Category Archives: Health Policy Fellows

Mar 25 2014
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Sharing Nursing’s Knowledge: The March 2014 Issue

Have you signed up to receive Sharing Nursing’s Knowledge? The monthly Robert Wood Johnson Foundation (RWJF) e-newsletter will keep you up to date on the work of the Foundation’s nursing programs, and the latest news, research, and trends relating to academic progression, leadership, and other essential nursing issues. Following are some of the stories in the March issue.

Nurses Need Residency Programs Too, Experts Say
Health care experts, including the Institute of Medicine in its report on the future of nursing, tout nurse residency programs as a solution to high turnover among new graduate nurses. Now, more hospitals are finding that these programs reduce turnover, improve quality, and save money. Success stories include Seton Healthcare Family in Austin, Texas, which launched a residency program to help recent nursing school graduates transition into clinical practice. Now, three out of four new graduate nurses make it to the two-year point, and five or six new nurse graduates apply for each vacant position.

Iowa Nurses Build Affordable, Online Nurse Residency Program
Some smaller health care facilities, especially in rural areas, cannot afford to launch nurse residency programs to help new nurses transition into clinical practice. A nursing task force in Iowa has developed an innovative solution: an online nurse residency program that all health care facilities in the state—and potentially across the country—can use for a modest fee. The task force was organized by the Iowa Action Coalition and supported by an RWJF State Implementation Program grant.

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Mar 6 2014
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RWJF Scholars in the News: Nurse staffing and patient mortality, communicating about vaccines, specialized HIV training for NPs, and more.

Around the country, print, broadcast, and online media outlets are covering the groundbreaking work of Robert Wood Johnson Foundation (RWJF) leaders, scholars, fellows, alumni, and grantees. Some recent examples:

A study led by Linda H. Aiken, PhD, FAAN, FRCN, RN, and covered by CNN.com, finds that hospital nurse-patient ratios and the share of nurses with bachelor’s degrees both have an important impact on patient mortality. Aiken, a research manager supporting the Future of Nursing: Campaign for Action and a member of the RWJF Interdisciplinary Nursing Quality Research Initiative (INQRI) National Advisory Committee, found that increasing a hospital nurse’s workload by one patient increased by 7 percent the likelihood of an inpatient death within 30 days of admission. The same research revealed that a 10-percent increase in the number of nurses with bachelor’s degrees at a given hospital reduces the likelihood of a patient death by 7 percent. Aiken’s study has also been covered by the Guardian, Philly.com, and FierceHealthcare, among other outlets.

Public health messages aimed at boosting childhood vaccination rates may be backfiring, according to a new study led by RWJF Scholars in Health Policy Research alumnus Brendan Nyhan, PhD. Campaigns that use studies, facts, and images of ill children increased fears about vaccine side-effects among some parents, NBC News reports. In fact, messaging that debunked myths about links between vaccines and autism actually made parents less inclined to have their children inoculated. Time magazine online also covered the study.

The Johns Hopkins University School of Nursing has developed a new curriculum that provides specialized HIV training to nurse practitioners, with funding from the Health Resources and Services Administration, Medical Xpress reports. “The design of our program starts with the recognition that HIV care cannot be provided in a silo, that it needs to be integrated holistically into primary care," RWJF Nurse Faculty Scholar Jason Farley, PhD, MPH, said in a statement. Farley is the developer of the curriculum.

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Feb 14 2014
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Affordable Care Act Marketplaces Can Contribute to Health System Transformation!

Jay Himmelstein, MD, MPH, is a professor of family medicine and community health and chief health policy strategist at the Center for Health Policy and Research at the University of Massachusetts Medical School (UMMS). He serves as a senior advisor to the UMMS Office of Policy and Technology, and is a senior Fellow in health policy at NORC, University of Chicago. Himmelstein is an alumnus of the Robert Wood Johnson Foundation Health Policy Fellows program, where he worked on the health staff of Senator Edward Kennedy. This post is part of the “Health Care in 2014” series.

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The nation's attention has focused in recent months on the politics and challenges related to the roll-out of state and federal health insurance marketplaces created by the Affordable Care Act (ACA). Despite website technical woes, significant numbers of Americans have already gained access to affordable insurance plans through the marketplaces and other provisions of the ACA, and it appears likely that the ‘marketplace’ concept will be successful over time in connecting consumers to health insurance and significantly decreasing the ranks of uninsured.

The better functioning marketplaces currently allow consumers to: 1) determine eligibility for subsidized health insurance, 2) use basic online shopping tools to compare and purchase health insurance plans based on four different "metallic tiers" (i.e., the platinum, gold, silver, and bronze tiers), and 3) make side-to-side comparisons between these plans on features such as deductibles, out-of-pocket cost limits, and number and proximity of doctors and hospitals. A few marketplaces also offer information about plan quality, the ability to search for health care providers and hospitals associated with specific plans, and rudimentary ‘cost calculators’ which estimate the total cost of plans inclusive of premiums, deductibles, and out-of-pocket costs.

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Feb 4 2014
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RWJF Milestones, February 2014

The following are among the many honors received recently by Robert Wood Johnson Foundation (RWJF) leaders, scholars, fellows, grantees and alumni:

Former New Orleans Health Commissioner Karen DeSalvo, MD, MPH, MSc, is now leading the Office of the National Coordinator for Health Information Technology in Washington, D.C. An RWJF Generalist Physician Faculty Scholar alumna, DeSalvo also was recently named one of Governing Magazine’s nine public officials of the year

Brendan G. Carr, MD, MA, MS, assistant professor of emergency medicine and epidemiology at the Perelman School of Medicine at the University of Pennsylvania, has been named director of the federal Emergency Care Coordination Center (ECCC). The ECCC was created by presidential directive to improve national preparedness and response by promoting research, regional partnerships, and effective emergency medical systems. Carr is an RWJF Clinical Scholars alumna.

RWJF Executive Nurse Fellows program alumna Ann Cashion, PhD, RN, FAAN, has been named scientific director of the National Institute of Nursing Research’s (NINR) Division of Intramural Research. Cashion was formerly a senior advisor to the NINR Office of the Director. Cashion’s research expertise focuses on genetic markers that predict clinical outcomes.

Pamela Jeffries, PhD, RN, ANEF, has been named the Johns Hopkins University School of Nursing’s first vice provost for digital initiatives. Jeffries, a professor and associate dean for academic affairs, will remain on the faculty at the School of Nursing. She is an RWJF Executive Nurse Fellows program alumna.

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Jan 20 2014
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Compassion and a Coffee Cup

Mia R. Keeys, BA, is a 2008 graduate of Cheyney University of Pennsylvania. Keeys has worked with loveLife, the HIV/AIDS prevention youth campaign of South Africa. She served as a U.S. Fulbright Fellowship in East Nusa Tenggara, Timor, Indonesia and is today a first-year doctoral student in sociology at Vanderbilt University and a Robert Wood Johnson Foundation Health Policy Fellow (2013).

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“'Scuse me, can I sit here?” she asked me.

I could have moved away. But, in a sea of patrons, it would have signified more than discomfort. What was I implying by staying seated? Was it a statement—a sit-in, if you will—to prove to myself she is no less valuable in our shared humanity? Was it to quell the guilt that I felt because I wanted to move and, furthermore, failed to ask her name? Her tawny hoodie reeked of the cold of black nights she likely endured in the last week, while I was home wrestling with my white feather-down comforter. From my seat and hers on a faux-leather brown couch—the brown of both our faces—the flames perform within the fireplace in front of us, as I perform indifference for those around me. I am not prejudice. I cross one leg sophisticatedly over the other. I am not prejudice.

A furtive leftward glance at my cell phone (albeit an archaic flip phone) exposed in my open bag—the only object separating our arms from touching. I am not prejudice. A chill in the air tickles my nose, but I resist a sneeze or even a nose-crinkle, lest the gesture of an otherwise trivial facial contortion suggest any discomfort associated with the stench of her clothes. 

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Jan 10 2014
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The Primary Care Technician: A New Class of Health Care Providers

Arthur Kellermann, MD, MPH, FACEP, an alumnus of the Robert Wood Johnson Foundation (RWJF) Clinical Scholars and Health Policy Fellows programs, is dean of the F. Edward Hébert School of Medicine at the Uniformed Services University of the Health Sciences. He wrote an article in the November issue of Health Affairs calling for a new class of health care provider—the primary care technician—to improve accessibility to and affordability of primary care.

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Human Capital Blog: What is the thrust of your idea?

Arthur Kellermann: We’ve had a decades-long shortage of primary care physicians in this country and, up until now, it has defied solution. One definition of insanity is to continue to do the same thing over and over again and expect a different result. My article suggests a rethinking, and literally a reengineering, of how we deliver primary care in this country. It makes the case for a new class of providers—primary care technicians (PCTs)—who would work remotely, under the online supervision of primary care physicians or nurse practitioners (NPs), to manage stable chronic disease patients, treat minor illnesses and injuries, and provide basic preventive services. These PCTs would make primary care more accessible, more convenient, and more affordable to Americans, wherever they live.

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Jan 9 2014
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Human Capital News Roundup: Demand for minority physicians, ADHD treatment, anxiety and strokes, and more

Around the country, print, broadcast, and online media outlets are covering the groundbreaking work of Robert Wood Johnson Foundation (RWJF) leaders, scholars, fellows, alumni, and grantees. Some recent examples:

Newly insured patients need time to adjust to not using emergency care as a primary medical service, Sara Rosenbaum, JD, recipient of an RWJF Investigator Award in Health Policy Research, told the New York Times. A study co-authored by Amy Finkelstein, PhD, MPhil, also a recipient of an RWJF Investigator Award, found that newly insured Medicaid recipients in Oregon went to the emergency room (ER) more often than people without insurance. The finding raises doubts about whether expanded insurance coverage will help control ER costs, at least in the short term. This story was also covered by NPR, NBC News, and CBS News.

Doctors who are Black, Hispanic, and Asian provide the most care to minority patients, and demand for their services may increase as the Affordable Care Act provides health insurance coverage to those who are currently without it, Bloomberg News reports. The story is based on a study co-authored by Steffie Woolhandler, MD, MPH, an RWJF Health Policy Fellows alumna. It was also covered by WBUR in Boston and The Charlotte Post.

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Dec 12 2013
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Human Capital News Roundup: TV coverage of terrorism, alcohol laws, electronic health records, and more.

Around the country, print, broadcast, and online media outlets are covering the groundbreaking work of Robert Wood Johnson Foundation (RWJF) leaders, scholars, fellows, alumni, and grantees. Some recent examples:

MedPage Today reports that Medicare could save up to $560 million per year if the program reimbursed ambulances for transporting patients to places other than hospital emergency departments. Roughly 35 percent of Medicare patients taken to a hospital could be treated at other places, according to an analysis by Gregg Margolis, PhD, director of health care systems and health policy at the U.S. Department of Health and Human Services. Margolis is an alumnus of the RWJF Health Policy Fellows program.

Six or more daily hours of exposure to media coverage of the Boston Marathon bombings in the week following the tragedy was linked to more acute stress than having been at, or near, the marathon, reports KMBZ, an ABC affiliate in Boston. “We were very surprised at the degree to which repeated media exposure was so strongly associated with acute stress symptoms,” said E. Alison Holman, PhD, FNP, the study’s lead author and an RWJF Nurse Faculty Scholar. The study was also covered in Medical Xpress.

The herpes virus that produces cold sores has been linked to cognitive impairment throughout life, BioScience Tech reports. A study led by RWJF Health & Society Scholars alumna Allison Aiello, PhD, MS, documents that the virus’ effects on children ages 12 to 16 include lower reading and spatial reasoning test scores. The study is also covered in Medical Xpress.

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Oct 31 2013
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Human Capital News Roundup: The cost of disposable diapers, toxins in fish, fast food calories, and more.

Around the country, print, broadcast, and online media outlets are covering the groundbreaking work of Robert Wood Johnson Foundation (RWJF) leaders, scholars, fellows, alumni, and grantees. Some recent examples:

WNYC in New York City broadcast an interview with RWJF Community Health Leader Joanne Goldblum about families reusing disposable diapers due to economic hardship. Goldblum, who is founder and executive director of the National Diaper Bank Network, conducted a study that shows how the practice leads to a range of problems for families living in poverty.

When it comes to digital health and new ways to deliver care, the focus should be on the consumer and improving outcomes, not on the technology, according to experts at a recent Connected Health Symposium in Boston, Massachusetts. Mobile Health News reports that Propeller Health (formerly Asthmapolis) CEO David Van Sickle, PhD, MA, an RWJF Health & Society Scholars alumnus, pressed for greater emphasis on outcomes.  Read more about Van Sickle’s work here and here.

An American Thoracic Society panel of experts, including RWJF Interdisciplinary Nursing Quality Research Initiative (INQRI) grantee Richard Mularski, MD, is calling for better care for those who suffer severe shortness of breath due to advanced lung and heart disease. The Annals of the American Thoracic Society reports that the panel recommends patients and providers develop individualized actions plans to keep episodes from becoming emergencies, Medical Xpress reports.

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Sep 13 2013
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An Opportunity for Collaboration

Richard Rieselbach, MD, is an alumnus of the Robert Wood Johnson Foundation Health Policy Fellows program and a professor emeritus and health policy consultant for the University of Wisconsin Medical Foundation.

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In the last decade, the nation’s community health centers (CHCs) have doubled their capacity. They now provide care for more than 22 million underserved children and adults in every state. But they’re going to need to do it again. By 2019, some 40 million patients will be in need of care.

The United States does not have enough primary care providers to serve these new patients, and our public investment in health professions education—graduate medical education (GME)—is failing to produce the pipeline we need. Medical students are choosing specialties over primary care at an alarming rate, and a policy vacuum keeps the GME program from being held accountable.

An initiative was launched in 2011 that I think holds great promise: the Teaching Health Center Graduate Medical Education initiative. This five-year, $230 million program was funded by the Affordable Care Act and created to increase the number of primary care graduates trained in community settings.

My colleagues and I have proposed a modified and expanded version of this initiative, called “CHAMP” Teaching Health Centers (CHAMP THCs). Our teaching model would pair CHCs with academic medical centers to develop a THC track that would encourage students to graduate in primary care and practice in urban and rural underserved areas.

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