An STTI board member responds to President Catrambone’s call to action.
Population health and interprofessional education and collaborative practice are career-long pedagogy, scholarship, and service passions of mine. In 2015, when I campaigned for the position of director-at-large on the board of directors of the Honor Society of Nursing, Sigma Theta Tau International (STTI), I vowed that, if elected, I would draw on my years of leadership and involvement in pursuing the above passions in carrying out that role. Now, as I reflect on my first year and a half as an STTI director, I am overwhelmed with thankfulness for the opportunities I have had to serve and work toward fulfilling my vow.
It has been my honor to help advance STTI’s mission and vision and to support the call to action that President Cathy Catrambone, PhD, RN, FAAN, made at the 43rd Biennial Convention in Las Vegas. An added bonus is that, by sharing my personal journey of advocacy for advancing population health and interprofessional education and collaborative practice, I am able to answer her call: “Influence to Advance Global Health and Nursing.”
Now is the time
In her call to action, President Catrambone said, “Now is the time for nurses to leverage our expertise to influence the health of the world’s people and to advance the profession through advocacy, policy, philanthropy, and lifelong learning.” But why now? Why is now the time?
Now is the time to advocate for population health and interprofessional education and collaborative practice because healthcare is in the process of being transformed to meet the demands of the 21st century. Twentieth-century clinician-centered care has been disrupted by care that centers on individuals, families, communities, and populations. No longer are patients passive compliers in a hospital-based system that focuses solely on cure. Instead, they are co-producers of well-being—for themselves and others. Healthcare delivery in the 21st century is about prevention, cost reduction, and improvement of care experience. Gone are the days of good care available only to known patients, silos of delivery, and finance-driven decisions.
Now is the time of population-centered equitable care, systems, networks, and evidence-based decisions. Sustaining innovation activates the creation of “bigger and better” while disruptive innovation stimulates the formation of services and products that may be more affordable and accessible. Through the inevitability of change and demand for healthcare that is both affordable and accessible, the status quo of healthcare has been disrupted. There is no better time than now for nurses to leverage their expertise to influence the health of the world’s people.
Leadership is influence
John Maxwell, an American speaker, pastor, and author who has written numerous books on leadership, says, “Leadership is influence, nothing more, nothing less.” Maxwell contends that true leadership comes only from influence and cannot be awarded, appointed, or assigned—it must be earned. In identifying several factors that contribute to emerging leaders succeeding in influencing influencers, Maxwell lists character, relationships, knowledge, intuition, experience, past success, and ability.
In Catrambone’s call to action, she challenges nurses to leverage their expertise to influence. I see this call to influence as a call to lead—to draw upon the same leadership assets that are identified by Maxwell. Titles or positions are not required for leadership, nor are they required to exert influence.
With more than 20 years of experience in collaborating with interprofessional teams to design and implement health promotion and disease prevention programs, I have leveraged my expertise in population health and interprofessional education and collaborative practice to lead in advancing the health of the world’s people and the profession of nursing. Population health and interprofessional education and collaborative practice are two areas where major innovations are disrupting the status quo of healthcare. Although neither focus is new, both are relevant in addressing, through affordability of and accessibility to healthcare, challenges around the globe.
The debate over the relationship between economic growth and human health that characterizes the study of population health can be traced back to the 18th century, but a single definition for population health has yet to emerge. Most experts agree, however, that a population-health approach targets entire populations; intervenes with families, communities, systems, and individuals; and emphasizes the impact of multiple determinants on health outcomes. Several 21st-century health policies and initiatives incorporate some aspects of a population-health approach.
For example, World Health Organization (WHO) programs and policy initiatives address the impact of multiple determinants on population health outcomes. The 17 Sustainable Development Goals of the United Nations are an agenda for improving population health, ending poverty, protecting the planet, and ensuring prosperity around the world by 2030. Population-health concepts are now being used globally in policy, healthcare, communities, and research settings, and funding is being directed toward strengthening health systems and improving population health outcomes. As a passionate advocate of population health initiatives, I see these disruptions as exciting. In my opinion, there is no question that now is the time to leverage my expertise in population health to advance the health of the world’s people and the profession of nursing.
Interprofessional education and collaborative practice
In 1978, the World Health Organization identified interprofessional education as an important aspect of primary care. A 1988 WHO technical report titled “Learning Together to Work Together for Health” expanded on the value of interprofessional education, and, in 2006, establishment of a WHO Study Group on Interprofessional Education and Collaborative Practice institutionalized the importance of interprofessionism around the globe.
In 2010, the WHO Study Group published “Framework for Action on Interprofessional Education and Collaborative Practice” to provide policymakers with ideas on how to implement interprofessional education and collaborative practice within their own contexts while advancing shared understanding. In that report, interprofessional education is defined as “two or more professions learn[ing] about, from and with each other to enable effective collaboration and improve health outcomes.” The same report describes interprofessional collaborative practice as “multiple health workers from different professional backgrounds provid[ing] comprehensive services by working with patients, their families, careers and communities to deliver the highest quality of care across settings.”
Health professions, educational institutions, healthcare networks, funding institutions, and community agencies around the world are adopting and incorporating these concepts in their settings. But why now? The concepts are not new. One of the key messages from the 2010 report is that “there is sufficient evidence to indicate that effective interprofessional education enables effective collaborative practice.” Interprofessional education is key to producing a collaborative-practice-ready workforce, and a collaborative-practice-ready workforce is now widely recognized as essential for producing optimal health services, strengthening health systems, and improving population health outcomes.
My passion for interprofessional collaborative practice is tied to 30 years of active-duty service as a nurse in the U.S. Navy. Currently, I am privileged to serve as part of a team that has the honor of “improving the health of the community by engaging students, faculty, staff, and the larger community in the preparation of healthcare leaders, scholars, and professionals.” For me, there could be no better time than now to draw upon my experience in interprofessional education and collaborative practice and use my influence to advance those concepts on behalf of global health and nursing.
Advocacy, policy, philanthropy, and lifelong learning
In her call to action, President Catrambone charges nurses to “leverage our expertise to influence the health of the world’s people and to advance the profession through advocacy, policy, philanthropy, and lifelong learning.” So why have I focused only on advocacy?
In reality, I have not. Advocacy best fits my character (who I am), my intuition, and how I relate to people. Synonyms for advocacy, such as advancement, encouragement, promotion, and championing are authentically me. But when I reflect on my journey and how my expertise in advocacy and engagement in population health and promotion of interprofessional education and practice has developed across the years, it is evident that my strength in advocacy has also positively impacted advancement of policy, philanthropy, and lifelong learning.
Through scholarly activities and giving of time and money, I have contributed to expanding knowledge and shaping policy related to population health. My philanthropy has also resulted in establishing numerous healthcare industry and community partnerships targeted toward producing a collaborative-practice-ready health workforce and improving health outcomes. Even as I write this, my commitment to, promotion of, and participation in lifelong learning are evident to me. In other words, in reflecting on my efforts to advance global health and the profession through advocacy, I see how I have also helped advance global health and the profession through policy, philanthropy, and lifelong learning.
An unknown author observed, “The reason why people give up so fast is because they tend to look at how far they still have to go instead of how far they have gotten.” A year and a half into my four-year term as an STTI director, I am aware that there is so much more that I have yet to do to fulfill my election vow. But reflection has taught me to consider my progress and acknowledge with gratefulness the opportunities I have already had to serve, lead, and influence to advance global health and nursing.
Sandra Bibb, DNSc, RN, FAAN, dean and professor, College of Health Professions, Wichita State University in Wichita, Kansas, USA, and director-at-large on the STTI board of directors, previously served as associate dean and department chair in the Daniel K. Inouye Graduate School of Nursing (GSN) at the Uniformed Services University in Bethesda, Maryland. Before her time at GSN, Bibb served in the U.S. Navy as an active-duty nurse for three decades, retiring with the rank of captain.