Tag: Robert Wood Johnson Foundation

Patient engagement: A discussion with Susan Mende of the Robert Wood Johnson Foundation

May 27th, 2014 by
Susan Mende, Sr. Program Officer
Susan Mende, Sr. Program Officer

The Robert Wood Johnson Foundation (RWJF) is investing in understanding and improving patient engagement. In this podcast interview, Senior Program Officer Susan Mende shares some of the lessons RWJF has learned and points listeners to a variety of resources that the Foundation is making available.

We discuss the three components of patient engagement, the role of families, the correlation between higher levels of engagement and patient outcomes, and how Aligning Forces for Quality (AF4Q) communities are pioneering patient engagement approaches.

RWJF has also published an issue brief on the topic.

By healthcare business consultant David E. Williams of the Health Business Group


Physician ratings edge closer to the mainstream

April 18th, 2014 by

Doctor ratings and reviews have gotten a bad name, especially from doctors. There are concerns about their validity and usefulness. And while I share these worries I also believe ratings and reviews are important and have the potential to become much more prominent and useful over time.

I’m encouraged that some healthcare providers are reversing course and starting to publish ratings and reviews on their own websites. University of Utah is doing it, the Cleveland Clinic is considering following along, and others are also starting to think about it (Hospitals get into doc rating business).

That’s a good sign that patient reviews are going mainstream. We’ll be even better informed once the sites include other information that’s becoming available, such as the recently released Medicare claims data and complementary data on quality and cost from the private market, such as information that will be provided by the Robert Wood Johnson foundation-sponsored DOCTOR Project.

By healthcare consultant David E. Williams of the Health Business Group

More nursing shortage myth building

February 4th, 2014 by

My piece on the nursing shortage myth received more than 100 comments when it was reposted on the Health Care Blog a year ago. My basic theme was as follows:

  • There’s a well-established narrative that there is a large and growing shortage of nurses
  • Evidence to the contrary –such as difficulty of new nursing graduates finding jobs– is dismissed by nursing shortage cheerleaders with two arguments: 1) experienced nurses come back into the workforce when there’s a recession, and 2) demand will explode over time as older nurses retire and baby boomers age
  • These arguments don’t hold much water and I am not particularly worried that the country will run short of nurses
  • Many of those predicting a looming nursing shortage have a vested interest in doing so because they are involved in the business of running nursing schools

It seems like I could re-write that blog post every year or so, because there always seems to be a new story acknowledging the current surplus of nurses but predicting a giant shortage in the future. I wrote a similar post a year earlier, for example.

Today I read another story about the so-called nursing shortage in HealthLeaders (New Nurses Report Tougher Job Market):

“The economic recession may be to blame for a downturn in demand for newly licensed registered nurses, suggests a survey from the Robert Wood Johnson Foundation. The lead author speculates, however, that demand will grow stronger as healthcare reform is implemented.”

The author –a professor of nursing– says the problem is the recession. Then she adds that older nurses are going to retire and the Affordable Care Act is going to boost opportunities. “The opportunities for nursing are going to be humongous,” she concludes.

As before, I have my doubts:

Workforce projections rarely take into account long-term technological change, but simply assume that nurses will be used as they are today. I’ve taken heat for writing that robots will replace a lot of nurse functions over time. People seem to be offended by that notion and have accused me of not having sufficient appreciation for the skills nurses bring.

So let me try a different tack. Think about some of the job categories where demand is being tempered by the availability of substitutes. Here are a few I have in mind that have similar levels of education to nurses:

  • Flight engineers. Remember when commercial jets, like the Boeing 727 used to fly with two pilots and a flight engineer? Those planes were replaced by 737s and 757s that use two member flight crews instead
  • Junior lawyers and paralegals. Legal discovery used to take up many billable hours for large cases. Now much of it is being automated
  • Actuaries. Insurance companies used to hire tons of them, but their work can be done much more efficiently with computers

I don’t hear visionary leaders of provider organizations banging the drum about a nursing shortage and clamoring for more grads. And if somehow I’m wrong and demand rises, the problem can be solved with a more welcoming immigration policy.

Like I wrote before, “If you want to be a nurse, go for it. But if you’re choosing nursing because you think it’s a path to guaranteed employment, think again.”


By David E. Williams of the Health Business Group

Avoidable emergency department visits: Lessons from the Robert Wood Johnson Foundation (podcast)

December 9th, 2013 by
Susan Mende, Sr. Program Officer
Susan Mende, Sr. Program Officer

Only about 30 percent of patients treated in hospital emergency departments need to be there. The other 70 percent might be better off in primary care, where care could be better coordinated and costs are about one-quarter, according to The Robert Wood Johnson Foundation (RWJF). In recognition of this issue, RWJF has been funding programs to tackle the problem of avoidable emergency department visits.

In this podcast interview, RWJF Senior Program Officer Susan Mende discusses the work of Aligning Force for Quality grantee communities in identifying the root cause of avoidable visits and developing interventions to help primary care practices achieve their missions. Resources are available for free on the RWJF website.

Susan is optimistic that there will be significant progress in addressing this issue over the next few years.


By David E. Williams of the Health Business Group.