The Work of Robert Wood Johnson Foundation Committee Initiative

The Work of Robert Wood Johnson Foundation Committee Initiative

There is the need for health care system transformation to provide affordable, seamless and quality care that is; evidence based, patient-centered, accessible and leads to improved health outcomes. The nursing profession plays a vital role in this transformation as it is the largest health care workforce in the nation with more than 3 million members. A two-year initiative was launched in 2008 by The Robert Wood Johnson Foundation (RWJF) and the Institute of Medicine (IOM) to transform and assess the nursing profession (Cronenwett, 2007). The recommendation of the initiative included: ensuring the practice of nurses is to the full of their education and training; nursing education improvement; provision of opportunities to nurses for leadership positions; and improvement of data collection for employee policy making and planning.

Practice of Nurses to Their Full Extent of Training and Education

There is a great potential for nurses leading in innovative strategies for health care system improvement. However, according to Shalala, (2011), a variety of policies, regulatory, and historical barriers limits their ability to generate the widespread transformation. The particular problematic barriers are regulation barriers that occur due to a differential in licensing and practice rules among states. This affects the ability that a nurse has after graduation, not because of their training or education, but due to political differences. The reports give recommendations to a range of stakeholders in ensuring that nurses practice to the full extent of their training and education.

Improvement of Nursing Education

The second key message in this report is that nurses should aim at achieving higher educational and training levels by use of an improved education system which will encourage a continuous academic progression. Cronenwett, (2007) explain that the health care system and practice environment in the United States requires major changes that call for equal changes in nurses’ education both after and before licensing. Improving on nurses’ education will ensure that future and current nurses’ generations’ delivers quality and safe patient-centered care in all health settings. 

The third key message is making nurses full partners with physicians and other health personnel to redesign the US health care system. For this transformation to occur, it is critical to have strong leadership from nurses throughout the system. The leaders will be full partners with other health personnel and they thus require leadership competencies and skills applicable to the profession and collaboration. 

The last key message is that an effective employee’s policy making and, planning requires an improved information structure and better data collection. This means that there is a need for a balance of perspective and skills among nurses, physicians, and other healthy personnel. According to the mandate of 2010 Affordable Act, a  National  Health  Care  Workforce  Commission should be created that would estimate health care workers demand and  National  Center for Workforce Analysis in supporting employees’ data collection and analysis (Cronenwett, 2007). The collected data assists in the impact of innovations. 

The Importance of the IOM “Future of Nursing”

The IOM report assists in informing critical health issues to the future.  According to Finkelman and Kenner (2009), the IOM focuses on the fundamental interdependent goals triad to improve the healthcare system of the United States: cost, access, and quality of care. The IOM reports also contain important recommendations and data that assist in improving nationally the healthcare safety and quality. The reports assist in defining the role of leadership especially the government roles, nursing workplace analysis, exploration of critical issues related to diversity and public health, and priority specifications of quality improvements initiatives. 

The IOM report improves the current organizational, regulatory and business conditions not only to the nurses, but also to the insurance industry, professional associations, healthcare organizations, businesses, and government where they all play an important role. These recommendations are directed to payers; individual policy makers; local government leaders, state and national; and health care researchers together with groups like philanthropic organizations, educational institutions, and consumer advocacy organizations. Therefore, collaborative team works introduced by IOM assist in ensuring that the health care system provides accessible, quality seamless and affordable care thus improving health.

Role of State Based Coalition

There is a need for the state-based coalition, as lack of respect and poor communication between nurses and physicians can cause harmful outcomes to patients. Finkelman and Kenner (2009) explains that since the 1970s, there is emphasize of greater inter-professional collaboration. Studies have illustrated that there is a link between effective teams to better patient’s outcomes and more utilization of resources. The author cites that a good relationship between a nurse and physician improves nurses’ retention in health facilities. Throughout the health care system, it is crucial to provide a coalition between the health personnel due to the increased need of a coordinated care.

It is beneficial to have differing perspectives between health professionals. The report by Institute of Medicine (US), Committee on the Robert Wood Johnson Foundation Initiative on the Future of Nursing (2011) explains that nurses are trained to treat clients not only from the management standpoint but also from the community, family, spiritual, and psychosocial standpoint. Occupational and physical therapists are trained in maintaining a patient’s functional capacity. On the other hand, social workers receive training on family dynamics. Therefore every health professional has his or her specialty which will give rise to differing perspectives.

A state should look for a right balance of professional skills and expertise as it provides care in multiple settings. The coalitions are advantageous as it gives each member a chance to utilize their teammate’s skills, education and expertise. All health professionals are mandated to work fully to their education and licensing. Therefore, state-based collaboration is essential both to the patients’ welfare and to the teammates.

Oklahoma Action Campaign

My home state is Oklahoma, which has an action coalition that drives the transformation of health and health care by use of nursing. The action coalition is working together with other stakeholders in modeling and creating innovative solutions, and building healthier communities. The campaign which is led by The Future of Nursing Oklahoma Network works together with the Action Coalition in the implementation of recommendations of Advancing Health, The Future of Nursing: Leading Change and the landmark Institute of Medicine (IOM). The two initiatives that were spearheaded by Oklahoma State’s action coalition were the expertise of its members and their proven capacity. The coalition has decided to take its energy and ideas to maximize on nurses’ contributions in delivering care to the state. 

One of the barriers facing Oklahoma Campaign for Action is outdated legal hurdles. These hurdles according to Austin (2012), limit the potential of increasing the accessibility of patients to health care, as well as reduction of unnecessary health care cost. The barriers mostly affect residents of rural and urban underserved areas where there are few nurses and other health professional to attend to the patients. However, Oklahoma Campaign for Action can provide caregivers and the patients with access to high-quality, cost-effective and convenient care by reducing or eliminating the outdated legal hurdles.  


Austin, S. (2012). The Future of Nursing Oklahoma Network Named as Action Coalition to Help Future of Nursing: Campaign for Action Ensure High – quality, Patient – centered Health Care. Retrieved from

Cronenwett, L., Sherwood, G., Barnsteiner, J., Disch, J., Johnson, J., Mitchell, P., … & Warren, J. (2007). Quality and safety education for nurses. Nursing outlook, 55(3), 122-131.

Finkelman, A. W., & Kenner, C. (2009). Teaching IOM: Implications of the Institute of Medicine reports for nursing education. Nursesbooks. org.

Institute of Medicine (US). Committee on the Robert Wood Johnson Foundation Initiative on the Future of Nursing. (2011). The future of nursing: Leading change, advancing health. Washington, DC: National Academies Press.

Shalala, D., Bolton, L. B., Bleich, M. R., Brennan, T. A., Campbell, R. E., Devlin, L., … & Harris, C. (2011). The future of nursing: Leading change, advancing health.

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