INQRI Grantee Featured in RWJF Newsletter

Congratulations to Gerri Lamb who was featured in the May 2009 edition of "Sharing Nursing's Knowledge." Read Gerri's profile here.

Updates from AHRQ

AHRQ Report Highlights Health Care Quality, Access Disparities Gap

A new report published by the Agency for Healthcare Research and Quality (AHRQ) finds that health care disparities across at least 60 percent of quality measures stayed the same or worsened between 2000 to 2001 and 2005 to 2006, AHA News Now reports. The National Healthcare Disparities Report takes into account 220 quality measures pertaining to effectiveness, patient safety, timeliness and patient centeredness, focusing on 45 core measures. Outlining three overarching conclusions, the report suggests that disparities persist in health care quality and access, that the magnitude and pattern of disparities vary within subpopulations, and that some disparities exist across multiple priority populations. However, the group also reports a reduction in some disparities. For example, the rate of deaths per 1,000 discharges with complications potentially resulting from care for African-American patients declined between 2000 and 2005, and the gap between African-American and white patients on that measure decreased to the point that African Americans have better outcomes than whites. Meanwhile, saying that patient experience is an important indicator of health care quality but noting that many minorities report poor provider-patient communication, the report suggests that addressing disparities will "require special attention to cultural attitudes and perceptions that affect health behaviors and patterns of health care access and utilization." (AHA News Now, 5/6/09; AHRQ report; HHS release, 5/6/09)

http://www.rwjf.org/qualityequality/digest.jsp?id=10615


Patients Receiving Only 59 Percent of Recommended Care, AHRQ Finds

The sixth annual National Healthcare Quality Report from the Agency for Healthcare Research and Quality (AHRQ) finds that the quality of care provided by the U.S. health care system continues to improve at a slow pace, but many Americans still do not receive recommended care, AHA News Now reports. The congressionally-mandated analysis tracks trends in health system performance on 45 core measures of the effectiveness, safety, timeliness and patient focus of care. According to the report, the median annual rate of change for all quality measures was 1.4 percent, while the median level of receipt of needed care was 59 percent across the core measures. Measuring improvement across prevention, acute care and chronic care management categories, the AHRQ found that acute treatment measures showed the strongest rate of quality improvement, with 66 percent exhibiting some gains. However, the report indicates that patient safety measures worsened by nearly 1 percent per year during the past six years. Meanwhile, quality improvements continued to be spread unevenly across health care settings. For instance, care delivered in hospitals improved at an annual rate of change of nearly 3 percent, while care provided in ambulatory care settings improved at a rate that only slightly exceeded 1 percent. Commenting on the report's findings, U.S. Department of Health and Human Services (HHS) Secretary Kathleen Sebelius urged providers to work harder at reducing health care-associated infections and announced the availability of $50 million in federal stimulus grants to help facilities meet this challenge. Specifically, HHS will allocate $40 million to create or expand state infection and surveillance programs and $10 million to improve processes and increase ambulatory surgical center inspections. Noting that the report demonstrates why the country "can't wait to enact comprehensive health reform," Sebelius, who was speaking at the United Nurses of America's National Nurses Congress, added, "the status quo is unsustainable." (AHA News Now, 5/6/09; AHRQ report, March 2009; AHRQ release, 5/6/09; Goedert, Health Data Management, 5/6/09)

http://www.rwjf.org/qualityequality/digest.jsp?id=10614

Updates on Nurse Staffing and Workforce Regulations

Federal Legislation Would Establish Inpatient Nurse Staffing Ratios

Rep. Jan Schakowsky (D-Ill.) has introduced legislation that would amend the Public Health Service Act to mandate national inpatient nurse-to-patient staffing ratios, AHA News Now reports. Under the Nurse Staffing Standards for Patient Safety and Quality Care Act of 2009, hospitals would be required to implement staffing plans that adhere to minimum direct care nurse-to-patient ratios and adjust nurse staffing levels based on patient acuity and additional factors, within two years of the bill's enactment. Commenting on the legislation, the United American Nurses president says the proposed bill would improve care quality, noting that studies have linked insufficient nurse staffing levels to poor patient outcomes. Moreover, she adds that minimum nurse-to-patient staffing ratios would help alleviate stress and fatigue that can lead to nurse burnout and attrition. Reps. Pete Stark (D-Calif.), Charles Rangel (D-N.Y.), John Conyers (D-Mich.), Eddie Bernice Johnson (D-Texas), Don Young (R-Ark.), Neil Abercrombie (D-Hawaii), James McGovern (D-Mass.), Brad Sherman (D-Calif.), Rosa DeLauro (D-Conn.), Keith Ellison (D-Minn.) and Tammy Baldwin (D-Wis.) are co-sponsoring the bill, which has been referred to the House Energy and Commerce and Ways and Means committees for further consideration (AHA News Now, 5/7/09; United American Nurses release, 5/7/09).

http://www.rwjf.org/humancapital/digest.jsp?id=10626


Legislators, Nurse Unions Push for National Workforce Regulations

Several of the nation's largest nursing unions, including the California Nurses Association/National Nurses Organizing Committee (CNA/NNOC), the AFL-CIO-affiliated United American Nurses (UAN), and the Massachusetts Nurses Association, are advocating for a single-payer health system and national workplace regulations, Modern Healthcare reports. The groups recently hosted an event called the National R.N. Day of Action featuring Sen. Barbara Boxer (D-Calif.), who is expected to introduce legislation addressing union priorities, including funding for nurse education, whistle-blower protections, mentoring of new nurses and minimum nurse-to-patient staffing ratios. The event followed the introduction earlier this month of a bill to amend the Public Health Services Act to require national nurse-to-patient staffing ratios. Sponsored by a bipartisan group of legislators and supported by the UAN, the bill would require that, within two years of enactment, hospitals implement plans that adhere to minimum direct care nurse-to-patient ratios, and adjust nurse staffing levels based on patient acuity and other factors. Citing a 2002 New England Journal of Medicine article finding that, when there is a lack of R.N.s, patient bedside care suffers, the UAN president says that mandating national inpatient nurse-to-patient staffing ratios would alleviate stress, reduce burnout in hospital nurses and make hospital nursing "an attractive option again." The bill has been referred to the House Energy and Commerce and Ways and Means committees for further consideration. Meanwhile, Rep. John Conyers (D-Mich.) has reintroduced the Nurse and Health Care Worker Protection Act of 2009, which would require the U.S. Occupational Safety & Health Administration to develop and implement the use of mechanical devices to eliminate manual lifting of patients by direct care R.N.s and other health workers (Blesch, Modern Healthcare, 5/13/09 [subscription required]; AHA News Now, 5/7/09; CNA/NNOC release, 5/13/09; UAN release, 5/7/09; UAN release, 5/13/09).

http://www.rwjf.org/humancapital/digest.jsp?id=10734

RWJF Publication Alert: 2008 Annual Report Released

The Robert Wood Johnson Foundation’s 2008 annual report is now available online, with easily accessible PDFs for individual sections of the report.

• RWJF President and CEO, Risa Lavizzo-Mourey, M.D., M.B.A., discusses the symptoms of an ailing health care system, offering a road to reform in the President’s Message, which was released online in January.
• The Year in Review provides updates on the Foundation's seven program areas.
• Grants list is a comprehensive look at the grants and contracts awarded in 2008.

Read the RWJF 2008 annual report.

The Foundation's audited financial statements will be available mid-summer. To receive a notice when the financial statements are available, please register for an e-mail notification.

How to Present Study Results for Maximum Policy Impact

Did you miss today's webinar? Don't worry - you can view it online on our Events Page. You will find helpful hints for translating research findings into powerful messages.

During the presentation, Janet and Caroline mentioned that our INQRI grantee team from Midwestern State University is using a blog to collect stories from nurses who work off-peak hours. Check it out here.

Finally, we want to hear from you! Share your suggestions for future webinars with Heather Kelley.

Special thanks to Janet Firshein and Caroline Broder from Burness Communications for hosting such a fantastic webinar!

Nursing Workforce Solutions for 21st Century Health Care: How Do We Get There?

Friday, June 12, 2009—9:00 a.m. - 12:00 p.m.
Union Station Columbus Club, Washington, DC
Register Here

This forum is presented by Health Affairs and the Center to Champion Nursing in America, a joint initiative of AARP, the AARP Foundation and the Robert Wood Johnson Foundation.

Join us for a discussion, moderated by Susan Dentzer of Health Affairs, examining the impact of the nursing workforce on health care delivery, access and quality. This event also marks the publication of several papers in Health Affairs focusing on the nursing workforce and health care quality.

Key to fundamental health care reform is building, empowering, and deploying a 21st century health care workforce. A right-sized, richly-skilled, and effectively integrated nursing workforce is essential to achieving high quality health care. Getting there from here, however, presents a significant strategic challenge.

Discussion will focus on:

• Specific ways health care reform can ensure we have the nursing workforce necessary to provide the primary and preventive care, chronic care management, and care coordination that form the core of a more effective and efficient health care delivery system.
• The shortage of nurses that threatens health care access, quality and cost effectiveness.
• Evidence-based solutions for ensuring sufficient numbers of highly-skilled nurses.
• Lessons from Oregon, an exemplar state addressing nursing workforce and health care delivery.
  

Speakers include:

• Congresswoman Lois Capps (invited), Chair, Congressional Nursing Caucus
  
• Caya Lewis (invited), Director of Outreach and Public Health Policy, Department of Health and Human Services Office of Health Care Reform
  
• Risa Lavizzo-Mourey, President & CEO, Robert Wood Johnson Foundation
  
• John Rother, Executive Vice President, Policy & Strategy, AARP
  
• Susan Reinhard, Senior Vice President & Director, AARP Public Policy Institute; Chief Strategist, Center to Champion Nursing in America
  
• Linda Aiken, Director, Center for Health Outcomes and Policy Research, University of Pennsylvania School of Nursing
  
• Peter Buerhaus, Director, Center for Interdisciplinary Health Workforce Studies, Vanderbilt University Medical Center
  
• Brenda Cleary, Director, Center to Champion Nursing in America
  
• Robin Newhouse, Assistant Dean, Doctor of Nursing Practice Program & Associate Professor, University of Maryland School of Nursing
  
• Jonathan Weiner, Professor, Health Policy & Management, Johns Hopkins University Bloomberg School of Public Health
  
• As well as several key Congressional staffers

For more information contact: Caroline Okumu — (703) 717-6243, aarp@smithfairfield.com

Call for Posters: 20th Symposium on Health Care Services in NY

United Hospital Fund, GNYHA Foundation, and the Symposium Planning Committee are pleased to announce the 20th Annual Symposium on Health Care Services in New York: Research and Practice.

Friday, November 20, 2009
CUNY Graduate Center
365 Fifth Avenue in New York City.


The deadline for abstracts for the poster session is Tuesday, June 30.

The application form is available at http://www.uhfnyc.org/calendar_contact3160/calendar_contact_show.htm?doc_id=909884.

Applications and cover sheets must be submitted to symposium@uhfnyc.org.

For poster application questions, please contact Kristina Ramos-Callan at 212-494-0791 or symposium@uhfnyc.org.

Posters presented in this session highlight research, practice, and/or policy findings relevant to the everyday concerns of health care managers, clinicians, and policymakers. Suggested topics include:


• Access to Health Care

• Acute Care

• Behavioral Health

• Disease Management

• Disparities

• Evidence-Based Medicine

• Financing of Health Services

• Health Care Management

• Health Information Technology

• Health Literacy

• Home Care

• Insurance and Managed Care

• Long-Term Care

• Maternal and Child Health

• Primary Care

• Public, Environmental, or Occupational Health

• Quality and Patient Safety

• Workforce Issues


There will be two main viewing opportunities: a dedicated morning poster session and additional time during the lunch break.

Medical Students, Health Care Professionals Tap IHI for Quality, Safety Courses

The Institute for Healthcare Improvement (IHI) has developed a series of free online courses designed to teach medical students, nurses and other health care professionals about quality improvement and patient safety, American Medical News reports. Offered under the Cambridge, Mass.-based nonprofit Open School for Health Professions, the program aims to prepare "the next generation of health professionals so they have the tools to enter the work force as prepared and active participants in providing the best care for patients," according to the program's director. Since launching in September 2008, the Open School has established six introductory courses that cover topics such as how to set goals, collect and analyze data, and implement changes to improve quality; how teamwork and communication can reduce the risk of patient harm; and how human factors, such as the design of medical equipment, signage and labels, can impact care. Students can view videos and podcasts, participate in discussion groups and read case studies. After completing the course, students can earn certificates that can be added to their resume. To receive advanced certification, students are required to implement the principles they have learned in a related improvement project in the clinical setting. According to American Medical News , IHI is currently seeking to have the courses qualify as continuing medical education credits. To date, 12,000 students have registered to participate in the courses and student-led Open School chapters have launched at 122 health science schools in 12 countries (O'Reilly, American Medical News, 5/4/09).

http://www.rwjf.org/qualityequality/digest.jsp?id=10553

Methods on My Mind

Given the topic of this week's webinar, it seemed a good time to share information about the upcoming Methods Seminars at the AcademyHealth Annual Research Meeting (ARM) this year. You can attend these meetings without registering for the full ARM. Check it out:

Expand Your Skills & Explore Your Interests with
Methods Seminars and Interest Group Meetings

>> METHODS SEMINARS
June 26 and June 27

These pre-conference sessions are ideal for both new and experienced researchers who want to enhance their skills in research methodologies.

Issues in the Analysis of Complex Sample Survey Data
Methods of Comparative Effectiveness Research
Introduction to Medicare Part D Data for Research
Enhancing Your Methodological Toolbox: An Introduction to Qualitative Research
Methods for Addressing Endogeneity and Selection Bias in Observational Studies

For more information about the Interest Group meetings, click here.

For more information about Adjunct meetings, click here.

Causal Modeling Webinar Available Online

Check out Bryan Dowd's webinar on causal modeling - Available now on the INQRI website.