For a little over a decade, the foundation’s Patient Care Program aimed to improve the experience and outcomes for patients. The conclusion of the program last year provided an opportunity to reflect on the experiences and outcomes of care the foundation strategically sought to improve throughout its history. Always with an emphasis on seeking important problems to address and creating enduring impact, the Patient Care Program focused on several key areas including quality, safety, education, and patient and family caregiver experience.
Nursing students at the Betty Irene Moore School of Nursing, UC Davis
Betty Irene Moore Nursing Initiative
Born out of our founder, Betty Irene Moore’s experience as a patient who suffered a medical error and as a family caregiver, Betty laid a vision for improving care through supporting efforts to improve safety and quality. Launching in 2012, the program built on the success of the Betty Irene Moore Nursing Initiative (2003-2015) which stressed three key elements: nursing leadership, improving the quality of patient care, and interdisciplinary, team-based professional learning and practice.
The program set out to address the challenges patients face in receiving safe and reliable care by creating improvements in hospital intensive care units due to the potential to advance safety and quality in one of the most complex and costly settings in health care. Through the Intensive Care Unit Redesign (ICU), the program funded efforts to improve care for patients in hospitals by eliminating preventable harms and increasing patient engagement. The cornerstone of the portfolio included a set of projects funded at four academic medical centers, the foundation’s support led to a reduction in clinical harms, a better understanding of best practices for patient and family engagement, and an increased awareness of the importance of dignity and respect in health care. At the same time the program was supporting efforts in the ICU, a strategy aimed at increasing patient and family engagement more broadly supported the development of a roadmap to help spur research and practice and provide a set of actions that could be taken to create meaningful partnerships between the health care system and patients and their families. Through a partnership with other foundations, engagement and transparency for patients was advanced through their ability to access their clinical visit notes.
Betty Irene Moore Speakers Series convening
With a growing number of Americans living with one or more chronic conditions and the growing burden on unpaid caregivers, the program next focused on improving the experience and outcomes for those experiencing serious illness and for high-needs patients and their caregivers. The program partnered with grantees to continue to improve public understanding of issues related to serious illness care. Through collaboration with key leaders and partners sought to improve the quality of serious illness programs while also helping to build effective quality measurement and accountability programs. Other strategies included strengthening the workforce supporting seriously ill patients including caregivers. Lastly, the program focused on providing support to develop systems and tools to train and support family caregivers. We also explored ways to improve safety in the community – a topic often overlooked – and through reducing safety issues caused by health information technology. This exploration included identifying ways to improve medication safety in community settings and ways to boost health information technology safety.
Diagnostic Excellence Initiative
Building on years of work in patient safety and quality, the Diagnostic Excellence Initiative launched in 2018 to improve diagnostic performance to reduce harm, improve health outcomes, and save lives while addressing the most common cause of medical errors reported by patients — diagnostic errors. The initiative supported the growth and capacity of the field by preparing leaders dedicated to the field of diagnostic excellence including five fellowship programs and promoting a better understanding of the different aspects of diagnostic excellence. Knowing the vital nature of measurement in informing quality care, the initiative funded the development of measure concepts to assess diagnosis.
Diagnostic Excellence Cohort
The last strategy supports the assessment of new technologies to improve diagnostic performance. The results of this work can be seen in part through our support of the Kaiser Permanente AIM-HI initiative, which includes a coordinating center that has been established to lead a research effort that evaluates the implementation of existing Artificial Intelligence/Machine Learning algorithms to enhance diagnostic decision-making. The final investment in the initiative was a national coordinating center to build the momentum created in the field.
Betty Irene Moore School of Nursing
Lastly, the foundation funded the establishment of the Betty Irene Moore Fellowship for Nurse Leaders and Innovators in 2019 to create the next generation of nurse leaders and further extend our co-founder’s legacy in improving care. The fellowship led by the Betty Irene Moore School of Nursing supports 65 nurse scientist leaders with the aim of advancing the profession of nursing while providing nurse leaders with the skills to pursue innovative research and advance solutions in health care.
Nurse Fellowship convening; guest lecture
With the many challenges faced by the health care system, the Patient Care Program explored meaningful strategies that have had an impact across the health care continuum. With the conclusion of this program, the foundation is grateful to all of the grantees, collaborators, advisors, and colleagues who contributed to its success since its inception. We expect to continue to see great strides in the improvement of experiences and outcomes for patients, families and communities across the field of health care.
Susan Song is a former program officer with the Patient Care Program at the Gordon and Betty Moore Foundation.