Gerri Lamb, Ph.D., R.N.,F.A.A.N., graduated in the early 1970s with a bachelor’s degree in nursing from the State University of New York at Albany, but her education in the nation’s health care system was only just beginning. She soon got a job at The Visiting Nurse Service of New York in lower Manhattan, where she encountered patients from all walks of life in one of the most diverse communities in the world. “It was an unbelievable education,” Lamb recalls. “I got to see when health care really worked and when it didn’t."
For Lamb, the system’s failures were the most enlightening, and those failures most often involved the area’s most vulnerable patients: the elderly and those living in poverty. In one case, Lamb recalls climbing up five or six flights of stairs to treat a woman who lived in a one-room apartment who was suffering from complications of diabetes and leg ulcers. The woman had run out of supplies but could not manage the journey down the stairs and to the pharmacy, so she was forced to bandage her legs with newspapers.
It was that kind of up-close-and-personal experience that formed the foundation of Lamb’s lifelong commitment to improving the health care system, especially for older and vulnerable populations. Some 40 years after her first job as a visiting nurse—and after earning master’s and doctorate degrees in nursing and holding jobs in academia and other health care organizations—she is still working toward that goal.
In a project for the Interdisciplinary Nursing Quality Research Initiative (INQRI), an initiative funded by the Robert Wood Johnson Foundation (RWJF), Lamb worked with a team of nurse scientists and engineers to understand how nurses contribute to and can improve the quality of patient care through care coordination activities such as sharing health care information with patients and providers and mobilizing caregivers to provide care.
Her team developed the first tool to measure staff nurse care coordination in the hospital. Early results have shown a significant relationship between staff nurses’ rates of care coordination activities and quality outcomes such as improved patient satisfaction and reduced medication errors and patient falls. She shares: “It is clear to us from hundreds of hours of observation and interviews with nurses and their team members that nurses play a pivotal role in making sure patients progress well through their hospital stay.”
Now, Lamb wants to refine the Nurse Care Coordination Instrument so she can hone in on care coordination activities that have the biggest impact on critical quality outcomes. That, she hopes, will help her demonstrate that nurses’ care coordination activities are essential to achieving positive patient outcomes and reducing hospital readmissions—which, in turn, will increase efficiency and reduce costs at hospitals and health care systems.
Lamb is also working on another RWJF-funded project to develop an interdisciplinary curriculum in health care design to facilitate communication between health care professionals from fields ranging from nursing to architecture to engineering. Her hope is that the coursework will enable diverse groups of professionals to find ways to create more effective environments for health care.
Lamb, of course, is not limiting her work to research. After serving as a visiting nurse, nurse practitioner, nurse administrator, nurse faculty member and associate dean, she now has one more title to add to her lengthy resume: co-chair of the steering committee on care coordination for the National Quality Forum, a non-profit organization that aims to develop and implement a national strategy for health care quality measurement and reporting. “My career is a testament to all of the opportunities that nursing offers to make an impact on patient care and our healthcare system,” she says.