RWJF's Year in Research

Once again, the Robert Wood Johnson Foundation has conducted a Year in Research online voting initiative where the public voted for their top articles from a list of 21 nominated contenders. More than 900 people cast votes from 48 states and the District of Columbia.

• See the full results of this year’s voting.
• Join the discussion on RWJF's Health Reform Blog.

Putting Social Media to Good Use

The newest edition of "Focus on Patient Safety," the newsletter from the National Patient Safety Foundation (NPSF), features an interesting piece on using social media to improve patient safety.  Written by Susan Carr (the editor and associate publisher of Patient Safety and Quality Healthcare), the piece details ways that social media sites can serve as resources and includes recommendations for additional reading.

Check it out here.

For information on the upcoming NPSF Annual Conference, click here.

NQF's Safe Practice 18 - A Call to Action

"Pharmacy leaders should have an active role on the administrative leadership team that reflects their authority and accountability for medication management systems performance across the organization."

- Pharmacist Leadership Structures and Systems - Safe Practice 18, from the National Quality Forum's 2009 Update to their Safe Practices for Better Healthcare Report

The American Society of Health-System Pharmacists recently published an article focusing on the growth opportunities available to the field of pharmacy by the endorsement of Safe Practice 18.  Hayley Burgess, Pharm.D., BCPP, one of the writers of the standard, believes that this is a "call to action" for pharmacists to take on larger leadership roles.

INQRI agrees that pharmacists have an important role to play in ensuring effective medication management.  In 2007, we funded a nurse-pharmacist team to conduct a project at Johns Hopkins Hospital.  In their project, "Nursing-Pharmacy Collaboration on Medication Reconciliation: A Novel Approach to Information Management,"  Drs. Linda Costa (a nurse) and Robert Feroli (a pharmacist) examined how to economically support direct care providers in medication reconciliation in order to facilitate safe transition to and from hospital and community.  Costa and Feroli believe that deficits in communication across the continuum of care in regards to medication use can place patients at serious risk for harm. The team evaluated the effectiveness of a nurse-pharmacist clinical information coordination team in improving drug information management on admission and discharge, quantified potential harm due to reconciliation failures, and determined cost-benefit related to averted harm.

Check out a recent webinar presented by Dr. Costa about this collaboration.

National Health Policy Conference - Sponsored by AcademyHealth and Health Affairs

February 8-9, 2010
JW Marriott, Washington, D.C.

The National Health Policy Conference (NHPC), hosted by AcademyHealth and Health Affairs, provides clarity on the critical health care issues and priorities for the upcoming year. Now in its tenth year, the NHPC continues to deliver a program with insider perspectives from health policy leaders to an audience of more than 800 that includes researchers, policy experts, and advocates, who all share your concerns and interests.

Click here to read the agenda.
Click here for information on adjunct meetings.
Click here to register.

The First Translation Webinar was a Success

Thank you to Ben Milder, Elizabeth Wenk and Andrew Peters from Burness Communications for kicking off our Translation webinar series!

If you missed their presentation on how to "Translate Research into Policy," please click here to view the presentation on your desktop. You can also download or request the related materials:

• Findings vs. Message
• Practical Tips to Influence Policy and Change the World
• To receive the Connect Manual, please email Heather Kelley

This series is co-sponsored by the INQRI program and the Donaghue Foundation.

Upcoming Sessions:

Implementing the Transitional Care Model
Speakers: Mary Naylor, Ph.D., R.N., FAAN, University of Pennsylvania and Randall Krakauer, M.D., Aetna
Date: March 2, 2010: 4:00 p.m. - 5:00 p.m. EST
Click here to register.

Diffusion of New Ideas - What Works?
Speaker: Elizabeth Bradley, Ph.D., Yale University
Date: April 7, 2010: 12:00 p.m. - 1:00 p.m. EST
Click here to register.

Implementation Science and QUERI
Speaker: Brian Mittman, Ph.D., VA Quality Enhancement Research Initiative (QUERI)
Date: April 20, 2010: 2:00 p.m. - 3:00 p.m. EST
Click here to register.

In the News: Insurer Anthem invests in hospital initiative to improve safety, cut costs

By Duke Helfand, Los Angeles Times

January 20, 2010

California's largest health insurer is teaming with hospitals and doctors throughout the state to better share ways to improve patient safety and cut costs, leaders of the initiative said Tuesday.


Doctors, nurses and other health professionals at California hospitals will meet quarterly in person or over the Internet during the next three years to compare their practices and data for reducing medical problems such as hospital-borne infections. Woodland Hills-based Anthem Blue Cross is contributing $6 million toward the effort.

"When it comes to patient safety, we must do better," Leslie Margolin, Anthem's president, said at a news conference Tuesday at Ronald Reagan UCLA Medical Center. "We will take real, meaningful costs out of the system and we will save lives."
 
Click here to read the rest of the article.

Next Webinar - Monday

You've gone through the process of writing your grant proposal, made it through the various application stages, received your funding, completed your work and now wonder to yourself... "Now what?"


If you are wondering about how to reach policy makers and how to encourage evidence-based decision-making, tune in next Monday for the first INQRI-Donaghue webinar:

Translating Research into Policy

Speaker: Ben Milder, Burness Communications

Date: January 25, 2010: 2:00 p.m. - 3:00 p.m. EST

Click here to register.

Nurse Leadership from Bedside to Boardroom

Yesterday, RWJF leaders released the RWJF/Gallup survey data: Nursing Leadership from Bedside to Boardroom: Opinion Leaders’ Perceptions at a press briefing in Washington, DC.  This press release provides findings from the report:

Groundbreaking New Survey Finds that Diverse Opinion Leaders Say Nurses Should Have More Influence on Health Systems and Services

Opinion Leaders Trust Nurses, but Cite Barriers to Nursing Leadership

Princeton, NJ: From reducing medical errors, to increasing the quality of care, to promoting wellness, to improving efficiency and reducing costs, a new survey finds that an overwhelming majority of opinion leaders say nurses should have more influence. But these opinion leaders—including insurance, corporate, health services, government and industry thought leaders as well as university faculty—see significant barriers that prevent nurses from fully participating as leaders in health and health care. Those are key findings from a first-of-its-kind survey, Nursing Leadership from Bedside to Boardroom: Opinion Leaders’ Perceptions, conducted by Gallup on behalf of the Robert Wood Johnson Foundation. Gallup interviewed 1,504 opinion leaders across key roles and industries for the survey, which was conducted Aug 18-Oct 30, 2009.

Gallup historically has found nursing ranked among the most ethical and honest professions by the nation’s adults. This new survey finds that opinion leaders also view nurses as one of the most trusted sources of health information, but see nurses as having less influence on health care reform than government, insurance and pharmaceutical executives and others. Yet a strong majority of respondents say nurses should have more influence than they do now on health policy, planning and management.

“Nurses are highly trusted sources of health care information, but as we look to reform our health system, our nation is not taking advantage of all that nurses have to offer,” said Risa Lavizzo-Mourey, M.D. M.B.A., president and CEO of the Robert Wood Johnson Foundation. “This survey shows that opinion leaders recognize that we are squandering opportunities to learn from nurses and implement their ideas. We must build on the widespread trust of nurses’ expertise as an essential component in leading and implementing reform.”

Opinion leaders identify as major barriers to increased influence for nurses that nurses are not perceived as important decision makers or revenue generators compared with doctors, and do not have a single voice on national issues. Opinion leaders rank nurses behind six other stakeholders when it comes to influencing health reform over the next five to ten years.

“It is obvious that nurses have the expertise, experience, knowledge and skills necessary to improve health care delivery and the health of individuals,” said Reed V. Tuckson, M.D., F.A.C.P., executive vice president and chief of medical affairs for UnitedHealth Group. “Every day, I see nurses exercise their clinical judgment and leadership skills to make important and much-needed changes that increase access to and improve the quality and affordability of health care. Therefore, it is essential that we do more to support nurses in taking on leadership positions and ensure that they have a place and a voice at decision-making tables.”

Other key findings from the new Gallup survey:

§ Opinion leaders feel that nurses' primary areas of influence are reducing medical errors (51%), improving quality of care (50%), and coordinating patient care in the health care system (40%).

§ Large majorities of opinion leaders said they would like to see nurses have more influence in a large number of areas, including reducing medical errors and improving patient safety (90%); improving quality of care (89%); promoting wellness and expanding preventive care (86%); improving health care efficiency and reducing costs (84%); coordinating care through the health care system (83%); helping the health care system adapt to an aging population (83%); and increasing access to health care (74%).

§ Seventy-five percent of opinion leaders say government officials will have a great deal of influence in health reform in the next five to ten years, compared to 56% for insurance executives, 46% for pharmaceutical executives, 46% for healthcare executives, 37% for doctors, 20% for patients and 14% for nurses.

§ Opinion leaders identified the top barriers to nurses’ increased influence and leadership as not being perceived as important decision makers (69%) or revenue generators (68%) compared with doctors; nurses’ focus on primary rather than preventive care (62%); and nursing not having a single voice in speaking on national issues (56%).

Methodology—The survey was conducted by Gallup on behalf of the Robert Wood Johnson Foundation. Results are based on telephone interviews with 1,504 national opinion leaders, (aggregating samples of several types of leaders) conducted Aug 18-Oct 30 2009. For results based on a random a sample of this size, one can say with 95% confidence that the maximum margin of sampling error is ±3 percentage points. In addition to sampling error, and the specified representation of different types of opinion leaders interviewed, question wording and practical difficulties in conducting surveys can introduce error or bias into the findings of public opinion polls.

Check out more information about the report here.

Yesterday's Webinar: "Nursing-Pharmacy Collaboration on Medication Reconciliation: A Novel Approach to Information Management"

Special thanks to INQRI grantee, Linda Costa, for presenting yesterday's very informative webinar as part of our Medication Management series. If you missed Linda's presentation, you may download her PowerPoint Presentation or view the Webinar Presentation on your desktop.

For more information on the INQRI webinars, please visit our Events page on the INQRI website.

Next webinar: "Translating Research into Policy" - Monday, January 25th from 2:00 p.m. - 3:00 p.m. EST. Click here to register.

Nursing Leadership from Bedside to Boardroom: Opinion Leaders’ Perceptions

This week, the Robert Wood Johnson Foundation and Gallup are releasing results of a groundbreaking new opinion leader survey on nurses’ influence on health systems and services. Risa Lavizzo-Mourey, president and CEO of the Robert Wood Johnson Foundation and Frank Newport, Editor in Chief of The Gallup Poll will be joined by a panel of nursing and health care leaders to discuss the results.

To register for the live webcast visit www.visualwebcaster.com/nursing-leadership and fill in information as prompted. You can also opt to perform a system check to confirm that your computer is able to receive live streaming media. Once you are registered you will simply need to click on the URL above and you will be connected to the live feed on the day of the event.

When: Wednesday, January 20, 2010
Time: 9-11 a.m. ET
Contact: Lauren Musiol at lmusiol@gymr.com or 202-745-5051 with any questions.

Dr. King's Legacy

Today, we remember the struggle and the commitment of one of the most inspiring civil rights leaders we have ever known. In honor of Dr. King's enduring legacy, we thought it appropriate to share this collection of studies presented by the Journal of the American Academy of Physician Assistants: Eliminating Health Disparities: What Works?

Next Webinar - Tuesday, January 19

Please join us for the next webinar...

"Nursing-Pharmacy Collaboration on Medication Reconciliation:

A Novel Approach to Information Management"
Presented by INQRI grantee Linda Costa
January 19 from 2:00 p.m. - 3:00 p.m. EST
Please click here to register.

This session is part of our Medication Management series

and is co-sponsored by the Gordon and Betty Moore Foundation.

Evidence-based treatments have improved care quality, Joint Commission says

This week, Victoria Forlini wrote a piece for FierceHealthcare, explaining the way that the Joint Commission says that evidence-based practices improve patient care.

Hospitals are striving for--and hitting--many outcome improvements, the Joint Commission reports. National improvement on 12 outcomes, reflecting best evidence-based treatments for heart attacks, heart failure and pneumonia, rose between 4.9 percent and 58.8 percent between 2002 to 2008, according to Improving America's Hospitals: The Joint Commission's Report on Quality and Safety 2009.

"In addition to saving lives and improving health, improved quality reduces healthcare costs by eliminating preventable complications," said Mark Chassin, the accreditor's president. Hospital improvements included:

• Overall heart failure care results improving so that evidence-based treatments were given 91.6 percent of the time, up from 59.7 percent in 2002.
• Evidence-based treatments being given 92.9 percent of the time in pneumonia cases in 2008, up from 72.3 percent in 2002.

The report presents scientific evidence of improvement and how it relates to common medical conditions and procedures. The Joint Commission measures 31 outcomes, including several for children's care. More than 3,000 Joint Commission-accredited hospitals contributed data.

For more information, check out this press release.

New Article: "New Nurses Feel Unprepared to Focus on Quality Improvement"

NurseZone.com is featuring a new article by Debra Wood, RN, which focuses on the challenges new nurses face as they enter a health system which emphasizes quality improvement.

Although nursing administrators and other health care leaders have placed a strong emphasis on quality improvement, many new nurses enter the profession feeling "poorly" or "very poorly" prepared by their nursing education programs to implement quality improvement measures, according to new research findings. In fact, 12.6 percent reported never having heard of the widely-used term now at the forefront of health reform discussions.

Christine Kovner, PhD, RN, FAAN, said she was surprised by the number of new nurses who felt unprepared to participate in quality improvement initiatives."I see this as a wake-up call and a piece of evidence," said Christine Kovner, Ph.D., RN, FAAN, a professor at New York University's College of Nursing and lead author of a study published in the January 2010 issue of The Joint Commission Journal on Quality and Patient Safety.

Click here to read the entire story.

INQRI's 5th Call for Proposals - Released TODAY

Over the past four years INQRI has awarded grants to 34 teams that have focused on establishing linkages between nursing and the quality of care delivered to people within and across a variety of health care settings. This year we turn our attention to another core dimension of INQRI’s mission—the translation of knowledge to achieve a direct impact on the care of the people served by nurses.

Click here to read the Call for Proposals.

We plan to award up to eight 18-month grants of up to $300,000 each will be awarded in 2010. Here are the key dates for this round of INQRI funding:

February 17, 2010 (3 p.m. ET)—Deadline for receipt of brief proposals.
April 27, 2010—Applicants notified if invited to submit a full proposal.
June 1, 2010 (3 p.m. ET)—Deadline for receipt of full proposals (by invitation).
August 16, 2010—Grantees notified of funding decisions.
September 15–16, 2010—INQRI annual meeting (attendance required). Each selected team must be represented at the meeting by the two project directors who are scholars from nursing and another discipline. The meeting will be held at the Robert Wood Johnson Foundation in Princeton, N.J.
November 1, 2010—Research grants start.

All brief proposals must be submitted electronically. Click here to begin your online application.

Contact Heather Kelley with any questions.

National Quality Forum Measures

Last week, Modern Healthcare reported that "The National Quality Forum is endorsing 70 performance measures that combine data from various electronic sources—such as administrative claims, pharmacy and laboratory systems, and registries—in order to advance the use of electronic data platforms to measure, report and improve quality."

Click here to read the article.

In February 2003, the National Quality Forum undertook a 14-month project to study the relationship between nursing personnel and quality, and the degree to which national voluntary consensus standards for nursing-sensitive care could be established.  The 15 indicators of nurse-sensitive care endorsed by NQF represented the first set of nationally standardized performance measures designed to assess how nurses in acute care hospitals contribute to health care quality, patient safety, and a professional and safe work environment.

This work greatly informed the development of the first INQRI call for proposals in 2005 which focused on measurement.  The teams selected via that call began their work in August 2006 and completed their work in fall 2008. The nine research projects covered three major areas: (1) investigating the link between the work of nurses and the quality of care provided in hospitals; (2) producing and validating measures that capture nurses' contributions to quality care in hospitals; and (3) evaluating the impact of innovative nurse-led initiatives on patient outcomes.

To read more about the nine teams in INQRI's first cohort, please click here.

What Nursing Leaders Know

"Current conditions have created a critical time for nurse leaders to not only know what they know, but to know what they don’t know."

Diane Sieg, RN, BSN, CYT, CSP, an emergency room nurse with more than 20 years experience, has written an excellent piece, "What Nursing Leaders Know: Seven Truths from Top Health Care Professionals" for Sigma Theta Tau's website "Reflections on Nurse Leadership."  Sieg interviewed top nurse leaders including CEOs, CNOs and nurse educators to get their unique take on the challenges facing nurses in today's health care system.

From the nursing shortage to health care costs to the value of Magnet designation, nurses weighed in on issues all across the spectrum.  Click here to learn the "Seven Truths."

Click here to learn more about Sigma Theta Tau International.

NYT Article: Hospitals Could Stop Infections by Tackling Bacteria Patients Bring In, Studies Find

On Wednesday, the New York Times featured an article about two new studies in the New England Journal of Medicine which examined surgery site infections, a problem that affects more than 300,000 patients annually.  There has been much focus of late on efforts to prevent hospital-acquired infections (including by INQRI researchers at Johns Hopkins).  However, these new studies focus on the bacteria that patients may be carrying when the enter the hospital.

Read the article here.

Read the studies:
"Preventing Surgical-Site Infections in Nasal Carriers of Staphylococcus aureus"

"Chlorhexidine–Alcohol versus Povidone–Iodine for Surgical-Site Antisepsis"

Save the Date: Gallup Survey Release on Nursing Leadership

On Wednesday, January 20, the Robert Wood Johnson Foundation will release the results of the first-ever large-scale Gallup Survey to explore the views of leading stakeholders about nurses’ ability to influence health reform and improve health care in the United States. The survey, Nursing Leadership from Bedside to Boardroom: Opinion Leaders’ Perceptions, provides valuable information about the perception of nurses as leaders and change-makers by key players in health care, business, government and higher education.


The survey will be released at a news briefing from 9 a.m. – 10 a.m. at the National Press Club in Washington, DC, immediately followed by a one-hour discussion of the results by a panel of local and national experts, and Robert Wood Johnson Foundation leaders and nurses. Speakers will include:

• Risa Lavizzo-Mourey, president and CEO of the Robert Wood Johnson Foundation
• Frank Newport, editor-in-chief of The Gallup Poll.

The panel discussion will be moderated by Susan Hassmiller, senior advisor for nursing at RWJF. Speakers will include:

• Mary Naylor, professor at the University of Pennsylvania School of Nursing, director of NewCourtland Center for Transitions and Health and program director of RWJF's Interdisciplinary Nursing Quality Research Initiative
• Patricia Gerrity, associate dean at Drexel University’s College of Nursing and Health Professions, director of 11th Street Family Health Services and RWJF Executive Nurse Fellow
• Richard Hader, chief nursing officer of Meridian Health at the Jersey Shore University Medical Center
• Beverly Malone, CEO of the National League for Nursing and National Advisory Council Member for RWJF’s Nurse Faculty Scholars program

Stay tuned for ways to participate via the web.  For those interested in attending in person, please contact Lauren Musiol at lmusiol@gymr.com.  Seating is limited, so please RSVP to reserve your spot today.

Upcoming IHI Program: Managing Hospital Operations

The Institute for Healthcare Improvement’s (IHI’s) innovative, scientifically-based Managing Hospital Operations program begins this February. This five-month program provides a highly individualized opportunity to address inefficiencies in health care organizations, potentially resulting in multimillion dollar savings, increased revenue, and enhanced overall quality.

Watch this short video to hear from a past participant about how he identified a way for his organization to potentially generate an additional $2-3 million in annual revenue... simply by adding one additional nurse during peak hours.

The ARCHeS Platform - a New Tool With Great Possibilities

Recently, INQRI's senior program officer, Lori Melichar published a post on RWJF's Pioneer blog about ARCHeS, a web-based platform which allows policy-makers and other leaders to use the Archimedes model to run virtual trials. Dr. David Eddy, founder of Archimedes, recently visited the Foundation to present about ARCHeS, which is supported by the Pioneer program.




"What struck me about ARCHeS was the opportunity it presented to make evidence-based policy decisions about nurse practitioners’ scope of practice that could potentially result in significant savings."

Click here to read Lori's piece.