Using Evidence to Design Cancer Care Facilities.

The nuts and bolts of planning and designing cancer care facilities-the physical space, the social systems, the clinical and nonclinical workflows, and all of the patient-facing services-directly influence the quality of clinical care and the overall patient experience. Cancer facilities should be conceived and constructed on the basis of evidence-based design thinking and implementation, complemented by input from key stakeholders such as patients, families, and clinicians. Specifically, facilities should be designed to improve the patient experience, offer options for urgent care, maximize infection control, support and streamline the work of multidisciplinary teams, integrate research and teaching, incorporate palliative care, and look beyond mere diagnosis and treatment to patient wellness-all tailored to each cancer center's patient population and logistical and financial constraints. From conception to completion to iterative reevaluation, motivated institutions can learn to make their own facilities reflect the excellence in cancer care that they aim to deliver to patients.

The Robert Wood Johnson Nurse Faculty Scholars Diversity and Inclusion Research.

Purpose: The purpose of this research is to deepen the understanding of DEI training and show how scholars across the nation incorporated DEI leadership into academic roles. Faculty and administrators' experiential experience in diversity, equity, and inclusion (DEI) plays a role in the success or failure of DEI training. DEI training at institutes of higher learning should include metrics that examine our bias for invisible and overt support for DEI. Methods: Robert Wood Johnson Foundation Nurse Faculty Scholars (RWJFNFS) were surveyed by The Gauda Group at Grayling. Data were collected from a diverse group of scholars across the nation. An online survey followed by an in-depth phone interview was used to assess participants' roles as leaders in academic nursing, challenges faced by scholars in addressing DEI, and perceived values of undertaking DEI activities. Results: Major themes emerged from the findings. The themes included championing for DEI comes with a personal and professional risk. Greater success was noted when DEI was supported by leadership and included in institutional strategic planning. Conclusion: DEI is important and necessitates commitment from all levels of leadership, faculty, and strategic planning initiatives. DEI training fills an important role and subsidizes leadership effectiveness as it relates to DEI.

Does Having Been Mentored Affect Subsequent Mentoring?

BACKGROUND: How to be an effective mentor is typically not taught formally because good mentoring is thought to beget good mentoring, but there is little concrete data to support that connection. PURPOSE: Scholars in the Robert Wood Johnson Foundation's Nurse Faculty Scholars (NFS) program were surveyed to find out if the mentoring they received influenced their subsequent mentoring. METHOD: The qualities that form the Mentorship Effectiveness Scale were used to investigate if the experience changed scholars' views of mentoring; open-ended questions provided an opportunity for scholars to describe additional insights. RESULTS: Thirty-nine out of 93 scholars (42%) replied. Scholars were influenced by the mentoring they received: they were now more inclined to give guidance on professional issues, provide constructive critiques, suggest resources, acknowledge mentees' contributions, and challenge mentees to extend their abilities. Scholars' experiences made them more aware of the power of mentoring, provided them with insights into how they might do the same, convinced them that mentoring shouldn't be confined to one advisor, made them realize that one style of mentoring doesn't work for everyone, and improved their likelihood of using an individual development plan when they mentored. CONCLUSIONS: Effective mentoring does seem to beget effective mentoring because the interaction with mentors seems to leave a lasting impression and the perceived obligation to "pay it forward."

Is it time to reconsider the term "cancer survivor"?

PURPOSE: To improve understanding of how people diagnosed with cancer perceive the term "cancer survivor" and what influences those perceptions. DESIGN: Patients' reactions to the term were surveyed quantitatively and qualitatively. SAMPLE: Women who have primarily experienced breast cancer belonging to The Dr. Susan Love Research Foundation's Army of Women. METHODS: An online survey including fixed-alternative and open-ended questions. CONCLUSIONS: Using the blanket term "survivor" to label a diverse group is problematic; although the term offers a positive identity for some, others reject it or find it offensive, at least for patients like those represented in this study. If cancer patients are going to be labeled, they should choose the one that is most empowering and reflective of their experience. Implications for Psychosocial Providers: Language used in providing care or describing patients is controllable. If evidence exists that a particular term has the potential to inflict psychological harm, why use the term?

Improving Nonclinical and Clinical-Support Services: Lessons From Oncology.

Nonclinical and clinical-support personnel serve patients on the front lines of care. Their service interactions have a powerful influence on how patients perceive their entire care experience, including the all-important interactions with clinical staff. Ignoring this reality means squandering opportunities to start patients out on the right foot at each care visit. Medical practices can improve the overall care they provide by focusing on nonclinical and clinical-support services in 5 crucial ways: (1) creating strong first impressions at every care visit by prioritizing superb front-desk service; (2) thoroughly vetting prospective hires to ensure that their values and demeanor align with the organization's; (3) preparing hired staff to deliver excellent service with a commitment to ongoing training and education at all staff levels; (4) minimizing needless delays in service delivery that can overburden patients and their families in profound ways; and (5) prioritizing the services that patients consider to be most important. We show how cancer care illustrates these principles, which are relevant across medical contexts. Without nonclinical and clinical-support staff who set the right tone for care at every service touchpoint, even the best clinical services cannot be truly optimal.

Robert Wood Johnson Foundation Nurse Faculty Scholars program leadership training.

BACKGROUND: The Robert Wood Johnson Foundation Nurse Faculty Scholars program was created to address the nursing shortage via development of the next generation of national leaders in academic nursing. PURPOSE: The leadership training combined development at the scholar's home institution with in-person didactic and interactive sessions with notable leaders in nursing and other disciplines. METHODS: A curriculum matrix, organized by six domains, was evaluated quantitatively and qualitatively. DISCUSSION: What set this program apart is that it immersed junior faculty in concerted leadership development with regard to all aspects of the faculty role so that teaching interactively, making use of the latest in information technology, giving testimony before a policy-making group, participating in strategic planning, and figuring out how to reduce the budget without jeopardizing quality were all envisioned as part of the faculty role. CONCLUSION: The domains covered by this program could easily be used as the framework to plan other leadership-development programs for the next generation of academic leaders.

Diversity: A key aspect of 21st century faculty roles as implemented in the Robert Wood Johnson Foundation Nurse Faculty Scholars program.

BACKGROUND: Academic nursing faculty play a vital role in recruiting a diverse student body to increase the diversity of the profession and educate students to provide culturally sensitive care to expand equitable health care. PURPOSE: The purpose of the study is to present the Robert Wood Johnson Foundation Nurse Faculty Scholars program diversity initiatives and outcomes. METHODS: Data on the diversity of the 90 scholars and their diversity-related leadership positions were compiled. DISCUSSION: Although the program was designed with selection criteria to encourage racial/ethnic and gender diversity, it was not until a diversity strategic plan was designed and implemented that sufficient diversity in the applicant pool and consistent diversity among the scholars was achieved. The program also included highly evaluated leadership content in diversity and inclusion. CONCLUSIONS: Lessons learned from the program are important for the assurance of continued diversity among tenure-track nursing faculty, commitment to diversity in the nursing workforce among all faculty, and support in nursing education on providing culturally sensitive nursing care and nursing research that addresses health inequities.

Overview of the Robert Wood Johnson Foundation Nurse Faculty Scholars program.

BACKGROUND: The Robert Wood Johnson Foundation Nurse Faculty Scholars program was created to address the nursing faculty shortage and thereby decrease the nursing shortage. PURPOSE: The purpose of the study was to describe the program development, implementation, and ongoing outcome evaluation. METHODS: Data on scholarly productivity, impact of research, research funding, and leadership positions were compiled, including an h-index (impact of publications) comparison with a comparison group of other interdisciplinary faculty at the same institutions of the 90 current and alumni scholars. DISCUSSION: There is evidence of the achievements of the individual scholars; however, the effect of the synergy of the multiple components of the program is difficult to capture in traditional evaluation strategies. CONCLUSIONS: The sense of possibility and responsibility (to the profession, to improving the health of all Americans, and to one's school of nursing and university) was a significant outcome of the program. Lessons learned from the program are important for the leadership development and retention of nursing faculty.

Characteristics of hypotonia in children: a consensus opinion of pediatric occupational and physical therapists.

PURPOSE: The term hypotonia is often used to describe children with reduced muscle tone, yet it remains abstract and undefined. The purpose of this study was to identify characteristics of children with hypotonia to begin the process of developing an operational definition of hypotonia. METHODS: Three hundred physical and occupational therapists were systematically selected from the memberships of the Pediatric Section of the American Physical Therapy Association and the Developmental Delay Section of the American Occupational Therapy Association and asked to complete an open-ended survey exploring characteristics of strength, endurance, mobility, posture, and flexibility. RESULTS: The response rate was 26.6%. Forty-six physical therapists and 34 occupational therapists participated. The criterion for consensus about a characteristic was being mentioned by at least 25% of respondents from each discipline. The consensus was that children with hypotonia have decreased strength, decreased activity tolerance, delayed motor skills development, rounded shoulder posture, with leaning onto supports, hypermobile joints, increased flexibility, and poor attention and motivation. CONCLUSION: An objective tool for defining and quantifying hypotonia does not exist. A preliminary characterization of children with hypotonia was established, but further research is needed to achieve objectivity and clarity.