To Improve Health and Health Care


Since 1972, the Robert Wood Johnson Foundation has been the nation's largest philanthropy devoted exclusively to health. To further its mission of improving the health and health care of all Americans, the Foundation strives to foster innovation, develop ideas, disseminate information, and enable committed people to devote their energies to improving the nation's well-being. As part of the Foundation's efforts to inform the public, the Robert Wood Johnson Foundation Anthology series, To Improve Health and Health ...

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Since 1972, the Robert Wood Johnson Foundation has been the nation's largest philanthropy devoted exclusively to health. To further its mission of improving the health and health care of all Americans, the Foundation strives to foster innovation, develop ideas, disseminate information, and enable committed people to devote their energies to improving the nation's well-being. As part of the Foundation's efforts to inform the public, the Robert Wood Johnson Foundation Anthology series, To Improve Health and Health Care, provides an in-depth look into the programs it funds.

This volume of the Anthology focuses on the Foundation's efforts to learn from programs that didn't work out as planned. The first four chapters examine the topic from different perspectives: drawing lessons from programs that did not meet expectations; redesigning programs while they are in progress; and a case study of a single program. These chapters are followed by a commentary on the role of failure in philanthropic learning. Written by the country's leading science and medical journalists, as well as experts from universities and the Robert Wood Johnson Foundation, Volume XIII includes chapters on

Learning from programs that didn't work out as planned

Communications at the Robert Wood Johnson Foundation

Combating drug addiction

The Reclaiming Futures program

The College Alcohol Study

Overcoming language barriers to care

MicheLee Puppets and the fight against childhood obesity

The book contains black-and-white illustrations.

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Editorial Reviews

Eugene C. Rich
This book provides a forum for experts familiar with various programs of the Robert Wood Johnson Foundation (RWJ) to discuss the background and outcomes of these programs. A series of 11 chapters provide information on RWJ initiatives ranging from the healthcare workforce, to access to care surveys, to the homeless families programs. The editors intend the articles in this book to provide an informed assessment of the RWJ strategies and the lessons learned from RWJ programs in three major subject areas: access to healthcare services, changes in the healthcare system, and efforts to improve services to vulnerable groups. The intended audience ranges from public policy professionals to officers and trustees of foundations addressing social problems, to members of the public interested in health and healthcare. Because the book focuses on work by RWJ, the references in each chapter largely cite scholarly publications deriving from these projects. In some cases, the scholarship supported by the RWJ has provided a remarkably thorough and wide-ranging exploration of the subject (e.g., the SUPPORT project, medical malpractice initiatives). Other chapters provide an excellent review of the history of scholarship in a particular area punctuated by contributions from RWJ (e.g., review of the National Access to Care surveys). Although this book's content is necessarily circumscribed because of its focus on the RWJ-sponsored projects, these projects have thoroughly examined many important issues in healthcare during the 1990s. The scholars writing each chapter are thoughtful and erudite. Readers interested in the history and programs of RWJ will certainly find the book highly informative.Those interested in the general themes of the book may be better served by publications more broadly addressing those topics. Nonetheless, individual chapters in this book are gems and the dedicated reader will certainly be rewarded.
Ann H. Cary
This third volume of the Robert Wood Johnson Foundation (RWJF) series of anthologies is a description of outcomes and processes from selected RWJF projects and programs. In addition, the Foundation's strategies to grant making in the research area (research, policy analysis, and evaluation) are highlighted. The editors have three objectives: to demystify the world of philanthropy, to inform the public of the programmatic investments by the Foundation, and to offer lessons and conclusions gained from 25 years of grant making for selected projects. While the world of foundations and philanthropy remain intriguing to many on the outside, the editors of this volume seek to provide the background, context, and content to unravel the mysteries of project/program selection, impact, and limitations. As such this is a useful guide to both the grant seeker and the planner of similar projects who address health and healthcare needs in communities. The volumes are written for practitioners, community planners, civic leaders, students, policy makers, faculty, and consumers. A Foundation insider (Dr. James R. Knickman) and outsider (Stephen L. Issacs) have teamed to edit this collection as written by project personnel and writers. The reader senses the balance in perspective in project outcomes and lessons by the authors of each chapter -- a refreshing read. Conclusions and lessons learned from projects include school-based health clinics, children's health insurance, minority medical education, assisted living for rural communities, adult day care centers, chronic mental illness, tobacco use prevention research, EMS programs, local funding partner initiatives, and the basis of the research grantmaking program at the foundation. Some chapters are more dynamic in the analysis, applicability, and generalizability of the lessons learned for future planning and implementation strategies. The table of contents from the previous two volumes is provided in the appendixes. This anthology is a useful evaluative snapshot of the Foundation's programmatic impact, influence, and limitations for the health of communities in both broad and specific terms. Potential Foundation applicants will find it particularly helpful.
Science writers and scientists themselves profile 10 projects funded by the largest US philanthropy devoted exclusively to health. They include demonstration projects, training, educational and communications activities, policy analysis, and research. There is nothing special about the year; earlier volumes considered 1997 and 1998-99. Annotation c. Book News, Inc., Portland, OR (
Doody's Review Service
Reviewer: Benn Greenspan, PhD, MPH/MHA(University of Illinois at Chicago School of Public Health)
Description: This is an intriguing insight into the strategic thinking of the Robert Wood Johnson Foundation and its grant-making programs. The book discusses key issues like learning from mistakes; the role of communication in successful strategy; and how strategic orientation of grant-making affects program success.
Purpose: The editors of this anthology have set out to honor the foundation's commitment to public accountability. This work is intended to assist others in the business of making grants (and also those who propose to achieve societal change through such programs) learn from the foundation's experience. This is an important effort that shares a substantial wealth of experience in an accessible, easy to read, and enthusiastic way. Where the book falls short of meeting its objectives is in structural inconsistencies that provide a level of interpretation in some sections but not in others.
Audience: While the book set out to serve foundation leaders and other practitioners in the human services fields, its open journalistic style makes it eminently accessible to students and other interested audiences at many levels. The benefits of this open style outweigh any appearance of lesser credibility created by the inclusion of many professional communicators in what is essentially an evaluative work.
Features: The four sections of the book cover critical topics related to learning from the foundation's efforts to achieve its goals. These include: the importance of openly examining mistakes; the role of communication strategy in executing foundation strategies and achieving foundation goals; how reducing substance abuse became a significant goal as the result of recognizing the role of individual lifestyle in improving health; and a brief look at two innovative programs aimed at improving communication to improve health and healthcare. The journalistic style of the book is at its best in the rapid sharing of the concepts, success, and failure of the many foundation initiatives. It also works well in helping readers understand the deliberation involved in strategic adaptation within the foundation.
Assessment: This is a welcome addition to the more formal literature about planning and strategy in the fields of human services and philanthropy. While setting out to provide transparency about the thinking and decision-making within the Robert Wood Johnson Foundation, the book includes discussions and examples that illuminate strategic thinking processes in general. Its journalistic style and discussions about how specific issues like leadership succession affect strategy will make it very useful in the graduate school classroom.

3 Stars from Doody
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Product Details

Meet the Author

Stephen L. Isaacs is president of Health Policy Associates in San Francisco, California.

James R. Knickman is vice president for research and evaluation at The Robert Wood Johnson Foundation in Princeton, New Jersey.

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Table of Contents

1 Reach Out: Physicians' Initiative to Expand Care to Underserved Americans 1
2 Improving the Health Care Workforce: Perspectives from Twenty-Four Years' Experience 21
3 A Review of the National Access-to-Care Surveys 53
4 Expertise Meets Politics: Efforts to Work with States 78
5 The Media and Change in Health Systems 97
6 Addressing the Problem of Medical Malpractice 109
7 Unmet Need in the Community: The Springfield Study 132
8 Unexpected Returns: Insights from SUPPORT 161
9 Developing Child Immunization Registries: The All Kids Count Program 187
10 The Homeless Families Program: A Summary of Key Findings 209
11 The National Health and Social Life Survey: Public Health Findings and Their Implications 232
About the Editors 251
About the Contributors 253
Index 263
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