The University of California-Irvine adds fuel to health management with its newly designated school of nursing. The Sue & Bill Gross School of Nursing, along with the schools of medicine and two programs—pharmaceutical sciences and public health—make up UCI’s College of Health Sciences.
The nursing school grew out of a program that started in 2006, springing to life with a $40 million gift in January from the William and Sue Gross Family Foundation that will fund construction of a building to house it.
The school, which plans to expand research, is also intended to address a registered nurse shortage that’s projected to grow 19% from 2.7 million in 2012 to 3.2 million by 2022, resulting in the need for 525,000 replacement nurses in the workforce, according to the Bureau of Labor Statistics.
“To keep [patients] well, we need nurse-scientists to direct evidence,” said founding school Dean Adeline “Adey” Nyamathi. She was previously a professor and associate dean for research and international scholarship at the University of California-Los Angeles. “Nurses should help with rigorous science trials, design interventions … to improve outcomes.”
Evidenced-based practice refers to a care delivery model that combines research and clinical evidence to achieve better patient recovery and reduce chances of rehospitalization.
Nyamathi said that nurses, who are often the ones administering care and ensuring patients follow instructions, are crucial in efforts to improve such programs as preventative care, care procedure, and even patient safety policy.
Examples of National Institutes of Health-funded research include studies on improving health and reducing risk behaviors to underserved populations, specifically the homeless and incarcerated; preventing tuberculosis among foreign-born people seeking permanent residency in Los Angeles area; nutrition for women with AIDS; identifying biological signs in stroke recovery; and assessing the impact of nutrition on cardiovascular health.
Growth Plans
Nyamathi said the school plans to hire five more faculty members to increase research in the next two years. The school currently has about 17 faculty members. It’s now hiring health sciences clinical instructors, according to its recruitment page.
The school offers bachelor, master and doctoral degrees in nursing and has 243 students. Nyamathi said it plans to replace the nurse practitioner master’s program by next year with a doctoral program that currently has 26 students. She stressed the importance of training “next-level” nurses who can perform a wider range of primary, preventative and acute care services for patient-centric practice.
Nurse Leaders
“We [train] registered nurses [to work at] bedside and communities. They do a lot of work with individuals, but … nurses must practice at their full scope of practice to manage chronic illness in and outside hospitals,” she said.
Advanced practice registered nurses are registered nurses with postgraduate degrees, including nurse practitioners, clinical nurse specialists, nurse anesthetists and nurse midwives.
Nyamathi said nurses must be prepared to take on senior-level duties and key leadership positions and participate in executive decisions to improve care quality and safety.
She said “healthcare must go” to areas such as population management, or managing patients based on aggregation of patient data across multiple resources, including health records and habits, to study how certain behaviors heighten the risk for chronic diseases.
The Centers for Disease Control and Prevention said chronic diseases and conditions, including heart disease, stroke, cancer, diabetes, obesity and arthritis, “are among the most common, costly and preventable of all health problems.” Seven of the top 10 causes of death in 2014 were chronic diseases, the top three being heart disease, cancer and chronic lower respiratory diseases.
Population Management
The rise of population health management derives primarily from the need for hospitals and insurers to manage the escalating costs of treating chronic disease in the U.S. The CDC reported that 86% of all healthcare spending in 2010—approximately $2.6 trillion—was for people with one or more chronic conditions. Average healthcare spending for people with one chronic condition is more than double that spent on those without any chronic conditions. That balloons to 13.5 times more for people with five or more chronic conditions.
U.S. healthcare expenditure was $3.2 trillion in 2015, up nearly 6% year-over-year, and is projected to hit $3.3 trillion for 2016, or more than $10,000 per person.
Part of the quest to find standards of care for chronic diseases involves “precision” health, Nyamathi said, which includes personalized treatments and leans more heavily on data science tools than in the past to translate clinical data and research into information that can better predict individual risk for disease and develop early detection and prevention methods.
The nursing school is working with UCI Medical Center on clinical and research initiatives. Nyamathi said the new building is in the early planning stage but that she’s open to it being home to other programs.
“It would be good if pharmacy and public health also got designated school status,” she said, adding that she hopes the nursing school can collaborate with the other College of Health Sciences programs to train students for interdisciplinary care.
