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The Prescription for Health projects,
a research initiative funded by The Robert Wood
Johnson Foundation and the Agency for Healthcare
Research and Quality, aim to help family practices
work with patients to develop healthier lifestyles.
Many of the projects rely on nurses such
as Jean Bell-Calvin, MSN, APRN (left), director
of the Silver Spring Community Nursing Center
in Milwaukee, to get that job done.
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Jeanne Baumann is spending a lot of time on the road
these days tackling one of medicine’s greatest
challenges—how to motivate people to change bad
habits.
Acting as a nurse consultant, Baumann, MSN, RN, is
part of a research initiative that is test-driving ways
to help family practice clinics improve the health of
their clients.
Operating under the Great Lakes Research in Practice
Network in Lansing, Mich., the research is one of 17
Prescription for Health projects funded by The Robert
Wood Johnson Foundation and the Agency for Healthcare
Research and Quality. This five-year grant initiative
focuses on four risky behaviors: smoking, drinking,
poor diet and inadequate exercise. All of these behaviors
are recognized as significant factors in heart disease,
diabetes and other chronic conditions.
The grant competition was open to family practice-based
research networks and attracted 70 applicants. The proposed
research projects had to target at least two of the
risky behaviors and propose an innovative way to deal
with them. Each of the grantees received $125,000 to
fund 16-month projects. One of the criteria was to come
up with innovations that could easily translate to other
family practices.
The mission of all the projects is the same: to help
family practices work with patients to develop healthier
lifestyles. Several of the projects, like Baumann’s,
rely heavily on nurses to get that job done.
“Consulting for a medical practice is new to
me, and I think it’s relatively new to nursing,”
Baumann said. “Nursing has traditionally been
based in the hospital. More and more, it is outpatient-based
and more involved with disease management.”
Working in the rural upper Michigan peninsula, Baumann
sometimes must drive three hours to get to the outlying
clinics participating in the research. She observes
the type of screening and follow-up assessment the clinicians
are doing with patients and advises them on how to design
a plan that addresses the needs of its specific population.
Logical choice
The Michigan project is based on the idea that a nurse
consultant would be someone already employed by a hospital
health system in a quality assurance role and someone
familiar with family practices. Baumann is an educator
in the primary care residency program at Marquette General
Health System, and helps train some of the doctors she
encounters in the clinics.
Two nurses are testing the consultant model: Baumann,
who is working with primary care practices owned by
the health system, and Anita Arnold, RN, who works in
an urban area with a network of family practices affiliated
with the Genesys Health System. Each nurse is working
with 10 practices.
Baumann sees her role as a facilitator to help each
clinic identify places in its practice where healthy
lifestyle changes could be encouraged. She observes
a clinic’s procedures to determine if it has a
screening process that can identify at-risk patients.
Does it also identify the at-risk patient’s readiness
to change? How does it assist with the change and follow-up?
She also helps the practices determine who on staff
should be performing the assessments and follow-ups.
The project addresses all four of the risky behavior
areas.
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