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Nurse-Designed Care Models Could Be Key to a Culture of Health

Study Examines How Evidence-Based Edge Runner Initiatives Could Help Other Care Providers Improve National Health.

There is an increased realization that health is influenced by a number of social, cultural, and environmental factors. The national culture of health movement, initiated by the Robert Wood Johnson Foundation, strives to build a collaborative approach to transforming what it means to be a healthy nation. Among healthcare providers, nurses are especially well positioned as change leaders to a culture of health in their communities.

A study, “Innovative Nursing Care Models and Culture of Health: Early Evidence,” published by Nursing Outlook, examines the extent to which nurse-designed care models focus on the culture of health in order to better understand how nurses may function as exemplars for other providers.

“Nurse-designed models are consistent with the culture of health framework, making them a potentially useful context for examining how other providers might contribute to a culture of health,” says one of the study’s  investigators, Antonia M. Villarruel, PhD, RN, FAAN, Professor and the Margaret Bond Simon Dean of Nursing at the University of Pennsylvania School of Nursing (Penn Nursing).

The study focused on a qualitative content review of documents describing 39 care-models designed by nurses, who are designated as Edge Runners. Edge Runners are nurses identified by the American Academy of Nursing who have developed care models and other interventions that demonstrate significant, sustained clinical and financial outcomes.

Most of the nurse-designed care models focused on at least one of four culture of health action areas identified by the Robert Wood Johnson Foundation: strengthening integration of health services and systems; fostering cross-sector collaboration to improve well-being; creating healthier, more equitable communities; and making health a shared value.

“This analysis provides evidence of nursing’s ability and commitment to lead and contribute to efforts to build a culture of health” says Villarruel. “Findings also provide a springboard for nurse leaders hoping to develop or expand models of care by providing specific examples of activities associated with successful models.”

The study serves as a foundation for future qualitative investigations to understand barriers and facilitators to developing and implementing these nursing models. Factors for exploration might include healthcare payment structures, scope of practice policies and workforce training requirements.

“Additional research on these nurse innovators and their promotion of a culture of health will help us better understand the extent to which these models may function as exemplars for other healthcare providers,” says Villarruel.

In addition to Villarruel, co-authors of the study include: Grant R. Martsolf, PhD, MPH, RN, RAND Corporation; Tamika Gordon, MS, RAND Corporation and SUNY Binghamton, School of Engineering; Linnea Warren May, MPH, RAND Corporation; Diana Mason, PhD, RN, FAAN, Hunter College, Center for Health, Media & Policy and American Academy of Nursing; and Cheryl Sullivan, MSES, American Academy of Nursing.