Kathy Quirk

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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.

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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