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Dean Villarruel Co-Principal Investigator of American Academy of Nursing Study

The American Academy of Nursing (AAN), through a grant received from the Robert Wood Johnson Foundation (RWJF), partnered with the RAND Corporation to examine ways in which Edge Runner initiatives – nurse developed care models that demonstrate significant, sustained clinical and financial outcomes – could improve national health.

Edge Runner models foster a culture of health by addressing many key social determinants of health and by empowering and supporting people to lead healthier lives. The study finds cross-sector and community-based partnerships are key in building a culture of health. 

“Nurses have been leaders in building a culture of health since the time of Florence Nightingale. This report demonstrates and affirms nurses’ critical role in working with individuals, families, and communities in managing illness and promoting health,” said Penn Nursing Dean Antonia Villarruel, PhD, RN, FAAN, co-principal investigator of the study. There are five designated Edge Runners at Penn Nursing. The most at any School of Nursing nationwide. Including Villarruel, they are: Diane Spatz, PhD, RN-BC, FAAN, Professor; Terri Lipman, PhD, CRNP, FAAN, Professor; Mary Naylor, PhD, RN, FAAN, Professor; and Kathryn Bowles, PhD, RN, FAAN, FACMI, Professor. Penn Nursing was also responsible for the Edge Runner-designated program Living Independently for Elders (LIFE), originally submitted by former Penn Nursing Professor Eileen Sullivan-Marx, PhD, CRNP, FAAN, and then executed by Pamela Cacchione, PhD, CRNP, FAAN, Associate Professor.

AAN partnered with the RAND Corporation to collect and analyze data from the Edge Runners’ models of care to identify key learnings that can be used to help other providers advance their efforts to promote a culture of health in communities. The four Action Areas of the RWJF Culture of Health framework include: making health a shared value; fostering cross-section collaboration to improve well-being; creating healthier, more equitable communities; and strengthening integration of health services and systems.

The key findings include:

  • Nurse-designed models of care can inform our understanding of the health sector’s role in building a Culture of Health;
  • These models focus on all four Culture of Health Action Areas, but especially on “strengthening integration of health services and systems”;
  • Strong leadership and broad community support are key to the success of these models of care;
  • Identifying a sustainable funding mechanism for community-level programs that address a Culture of Health is a persistent challenge; 
  • Workforce development should emphasize interdisciplinary learning and collaboration; and
  • Nurses are well positioned to lead and should be included in Culture of Health-related initiatives whenever possible. 

To date, the AAN has publicly recognized 62 individual Edge Runners who have created 48 innovative care models that deliver evidence-based high quality health care at reduced cost.  Many of these models focus on fostering a culture of health through building multi-sector partnerships and promoting equitable access to high-quality services.

Click here to access the full report. Authors of the study, The Nurse-Designed Care Models and Culture of Health: Review of Three Case Studies, include: Penn Nursing alumnus Grant R. Martsolf, PhD, MPH, RN, Co-Principal Investigator and Policy Researcher, RAND Corporation; Diana Mason, PhD, RN, FAAN, Lead Principal Investigator and Senior Policy Service Professor, George Washington University School of Nursing; Jennifer Sloan, MPH, Policy Analyst, RAND Corporation; and Cheryl Sullivan, MSES, Project Director and CEO, American Academy of Nursing.