Improving End of Life Care – Ask the Nurses
Everyone wants a dignified death – yet few actually experience one. Despite preferring to remain at home, most older adults spend their final days in hospitals, where they often undergo medical care that neither improves survival, quality of life, nor satisfaction and is often incongruent with their wishes and goals. A new study in the Journal of the American Geriatrics Society describes these problems in end of life care in nearly 500 U.S.
Cost Impact of The Transitional Care Model for Hospitalized Cognitively Impaired Older Adults
Using advanced practice nurses to support high risk patients and their families to transition from hospital to home can reduce postacute care use and costs. A study comparing three evidence-based care management interventions for a population of hospitalized older adults with cognitive impairment found that the Transitional Care Model, which relies on advanced practice nurses to deliver services from hospital to home, was associated with lower postacute care costs when compared to two “hospital only” interventions.
Nurses' and Patients' Appraisals Show Patient Safety in Hospitals Remains a Concern
In the report To Err is Human (1999), the National Academy of Medicine called for national action to improve patient safety in hospitals. The report concluded that improving nurse work environments—assuring adequate nurse staffing and supporting nurses’ ability to care for patients—was critical to these efforts. Two decades later, have nurse work environments improved, and has that had a noticeable impact on patient safety? To find out, a research team led by LDI Senior Fellow Linda Aiken, PhD, RN surveyed more than 800,000 patients and 53,000 nurses in 535 hospitals in 2005, and again in 2016.
Reimagining Care to Support Families and Workers
At some point in our lives, each of us will need care, or be asked to provide or arrange care for a loved one. Historically, we have relied on unpaid or poorly paid labor, largely delivered by women and minorities, to fill these needs; however, current arrangements are neither fair nor feasible.
Meet The New LDI Senior Fellows: The 2018 Fall Kickoff
A Policy Analysis of Legally Required Supervision of Nurse Practitioners and Other Health Professionals
Ashley Z. Ritter, Kathryn H. Bowles, Ann L. O'Sullivan, ...
Abstract [from journal]
The use of legally required supervision occurs across health professionals who provide similar services. Legally required supervision has the potential to disrupt the production of high-quality, cost-efficient, accessible health services across disciplines.
This paper examines the effects of nurse practitioner collaborative practice agreements and similar
...Perceptions of Factors Associated With Inclusive Work and Learning Environments in Health Care Organizations: A Qualitative Narrative Analysis
Jaya Aysola, Frances K. Barg, Ana Bonilla Martinez, Matthew Kearney, ...
Abstract [from journal]
Importance: Diversifying the health care workforce remains a critical goal for health care organizations focused on reducing disparities in care. However, it remains unknown what factors create inclusive health system environments and help organizations retain a diverse workforce.
Objective: To understand from members of the health care workforce what factors contribute to inclusive work and learning environments and what can be done to improve inclusion within health care organizations.
...
Charles Bosk Wins Guggenheim Fellowship for a Book About Medical Errors
LDI's Presence at the 2018 AcademyHealth Annual Research Meeting
IRB Oversight of Patient-Centered Outcomes Research: A National Survey of IRB Chairpersons
Joel S. Weissman, Eric G. Campbell, I. Glenn Cohen, Holly Fernandez Lynch, Emily A. Largent, Avni Gupta,Ronen Rozenblum, ...
ABSTRACT [FROM JOURNAL]
Patient-centered outcomes research (PCOR) is becoming increasingly common. However, there is little evidence regarding what novel ethical challenges, if any, are posed by PCOR with relevance to institutional review board (IRB) oversight and human subjects protections. This article reports the results of a national survey of all IRB chairpersons from research-intensive institutions in the United States. Findings address the responsibilities of IRBs and the challenges associated with PCOR review and oversight. IRB chairpersons varied in their judgment of PCOR...
Modernizing Medicare Funding for Nurse Education
With policies rooted in the 1960s, it’s time to change how Medicare pays for nurse education. In a New England Journal of Medicine Perspective, LDI Senior Fellow Linda Aiken and colleagues present a compelling case for funding a new consortium model that trains nurse practitioners (NPs) in the community settings where they are a crucial source of primary care.
Chart of the Day: Nurse Practitioners in Primary Care
A new study in Health Affairs by Hilary Barnes, Matthew McHugh, and colleagues, demonstrates the increasingly important role nurse practitioners (NPs) have in primary care in the United States.
Photo Page: Penn Nursing's National 'Think Tank' on Vulnerable Elder Care
An Afternoon with Atul Gawande at Penn Medicine
Let’s Truly Engage Patients to Drive Health Care Innovation
Tradition can be a great thing, but we need to re-evaluate how the practices and lessons of the past apply to the present. That was one message stressed by Dr. Mark Smith as he delivered Penn LDI’s Charles C. Leighton, MD Memorial Lecture. Dr.