The Problem: In Chicago, breast cancer death rates for African Americans and whites were the same in 1980, at 38 per 100,000 women. By 2002, the rate had declined to 26 per 100,000 for white women while it had risen to 40 per 100,000 for African-American women.
The Proposal: Donna J. Thompson, RN, MS, spent 10 years earning her bachelor's degree, juggling her studies with 12-hour shifts as a staff nurse at hospitals in Illinois three or four days a week. But by the time she entered the Robert Wood Johnson Executive Nurse Fellows Program in 2003, she had also earned a master's degree in nursing administration and was the chief operating officer for Access Community Health Network in Chicago. Access has 48 health centers and provides primary care for 120,000 Medicaid patients in Cook County.
To reduce the racial and ethnic disparities in access to breast and cervical cancer screening and treatment that she saw, Thompson worked with a coalition of lay advocates, pastors and priests to start Stand Against Cancer. "We needed to do something about women who were uninsured or underinsured and couldn't get access to affordable screening and treatment," says Thompson. "We first advocated for funding during the 2002 gubernatorial race. We then met with Gov. Rod Blagojevich and got increased funding for the Illinois breast and cervical cancer program."
Stand Against Cancer is a state-funded collaboration between Illinois churches, faith-based organizations, hospitals, health centers, community organizations and the American Cancer Society. It provides education, no-cost to low-cost screening (mammography, clinical breast exams, Pap smears and pelvic exams) for low-income and uninsured women, and diagnostic services for women with abnormal test results. Stand Against Cancer also provides a seamless system for women diagnosed with cancer, by providing patient navigation and nurse case management and by enrolling eligible women into the state Medicaid program.
Thompson looked to the fellowship to help her lead the organization more effectively.
Grantee Perspective/Results: The basic structure of Stand Against Cancer was taking shape when Thompson started her fellowship. She and her colleagues were recruiting organizational partners and volunteers and hiring staff to direct them. Thompson used the project portion of her fellowship to produce a video on the importance of breast and cervical cancer screening.
Then came an unforeseen challenge. The CEO of Access, a charismatic leader, was killed in a whitewater rafting accident in June 2004. Thompson was named acting CEO and turned to the fellowship program for the skills and support she needed to hold the organization together.
"I loved operations and I loved what I was doing," she says. "Now I was pushed in front of the media. And the staff was looking for stabilization and answers that I couldn't give. I reached out to the fellowship program for help."
Marilyn Chow, DNSc, RN, director of the program, provided reassurance that Thompson could handle the job. Thompson used her leadership account from the fellowship to work one-on-one with a leadership coach. And one of Thompson's program mentors, Sandy Goldberg, CN, PhD, a nutritionist and TV personality with Chicago's NBC-TV affiliate, helped her polish her media skills.
In November 2004, Thompson was named CEO of Access. "The fellowship program provided the mentorship, resources and skill set to be a more effective leader," she says. As of the fall of 2007, Thompson continues as CEO and Stand Against Cancer thrives, screening more than 17,000 women statewide in fiscal year 2007.
RWJF Perspective: The Robert Wood Johnson Executive Nurse Fellows Program was created in 1997 to capitalize on the profession's strengths and build the leadership capacity of nursing. "Nurses are in a unique position to serve in leadership roles and contribute to transforming our health care system," says Susan Hassmiller, PhD, RN, RWJF senior program officer. "The executive nurses program is part of the Foundation's building human capital strategy to attract, develop and retain diverse and high-quality leaders and a workforce to improve health and health care," says Hassmiller.
Thompson's work is related to RWJF's Quality/Equality program area, says Team Leader Anne F. Weiss, MPP. "In RWJF's work in Quality/Equality, we are engaging local leaders like Thompson who understand how to improve quality and reduce disparities in quality care through engaging consumer advocates."