Introducing Lori Melichar and her INQRI Panel...

At our upcoming meeting, Lori Melichar, senior program officer at the Robert Wood Johnson Foundation will lead a panel of three INQRI grantees: Linda Costa, Jill Marsteller and Linda Flynn.


Lori is a labor economist and senior program officer in the department of research and evaluation at the Robert Wood Johnson Foundation. During the past four years, she has coordinated the research, evaluation and performance measurement efforts of the Foundation portfolios working to improve the quality of care provided by physicians, nurses and and other health care professionals. Lori is leading the Foundation’s efforts to advance the science of Quality Improvement Research and Evaluation. In addition to serving on the leadership team of the INQRI program, she manages two other programs in the Human Capital Portfolio: Investigators in Health Policy and Health Policy Scholars. She is managing the evaluation of the New Jersey Nursing Initiative, the Foundation’s efforts to transform nursing education in New Jersey and a set of evaluations of quality improvement training programs across the country. Lori is currently serving as the director for research of the RWJF Initiative on the Future of Nursing, at the IOM.

The Panelists:

Linda Costa
Johns Hopkins Hospital
"Nursing-Pharmacy Collaboration on Medication Reconciliation: A Novel Approach to Information Management"

Deficits in communication across the continuum of care in regards to medication use can place patients at serious risk for harm. This interdisciplinary team is examining how to economically support direct care providers in medication reconciliation in order to facilitate safe transition to and from hospital and community. The team is evaluating the effectiveness of a nurse-pharmacist clinical information coordination team in improving drug information management on admission and discharge, quantify potential harm due to reconciliation failures, and determine cost-benefit related to averted harm.

Jill Marsteller
Johns Hopkins University
"Linking Blood Stream Infection Rates to Intensive Care"

The goal of this study was to implement a comprehensive safety program including an evidence based intervention to reduce central line-associated blood stream infections while examining the context of nursing care delivery on patient outcomes. This interdisciplinary research team used the expertise of nurses to develop and deliver a quality improvement initiative that reflects the positive clinical contributions of nurses in the critical care setting. This study should inform other nurse-led medical error reduction interventions, contribute to the quality improvement literature and to the science of rigorously evaluated evidence based interdisciplinary nursing practice.

Linda Flynn
University of Maryland
"Examining the Impact of Nursing Structures and Processes on Medication Errors"

The Institute of Medicine noted that a hospital patient on average is subject to at least one medication error per day, making medication errors the most common cause of preventable adverse events. This interdisciplinary study has been designed to disentangle the effects of nursing structures and care processes on non-intercepted medication errors in acute care hospitals. The economic impact of non-intercepted medication errors will be determined to explore the business case for evidence-based recommendations.

Meet the participants...

As we get closer to the event, we will be profiling the participating organizations. This week, we invite you to learn more about the Universal Health Care Foundation of Connecticut, the VA Center for Implementation Practice and Research Support and the W.K. Kellogg Foundation.

Mission: To serve as a catalyst that engages residents and communities in shaping a health system that provides universal access to quality health care and promotes health in Connecticut. We believe that health care is a fundamental right and that our work is part of a broader movement for social and economic justice.

Learn about SustiNet, a new Foundation proposal to control health care costs, save Connecticut’s families and businesses money, and make coverage available to everyone who needs it in the state.

The VA Center for Implementation Practice and Research Support (CIPRS) is a new QUERI resource center that aims to facilitate accelerated improvement in the quality and performance of the VA healthcare delivery system through enhanced VA implementation practice and research. CIPRS programs include education, technical assistance and consultation to VA implementation practitioners and researchers, and development of implementation theory and methods. CIPRS also facilitates better linkages and partnerships between VA implementation researchers and VA clinical practice and policy leaders. CIPRS collaborates with CIDER, HERC and VIReC in assessing and meeting the needs of the VA implementation community.

Mission: To support children, families, and communities as they strengthen and create conditions that propel vulnerable children to achieve success as individuals and as contributors to the larger community and society.

“We envision a nation that marshals its resources to assure that all children have an equitable and promising future – a nation in which all children thrive.”

An interesting read...

Innovation – The Case for Multi-Level Research

Authors: Brian Leavy and David Jacobson (1998/9).
Irish British and Administrative Research, Vol. 19/20 (1), 16-35.


One of our goals is to keep our meeting participants up to date on the literature in the field relating to translation and adoption. We will be posting articles and providing additional ones at our meeting. We would love to hear from you about articles you would like to see profiled. Email Heather Kelley with your ideas.

Meet the participants...

As we get closer to the event, we will be profiling the participating organizations. This week, we invite you to learn more about Grantmakers in Health, the Health Research Alliance and the John A. Hartford Foundation.

Mission: To foster communication and collaboration among grantmakers and others, and to help strengthen the grantmaking community's knowledge, skills, and effectiveness.

GIH is seeking session proposals for their 2010 Annual Meeting on Health Philanthropy Taking Risks at a Critical Time. The meeting will take place in Orlando, FL on March 10-12 and will explore how grantmakers can sustain their roles as change agents while rethinking strategies, and how grantmakers can be bold, creative, and take risks in how they approach their work and understand their missions. Proposals must be received by 5:00 p.m. EST, Wednesday, July 1, 2009. Click here for more information.

Mission: To foster collaboration among not-for-profit, non-governmental funders to support the continuum of health research and training from biomedical science to applications that advance health, by improving communication and collaboration:

• Internally, among member organizations, to share data and best practices, informed by current information on the landscape of the health research enterprise; and


• Externally, by encouraging communication and collaboration among grantmakers and the broader health research and policymaking communities.
  

Founded in 1929, the John A. Hartford Foundation is a committed champion of health care training, research and service system innovations that will ensure the well-being and vitality of older adults. Its overall goal is to increase the nation’s capacity to provide effective, affordable care to its rapidly increasing older population. Today, the Foundation is America’s leading philanthropy with a sustained interest in aging and health.

Through its grantmaking, the John A. Hartford Foundation seeks specifically to:

• Enhance and expand the training of doctors, nurses, social workers and other health professionals who care for elders, and
• Promote innovations in the integration and delivery of services for all older people.

An interesting read...

Evidence-Based Decision Making: When Should We Wait for More Information?

Authors: Kalipso Chalkldou, Joanne Lord, Alastair Fisher, Peter Littlejohns
Health Affairs, 27(6), 1642-1653.


One of our goals is to keep our meeting participants up to date on the literature in the field relating to translation and adoption. We will be posting articles and providing additional ones at our meeting. We would love to hear from you about articles you would like to see profiled. Email Heather Kelley with your ideas.

Meet the participants...

As we get closer to the event, we will be profiling the participating organizations. This week, we invite you to learn more about the Commonwealth Fund, the Fannie E. Rippel Foundation and the Gordon and Betty Moore Foundation.

Mission: To promote a high performing health care system that achieves better access, improved quality, and greater efficiency, particularly for society's most vulnerable, including low-income people, the uninsured, minority Americans, young children, and elderly adults.

The Commonwealth Fund carries out this mandate by supporting independent research on health care issues and making grants to improve health care practice and policy. An international program in health policy is designed to stimulate innovative policies and practices in the United States and other industrialized countries.

Mission: To strategically invest our limited resources to seed innovation, catalyze change, and create model processes that will lead to improvements in health.

The Rippel Foundation seeks to have a direct impact on the incidence and treatment of heart disease and cancer, the quality of health and life for women and the elderly, and the viability of our nation’s hospitals and healthcare delivery system.

Mission: As responsible stewards of the resources entrusted to us, the Foundation forms and invests in partnerships to achieve significant, lasting and measurable results in environmental conservation, science and the San Francisco Bay Area.

The Foundation’s science-based, results-driven orientation stems from the principles and interests of Gordon and Betty Moore. The Foundation operates proactively in the three specific areas of focus named in their mission statement—environmental conservation, science, and the San Francisco Bay Area—where a significant and measurable impact can be achieved. Distinct Initiatives have been created within these three Program areas. Each Initiative employs a portfolio of grants that are expected to help achieve targeted, large-scale outcomes in a specific time frame.

Introducing Charles Cutler... one of our keynote speakers

Dr. Charles Cutler was most recently the chief medical director for National Accounts for Aetna where he was responsible for the clinical strategy and clinical sales team that serves Aetna's largest customers. Prior to assuming this role, Dr. Cutler was the national medical director for Quality and Clinical Integration at Aetna, responsible for national quality strategy. He also provides clinical leadership for quality-related programs, such as pay-for-performance and selective provider networks. He serves on Aetna’s Racial and Ethnic Disparities Task Force, the NCQA Standards Committee, and the Ambulatory Quality Alliance.

Dr. Cutler was previously the chief medical officer at the American Association of Health Plans (now known as America's Health Insurance Plans, or AHIP) in Washington, DC, where he led national initiatives to improve chronic disease care including partnerships with professional organizations and the development of local partnerships with health plans, medical societies, and public health organizations. He provided clinical and health plan operations guidance to staff responding to and drafting health care legislation on the Federal and State level. At AHIP, he served on Aetna’s external advisory committee on race and ethnic disparities.

Meet the Participants...

As we get closer to the event, we will be profiling the participating organizations. This week, we invite you to learn more about the Agency for Healthcare Research and Quality, the Avon Foundation and the California HealthCare Foundation.

Mission: To improve the quality, safety, efficiency, and effectiveness of health care for all Americans.

Information from AHRQ's research helps people make more informed decisions and improve the quality of health care services. AHRQ's 2009 National Meeting will be held September 13-16, 2009 in Bethesda, MD. For more information on the meeting, click here.

Mission: To improve the lives of women, globally.

The Avon Foundation provides grants to organizations and institutions, predominantly 501(c)(3) or equivalent, in the following areas: breast cancer, domestic violence and emergency disaster relief. In 2005, the Avon Foundation celebrated 50 years of improving the lives of women and families.

Mission: To expand access to affordable, quality healthcare for underserved individuals and communities and to promote fundamental improvements in the health status of the people of California. The California HealthCare Foundation is an independent philanthropy committed to improving the way health care is delivered and financed in California. By promoting innovations in care and broader access to information, their goal is to ensure that all Californians can get the care they need, when they need it, at a price they can afford.

An interesting read...

One of our goals is to keep our meeting participants up to date on the literature in the field relating to translation and adoption. We will be posting articles and providing additional ones at our meeting. We would love to hear from you about articles you would like to see profiled. Email Heather Kelley with your ideas.

In the meantime, take a look at this week's selection:
Health Research Funding Agencies’ Support and Promotion of Knowledge Translation: An International Study

Authors:
JACQUELINE M. TETROE, IAN D. GRAHAM, ROBBIE FOY, NICOLE ROBINSON, MARTIN P. ECCLES, MICHEL WENSING, PIERRE DURIEUX, FRANCE LEGARE, CAMILLA PALMHØJ NIELSON, ARMITA ADILY, JEANETTE E. WARD, CASSANDRA PORTER, BEVERLEY SHEA, and JEREMY M. GRIMSHAW

The Milbank Quarterly, Vol. 86, No. 1, 2008 (pp. 125–155)
(c) 2008 Milbank Memorial Fund. Published by Blackwell Publishing.

Introducing Lucas Held... one of our keynote speakers

Lucas Bernays Held has been Director of Communications for The Wallace Foundation since 2002. He leads a team responsible for developing integrated communication strategies, including media outreach, conferences, websites, and partnerships, that help advance the Foundation’s effort to expand learning and enrichment opportunities by supporting and sharing effective ideas and practices.

Previously, he was Vice President for Public Affairs at Barnard College, Columbia University, from 1998-2002, where he helped raise the college’s profile and led the crafting of the college’s first strategic plan. He was Director of College Relations at Connecticut College, and an editor at The Middletown Press of Connecticut.

He presents regularly on strategic communications, has published articles on strategic communications, music and art criticism, and contributed the lead essay in the international exhibition catalogue for In a Field of Poppies by artist Richard Harden. He is the recipient of awards from the Council for the Advancement and Support of Education, the University and College Designers Association, and Admissions Marketing Report. He earned a certificate in marketing management from Columbia University Graduate School of Business, a B.A. in English from Haverford College. He is a graduate of The Commonwealth School.

Introducing Dr. Elizabeth Bradley... one of our keynote speakers

Dr. Bradley is a Professor of Public Health and Chair of the Global Health Concentration at the Yale School of Public Health. She also is the Director of the Health Management Program at Yale School of Public Health and Co-Director of the Robert Wood Johnson Clinical Scholars Program at the Yale School of Medicine. Dr. Bradley is a recognized expert in health services research with emphasis in management and implementation research, quality improvement, and health policy. She is currently conducting research in the U.S. on best practices for reduce door-to-balloon time for patients with heart attacks and diffusing new models of heart attack care to more than 1,000 hospitals throughout the U.S. In this work, she has pioneered a new approach to applying mixed methods to first characterize and then test statistically key distinguishing features of higher and lower performing hospitals in cardiovascular care. Dr. Bradley is working extensively in international settings on health system strengthening projects including improving hand hygiene and infection control policies in China with the World Health Organization, management training and evaluation for the National Health Service in the U.K. and for the Foundation for Professional Development in South Africa, enhancing hospital and county health team management functions in Liberia, and building hospital management capacity through quality improvement efforts in Ethiopia. The latter two projects are carried out in close collaboration with the Clinton HIV/AIDS Initiative and are initiatives in which strong government relations have been fostered and sustained. Dr. Bradley was previously a hospital administrator at Massachusetts General Hospital for several years, where she participated in the National Demonstration for Quality Improvement in Health Care. In her capacity as Principal Investigator, Dr. Bradley will oversee all aspects of the proposed project including direct supervision of the Yale Global Health Fellows and researchers and regular communication with CHAI, CIFF, and governmental officials as needed to ensure effective partnerships with all parties.

Dr. Bradley co-authored an issue brief for The Commonwealth Fund relating to the adoption of findings: Translating Research into Practice: Speeding the Adoption of Innovative Health Care Programs. Forum participants will find it interesting reading in advance of Dr. Bradley's talk in July.

About Your Hosts

The upcoming Funders Forum will be hosted by the Robert Wood Johnson Foundation's Interdisciplinary Nursing Quality Research Initiative (INQRI) and the Donaghue Foundation. Future blog entries will profile the other organizations who will participate with us on July 8-9 in Princeton. In the meantime, however, please take this opportunity to learn more about the hosts:

The Robert Wood Johnson Foundation

Mission: To improve the health and health care of all Americans.

Goal: To help Americans lead healthier lives and get the care they need.

• More on RWJF's Mission and History
• RWJF's Program Areas

The Donaghue Foundation

Vision Statement: We envision constant improvement both in people’s health and in the way research is converted into practical benefit.

Mission Statement: We will give the vision of Ethel Donaghue its best expression and thereby honor her and her family as an engaged, imaginative and collaborative participant in the process that begins with rigorous health research and ends in realized health benefits.

• More on the Donaghue Foundation's Mission, Vision, Goals and Values
• Grant Programs
  

The Interdisciplinary Nursing Quality Research Initiative (INQRI)

Primary Goal: To generate, disseminate and translate research to understand how nurses contribute to and can improve the quality of patient care.

• Cohort 1 Grants
• Cohort 2 Grants
• Cohort 3 Grants

Health Funders Forum: Creating Opportunities and Breaking Down Barriers to Adoption

Background

Private foundations that support health related projects have a wide range of missions and resources. Increasingly, these foundations seek to ensure that their initiatives are grounded in rigorous evidence. The bulk of their investments have supported the development and testing of new and innovative health services, public health practices and clinical interventions. Few invest in initiatives designed to foster translation, integration and dissemination of proven models. Those that do, often find that these efforts require much more time and resources than anticipated.

As a result, even the most effective and promising discoveries fail to reach widespread adoption. Evidence-based “best practices” still take an average of 17 years to have an impact in the real world of health care delivery. To shorten the gap between the generation and adoption of proven interventions, several Foundations are turning their attention to gaining a better understanding of the forces that move new knowledge into action.

Although there is an increasing number of stakeholders addressing the adoption of drugs and medical devices, including academic technology transfer offices, pharma companies, venture investors and organizations such as Faster Cures, there is far less attention paid to the adoption of innovations focused on individual and system change. Even less is understood about the mechanisms to accelerate and ensure the uptake of research into the world of health practice, policy, and consumer behavior.

Purpose:

The purpose of this funders’ forum is to bring together a group of private health funders to:

• Gain and share information on established and emerging conceptual and theoretical models related to adoption (E.g. Roger’s innovation/diffusion theory, Implementation Science, the role of interactive media, etc.)
• Explore the definitions, perceived value and use of research “evidence” to inform funding decisions
• Review successful examples from realms of new knowledge adoption (e.g. agriculture/IT/education and discuss their applicability to health)
• Share individual foundation learnings, strategies and challenges in being effective in this area
• Identify attributes and examples of success in adoption in the health realm
• Identify opportunities for cross foundation collaboration to promote adoption of proven approaches to health care.

Outcomes:

• Identify major facilitators and barriers to research translation
• Understand how funders provide opportunities for and create barriers to adoption
• Identify the potential to collaborate with sister funders and other sectors to speed and leverage adoption
• Propose/recommend ways that funders can be more effective in advancing adoption of health innovations