WHAT WILL CHANGE — AND WHAT WON’T
Under my presidency, I expect no radical departures from the past—in other words, evolutionary, not revolutionary change. We will focus on fewer issues, bringing more integrated strategies to a highly targeted set of program priorities. We will be looking two steps down the line in order to increase the chances that our grant dollars are paying off. We will put great emphasis on achieving and measuring concrete results. Grantees will find a much greater concentration on outcomes that signal systemic improvements, effect real social change, and bring discernible improvements to people’s lives.

Over the past 30 years, this Foundation has touched the lives—and careers—of millions of Americans. But our nation continues to need large-scale momentum to bring about demonstrable improvements in our weakened health care and public health systems. The Foundation needs to harness and focus our enormous potential to garner public support to broaden and deepen our impact.

The Robert Wood Johnson Foundation has been an innovator and leader in the way we communicate our goals, our programs and, of course, our grantees’ myriad accomplishments. I want our communications to become even better. We need to be more transparent about how we do our work, what we expect from grantees (and of ourselves), and how we evaluate our grant results. I want to make our key initiatives a constant part of the national debate and to find new venues to talk about the core issues that will determine the future health of all Americans.

What will not change is our Board’s vision, compassion and dedication—the legacy of our founder, Robert Wood Johnson—and the energy and resourcefulness of our staff and grantees in implementing that vision. While we are proud of what has been accomplished and look forward to the successes that we believe lie ahead, we are humbled by the magnitude of the task. We will continue to “work smart,” but we are neither omniscient nor omnipotent. The sea we seek to navigate is wide and deep and, even with the considerable financial and intellectual assets at our command, our boat is still quite small.

NEW CORE ISSUES
Many items in the portfolios will seem familiar issues for RWJF. Here’s my thinking about some of the newer issues that will be at the top of our agenda in the next few years.

Nursing: When we think about the future of health care, it will be the nurses and other front-line workers who will be on the leading edge of change. Over the next decade, we are committed to a thorough re-examination of the ways in which nurses interact with other health care providers. In the hospital setting, particularly, these relationships have to be retooled to adapt to shifting circumstances that include:

• An aging population with many complex chronic conditions.
• A hospital nursing workforce whose average age is 45.
• A disconnect between the existing workforce and an increasingly diverse patient base.
• A lack of professional autonomy coupled with institutional cultures that inhibit nurses from pressing for needed changes.

The nursing profession is in extremis, and our nursing initiatives, which will focus on improving the hospital work environment, will be at the core of our increased emphasis on health care quality.