Leveraging a funding collaborative to develop more PhD prepared nurse scientists and leaders.

BACKGROUND: Over its almost 50 year history, The Robert Wood Johnson Foundation (RWJF) has provided about $500M to nursing initiatives focused on education, practice, policy and leadership development. While RWJF was most often the sole funder of many of these initiatives, it has also joined with others to create a larger and more sustained impact on particularly challenging nursing, health, and health care issues. PURPOSE: The purpose of this article was to describe the challenges and opportunities of a unique funding collaborative developed to engage new partners, increase the visibility of doctoral nursing education and increase funding of the RWJF Future of Nursing Scholars program to develop more PhD prepared nurses and nurse faculty. METHODS: Interviews were conducted with several members of the FNS Funders Collaborative as well as the scholars they supported. The perspectives of three funders, a regional philanthropy (IBC Foundation) and two health systems (Cedars Sinai and Sharp HealthCare) are presented here. Together they supported 13 nurses to complete their PhD through the RWJF Future of Nursing Scholars program. FINDINGS: RWJF contributed $20 M and 13 other funders contributed an additional $3Mto the initiative. The additional funds supported 42 nurses to earn their PhD degree through the program. Six of the 13 funders are health systems, four are regional or health related philanthropies, and others include United Health Care, Johnson & Johnson, and the Care Institute. DISCUSSION: There were many lessons learned for RWJF and the other funders. Given the size of RWJF, some other philanthropies were concerned about how contributions would be represented, others wanted their funding to go directly to care improvement. Some health systems were not prepared for their nurses to decrease work time while pursuing further education. The nurse faculty and nurse PhD shortages have persisted now for over a decade. Although FNS made a significant contribution by developing over 200 new nurse PhDs (faculty and leaders), more funding collaborations that engage new and different partners must be developed so that nursing education does not have to focus on the same problems in the next decade.

Systems Addressing Frail Elder Care: Description of a Successful Model.

OBJECTIVE: The aim of this article is to describe the Systems Addressing Frail Elder (SAFE) Care model, features of the interprofessional team and reengineered workflow, and details of the intervention. BACKGROUND: Older inpatients are vulnerable to adverse events related to frailty. SAFE Care, an interprofessional team-based program, was developed and evaluated in a cluster randomized controlled trial (C-RCT). Results found reduced length of stay and complications. The purpose of this article is to support and encourage the replication of this innovation or to help facilitate implementation of a similar process of organizational change. METHODS: This was a review of model features and intervention data abstracted from electronic health records. RESULTS: Salient features of team composition, training, and workflow are presented. The C-RCT intention-to-treat sample included 792 patients, of whom 307 received the SAFE Care huddle intervention. The most frequent problem was mobility (85.7%), and most frequent recommendation was fall precautions protocol (83.1%). CONCLUSIONS: The SAFE Care model may provide a standardized framework to approach, assess, and address the risks of hospitalized older adults.

Improving the culture of patient safety through the Magnet® journey.

This article outlines how one academic medical center's nursing service has developed programs to improve patient safety and quality outcomes through the use of the Magnet Re-Designation Accreditation Process(R) and a shared governance model. Successful programs have been implemented across the continuum of care. These programs include educational initiatives that increased both the number of nurses with BSN degrees and specialty certifications and also the number of patient-focused initiatives, such as a reduction in central line infection rates, an increase in hand-washing compliance, and a decrease in fall rates. In this article we will describe how our Magnet Re-Designation Accreditation Process(R) and shared governance model have contributed to strengthening our culture of patient safety. The manner in which the Magnet components of transformational leadership; structural empowerment; exemplary professional practice; new knowledge, innovation and improvement; and empirical quality results have all contributed to improved patient safety are discussed.

Diversity: creating an environment of inclusiveness.

Diversity is a concept that most organizations espouse but find challenging to put into practice. It is especially critical for healthcare organizations to be responsive in addressing issues of diversity related to not only employees but also clients. This article identifies the following 3 areas that must be addressed if an organization is to succeed in creating an environment where diversity and inclusiveness are honored: (1) organizations and their leaders need to be aware of their reactions "those who are different" in their organization. This awareness is critical in identifying the underlying obstacles that prevent a truly inclusive workplace; (2) organizations and their leaders need to be able to expand their perspectives allowing them to not only understand but appreciate others. These expanded perspectives can provide a potentially powerful tool for both problem solving and conflict resolution; (3) if organizations and their leaders are actively engaged in exploring options and are open to alternatives, they will find that they not only succeed in creating an environment of inclusiveness but also are in a better position to meet the needs of employees, patients, and a multicultural society.

Eliminating health disparities among minority women: a report on conference workshop process and outcomes.

A national conference convened in May 2001 explored health disparities among minority women. It included 5 one-hour workshops that randomly assigned each participant to 1 of 4 groups. Groups generated recommendations on conference topics and from these identified priority recommendations. Trained facilitators guided groups through brainstorming and weighted voting processes; individual recommendations were submitted in writing. Participants generated 598 recommendations, 71 of them voted as priorities; these were analyzed to capture participants' "messages." Central themes focused on access issues and cultural incompetence as deterrents to the elimination of health disparities and on education, funding, and community-based, community-driven research as mechanisms for change. Strategies for change included reinventing or expanding the role of minority communities and changing health care itself and "how" it does its work. The essential element in all recommendations was community leadership and control.