the Pew Charitable Trusts (during which time it focused on physicians only) and then by RWJF (which expanded it to include NP's). The program sought to improve a core set of skills in physicians and nurse practitioners, including interprofessional collaboration, chronic illness management, systems-based care and practice-based quality.
The Albert Einstein Healthcare Network participated in the Take Care to Learn (TCTL) component of PQE. A project team of eight faculty and senior staff introduced changes enhancing asthma care at the Pediatric and Adolescent Ambulatory Center of the Albert Einstein Medical Center.
Lessons Learned: The project directors in 2003 offered this advice to others implementing a chronic illness management project:
- Engage all interested parties early in the project.
- Work hard to secure faculty buy-in.
- Visit with institutions that have practical experience you can use.
- Clearly identify roles for all project participants.
- Give residents who show the most interest in project activities the most responsibility.
- Use a multiple disease approach in teaching chronic care.
- Take on one chronic care model component at a time.
- Do not give up on creating change or become overwhelmed.
While the need to address disparities in care is well known, few strategies for reducing disparities have been studied systematically.
RWJF examines the types of competitive foods - foods and beverages schools offer outside of meal programs - available in our nation's school...
"The light at the end of the tunnel is ... that I carried the struggle further, and that I taught my children correctly, in the way they cho...
In 1990, Dr. Hotz's focus on collaboration led to the creation of another nonprofit organization designed to coordinate public and private h...
To Dr. Cheryl Holder, success lies in "…understanding the needs of my community and how to make solutions happen."
"I remember Ronald's smile and upbeat attitude about everything. No matter how despairing and hopeless I felt (I was clinically depressed) h...
To Dr. Arlene Goldsmith, anyone can become a leader, provided they are driven, have a personality that is open and engaging, and a passionat...
Whatever I learn from those experiences, I pass on to the people around me, so they don't have to go through what I went through in order to...
Since winning the award, Dr. Bonds has expanded her health-related educational programs, particularly through the increased use of technolog...
"Being a volunteer tests you, to see if you really can make a difference and if you really want to do it - because you do have to make sacri...
"Mr. Chatman will always be in my heart and mind. He taught me to love myself and others. He gave me a chance when no one else would."
The way Mr. Lynch looks at it, anyone can be a leader - with mentoring, training, and the right opportunity (the chance to make a living doi...