Dr Ferren: Can you describe how your career journey contributed to who you are today as a professional, dean, nurse leader, researcher, and policy advocate?
Dr Newhouse: One simple principle has guided my entire career; all decisions must keep people with health needs at the center. As an associate degree registered nurse (RN), I had the technical knowledge and skills to serve my patients well. However, when a quality improvement project was needed to enhance patient care in the ambulatory setting, I returned to school. A baccalaureate degree prepared me to serve as a supervisor of ambulatory services, lead quality improvement projects, and learn how to improve processes, policies, and structures to improve patient care. As a perioperative supervisor, I became part of a team to plan and open a surgery center. I was faced with important questions about implementing evidence-based practices and the cost-effectiveness of care requiring an economic analysis. I quickly recognized that I needed to go back to school for a master's degree. Next, as a service line leader, I was challenged with questions that did not have answers in the published literature or organizational data, so I went back to school, this time for my PhD. I thought that every degree I earned was the last; however, education provided the skills and knowledge to make decisions to improve clinical and economic outcomes affecting patients and healthcare organizations. I needed both education and experience to influence outcomes. I have also been blessed to work with several nursing leaders along my career journey that saw something special in me, provided support/mentorship, and encouraged me to keep going and growing.
Dr Ferren: You have a long history of successful academic-practice partnerships. How do you leverage partnerships to advance nursing research?
Dr Newhouse: I focus on building relationships to increase capacity together. As a researcher, we keep asking questions to understand the root of the problem. Practice partners seek help with the research strategy and implementation but are not asking researchers to come into their clinical setting and do the work for them; we are part of the same team. We conducted several multisite health systems and workforce research studies to evaluate, implement, and test interventions to improve healthcare quality. Each partnership is a new opportunity to understand the clinical issues and together develop strategies to optimize the use of evidence-based practices. Using a scientific approach and understanding the organizational context is vital for successful implementation and sustainability. Strengthening relationships builds the research capacity to conduct high-quality research and advance nursing science. An appreciation of the value and expertise inherent to these partnerships fosters an environment of mutual respect and benefit.
Dr Ferren: What else can be done to strengthen nursing research capacity?
Dr Newhouse: In addition to strengthening relationships with academic practice partners, building relationship with patients is key. Engaging patients and other relevant stakeholders in every step of the way is crucial to addressing problems from the patient's perspective and in verifying if we are asking the right questions. My passion for research and engaging patients and stakeholders in research led me to serve on the Methodology Committee of the Patient-Centered Outcomes Research Institute (PCORI). PCORI funds comparative clinical effectiveness research. Nurse scientists such as Dr Susan Rawl, PhD, RN, FAAN, was funded by PCORI to compare 3 ways to increase colorectal cancer screening,1 finding that a tailored DVD/video plus patient navigation increased patient screening rates compared with a DVD alone or usual care.
The nursing education continuum, from the associate degree to doctoral programs, should support students' competencies in evidence-based decision making, measuring patient outcomes, and conducting quality improvement projects and research to answer clinical questions. An engaged clinical nurse can serve on research teams to interpret the clinical context, advise on tailoring the implementation, or navigate the organizational policies and processes. The nurses who know their context are best at generating relevant PICO questions.
Dr Ferren: What do you see as the most significant opportunities for the nursing profession?
Dr Newhouse: The most significant opportunity is to advance nursing practice to meet the health needs of the people or population we serve. Some of the most urgent health needs experienced are by people with complex illnesses and chronic conditions. New models of care must emerge and be tested. The science and practice of care coordination and transitions in care should continue to be central to nursing education and practice.2 With our focus on person-centeredness, nurses should embrace and expand the science of care coordination, concentrating on better, cost-effective care.
Another opportunity is to consider innovations in care delivery given workforce shortages, technology expansion, and healthcare needs in ambulatory and primary care settings. Nurses can use patient-centered outcomes research approaches to examine care delivery from the patient's perspective and develop solutions that keep the patient at the center of care redesign. For additional inspiration in redesigning care delivery, the American Academy of Nursing has an initiative that recognizes nurse-designed models of care and interventions that influence cost, improves healthcare quality, and increases consumer satisfaction.3
Finally, the Future of Nursing report provides a wealth of insight into opportunities for the nursing profession and for research.4 This report creates a shared agenda to focus efforts and move us forward. Ideas for developing more research studies to advance nursing science to address health equity, disaster preparedness, paying for healthcare, the nursing workforce, and nurse well-being are included. Nurses should build knowledge and expertise in population health, social determinants of health, and health equity. As nurses, we have the opportunity to release our untapped potential. Recognize that you as a nurse have the power and the agency to change lives through your practice and collectively as the nursing profession.
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