1. Grady, Patricia A. PhD, RN, FAAN


A look at what we have achieved-and how new approaches must continue to evolve.


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This is a time of incredible transformation in the health sciences and health care professions. As we move forward, the expertise, innovative thinking, and leadership skills of nurse scientists and clinicians will be increasingly called upon to guide and shape health care practices and policies. These practices and policies will in turn help us to create a healthier global community; ensure that our children and our children's children will live longer, healthier lives; and actualize a health care system that provides outcomes-based, person-centered, cost-effective services of the highest caliber.


This fall marks the 25th anniversary of the National Institute of Nursing Research (NINR). For the past quarter-century, the NINR has overseen the development and evaluation of a robust research portfolio. Indeed, NINR-supported researchers have addressed clinical and policy deficiencies across the health and health care spectrums, bringing person-centered, point-of-care, translational research to the forefront of biomedicine. They've investigated all dimensions of the health sciences, including quality-of-care and quality-of-life issues in settings as disparate as neonatal ICUs and nursing homes; preventive interventions and symptom management for patients in acute critical care and those living with chronic illnesses; and health promotion and risk reduction initiatives for individuals, families, and communities. Our scientists have also provided strong leadership in the health policy arena, working to ensure that public policies are aligned with both current scientific evidence and public health needs. "The National Institute of Nursing Research: 25 Years of Bringing Science to Life" in this issue offers a representative "snapshot" of their achievements.


But it's ongoing introspection-our analysis of lessons learned and how these might apply to future endeavors-that will direct the investigations of the next generation. Although our work has improved quality-of-life and health outcomes across all settings and has brought biobehavioral research to prominence among the health sciences, we know there's much more to accomplish. Current challenges include the need to accelerate the translation of research findings into evidence-based practice; to eliminate health care disparities; to create seamless, efficient means of patient care coordination and transition; and to better mitigate and manage multiple, chronic comorbidities. Even as we face these challenges, we can be certain that new ones will arise-challenges that will continue to require our ingenuity and steadfast determination to overcome them.

Figure. Patricia A. ... - Click to enlarge in new windowFigure. Patricia A. Grady.

This past year there has been revitalized discourse about the health of Americans and of the U.S. health care system, as well as a renewed commitment to "course correction" through public policy measures. As scientists and clinicians, we must proactively translate these measures into improvements in health and health care. To accomplish this, we must explore and embrace new paradigms and processes. Examples include "disruptive" innovations, which can markedly refine or simplify existing systems or technologies, yielding higher-quality, lower-cost products and services; rapid-learning health care systems, which function to capture and apply knowledge at every point of the health care continuum; and "extreme" interdisciplinary collaboration, which combines emerging social science findings in team research with leading-edge, collaborative technologies. New approaches must continue to evolve if we are to successfully meet new challenges.


As we've benefited from the sacrifices, seminal work, and vision of earlier generations, so will subsequent generations benefit from ours. The future of our world lies with our children; their health and well-being will be our legacy. As we move forward, let us keep in mind something then-presidential candidate Barack Obama said, shortly before winning the election: "Change will not come if we wait for some other person or if we wait for some other time. We are the ones we've been waiting for. We are the change that we seek."