Welcome
to the Center for Health Outcomes and Policy Research

The first step in using research to influence policy is to select a research question with policy relevance. That is a major criterion guiding what the Center for Health Outcomes and Policy Research (CHOPR) investigators study and how we frame our grant proposals. Second, we make use of targets of opportunity and natural experiments to pursue our basic scientific interests in how the organizational context of nursing practice infuences patient outcomes. Third, we design our studies to withstand critical examination that often accompanies policy debate over contentious issues. Fourth, we use policy examples to illustrate our research findings. Fifth, CHOPR investigators spend considerable time responding to press inquiries and speaking at stakeholder meetings to explain the application of our findings to current challenges in healthcare.

An illustration of the use of all of these strategies was our National Institute of Nursing Research study of the impact of staffing and nurses’ education on patient outcomes. We have been committed to extending the science about nurses’ work environments from their effects on nurses and nurse retention to their impact on patient outcomes and care safety. Anticipating that our work might be considered controversial because we were studying the impact of nursing on preventable mortality, we created an interdisciplinary research team that brought to the design of the study state of the science research methods that could withstand scrutiny and critique from stakeholders who might not like the study’s findings. We published our findings in highly respectable scientific journals, including the Journal of the American Medical Association (JAMA). We framed our major paper about the outcomes of nurse staffing on patient mortality in terms of the specific patient to nurse staffing ratios being publicly debated in California even though our data were from Pennsylvania. This gave the press an interesting contemporary story and resulted in substantial media coverage that also brought our findings to the attention of policymakers.

Ultimately, our study provided scientific evidence that was used in deliberations by the California Supreme Court that upheld the California nurse staffing legislation. Similarly, our findings that hospitals with better educated nurses achieve more favorable patient outcomes, also published in JAMA, has been extensively cited in federal and state legislation upholding and/or in promoting the BSN as the requirement for registered nurses, and contributed to the decision by the American Organization of Nurse Executives to adopt a position statement in support of the BSN as the desired credential of hospital staff nurses. Our research on the value of BSN education has advanced progress toward improved educational standards for nurses more than any other factor since the American Nurses Association called for setting the BSN as the entry into professional practice more than 40 years ago.

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