Talk:John A. Hartford Foundation

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I created this page to fill an important gap here in the corporate history of The Great Atlantic & Pacific Tea Company; for many decades governance of that company was intimately connected with governance of the John A. Hartford Foundation, and that relationship has been the subject of a great deal of legal scrutiny. I hope future contributions can help guide interested readers to the specialty literature in this area.

Somewhat separate from that aim, I wished to provide a public space for interested parties to transparently (and, if desired, anonymously) document the history, governance, and outcomes of a large mission-driven philanthropic foundation. — Preceding unsigned comment added by Anomicworld (talk • contribs) 23:11, 21 August 2013 (UTC)

Proposed changes

John A. Hartford Foundation (main header)

• Specific text to be added or removed: The John A. Hartford Foundation (JAHF) is a private United States-based philanthropy whose current mission is to improve the care of older adults. For many years it made grants for research and education in geriatric medicine, nursing and social work. It now focuses on three priority areas: creating age-friendly health systems, supporting family caregivers and improving serious illness, and end-of-life care.
• This text will replace the current intro.
• Reason for the change: This more accurately depicts the mission of JAHF.
• References supporting change: https://www.johnahartford.org/

History (header)

• Specific text to be added or removed: The foundation's grants in the early and mid-20th century were predominantly for research centered on basic and clinical medicine and health care quality and costs; it was at one time the largest funder in these areas.[4] In 1982, the focus turned towards improving the care of older adults, as there became an increasing need to fund this underserved area. And in 1994, the foundation made this priority its chief mission.
• This text will replace the second paragraph of the section titled "History".
• Reason for the change: This information is more detailed and accurate.
• References supporting change: 3. "John A. Hartford Dies in Elevator. Chairman of the A. & P. Chain 3 Succumbs After Attending Chrysler Board Meeting". New York Times. September 21, 1951. Retrieved 2013-07-29. 4.Jacobson, J. S. (1984). The Greatest Good: A History of the John A. Hartford Foundation. The foundation.

Leadership (header)

• Specific text to be added: Terry Fulmer, PhD, RN, FAAN, is the President of The John A. Hartford Foundation. She serves as the chief strategist for the Foundation and her vision for better care of older adults is catalyzing the Age-Friendly Health Systems social movement. She is an elected member of the National Academy of Medicine and recently served on the independent Coronavirus Commission for Safety and Quality in Nursing Homes established to advise the Centers for Medicare and Medicaid Services. She previously served as Distinguished Professor and Dean of Health Sciences at Northeastern University.

Prior, she served as the Erline Perkins McGriff Professor and Founding Dean of the New York University College of Nursing. She has held faculty appointments at Columbia University, where she was the Anna C. Maxwell Chair in Nursing, and she has also held appointments at Boston College, Yale University, and the Harvard Division on Aging at Harvard Medical School. She is a Distinguished Practitioner of the National Academies of Practice and currently an attending nurse and senior nurse in the Yvonne L. Munn Center for Nursing Research at the Massachusetts General Hospital and an attending nurse at Mount Sinai Medical Center in NYC. Her clinical appointments have included the Beth Israel Hospital in Boston, the Massachusetts General Hospital, and the NYU Langone Medical Center. She is a Fellow of the American Academy of Nursing, the Gerontological Society of America, and the New York Academy of Medicine where she served as vice-chair. She has authored nearly 400 peer-reviewed papers. Reason for the change: There is an absence of leadership information on the page. References supporting change: https://www.johnahartford.org/images/uploads/resources/Terry-CV-jan-2021.pdf

'Priority Areas (header)

• Specific text to be added: In a rapidly evolving health care environment, the Foundation supports the spread of evidence-based models that can dramatically accelerate care improvement for older adults, which benefits all of us. The three priority areas are: Age-Friendly Health Systems; Family Caregiving, and Serious Illness & End of Life.

Age-Friendly Health Systems (sub-header) To prevent harm to older adults, improve health outcomes, and lower overall costs, health systems must adopt evidence-based models and practices that deliver better care to our rapidly aging population across all settings, including the home and community. In partnership with expert innovators and health care leaders, The John A. Hartford Foundation is working to create health systems that are age-friendly and better able to meet the goals of the Triple Aim. Family Caregiving (sub-header) There are nearly 18 million people in the US regularly providing care to an older loved one who needs assistance. These family caregivers frequently perform heroic tasks, but are often invisible in our health care system and receive little preparation and support. Recognizing the critical role that family caregivers play, The John A. Hartford Foundation is committed to transforming our health care and social services systems to meet the needs of family caregivers. Serious Illness & End of Life (sub-header) With increasing age comes greater risk for serious illness and the natural progression towards the end of life. Too often, care at this time fails to meet the goals and preferences of older adults and results in harm and burden. Palliative care and other effective approaches must be more widely available. The John A. Hartford Foundation will continue to promote care that preserves dignity and honors the wishes of older adults and their families. Reason for the change: There is an absence of priority areas information on the page. References supporting the change: https://www.johnahartford.org/grants-strategy/current-strategies

 Done. The list of CV info on Fulmer is not relevant to this page, but her connection to the foundation is, so it was included. The remaining information on Fulmer is better suited to her own page, so it was not included in the updates.

Also, the proposed Priority Areas section was not included. The priority areas are are already listed in the lead, and the subsections provide excess information that takes away from the focus of the page and strays from the WP:Encyclopedic style. Thanks, Heartmusic678 (talk) 14:10, 8 December 2021 (UTC)

Activities (header)

• Specific text to be added: From about 1980 to 2012, the foundation focused on a two-pronged effort consisting of building training capacity and conducting research into different models of care for older adults at schools of medicine, nursing, and social work.[6] In 2013, the Foundation organized its grantmaking in five portfolios: Interprofessional Leadership in Action, Linking Education and Practice, Developing and Disseminating Models of Care, Tools and Measures for Quality Care, and Policy and Communications. In 2015-16 [7], the Foundation implemented its current priority areas: creating age-friendly health systems, supporting family caregivers, and improving serious illness and end-of-life care. In 2016, the Age-Friendly Health System initiative was started in collaboration with the Institute for Healthcare Improvement (IHI), American Hospital Association (AHA), and the Catholic Health Association of the United States (CHA).[2]  Done.

Geriatric Training (sub-header)

• Specific text to be added: In order to grow the geriatric workforce, JAHF has helped to develop training programs across various disciplines, from university-based physicians to nurses and social workers. The hope has been to establish a strong interdisciplinary labor force that is well-trained clinically and well-equipped academically to further geriatric research and care.  Not done

Medicine (sub-sub-header)

• Specific text to be added: One of the largest and most important programs in the foundation's recent history has been to help build academic capacity in geriatric medicine through the Centers of Excellence in Geriatric Medicine, which started in 1986 . These Centers are located at academic medical centers around the country and were known as high-throughput producers of academic geriatricians as well as the generators of basic, clinical, and population level medical knowledge about older adults. As many as 55,000 physicians are trained or mentored at these centers annually. [8]  Done.

The Paul Beeson Physician Faculty Scholars in Aging Research Program was launched in 1994, in partnership with Atlantic Philanthropies, the Commonwealth Fund, and the Starr Foundation. As of 2019, the three-year fellowship has trained 225 scholars, with significant impacts to aging research.

The foundation has also supported training and development programs for medical students, fellows, junior faculty, and senior thought leader through its funding of the Association of American Medical Colleges for geriatric scholarships, residence programs, and curriculum development. Another important initiative has been building bridges from geriatric medicine out to the subspecialities of internal medicine and surgical and related specialties.[9]  Done

Nursing (sub-sub-header)

• Specific text to be added: Geriatric nursing has long been an important focus of JAHF, and this culminated in $5 million of funding to establish the John A. Hartford Foundation Institute for the Advancement of Geriatric Nursing in 1996, the first of its kind in the US. From supporting nursing societies to the American Association of Colleges of Nursing, the institute helped to build curriculums and experiences to expose nursing students to geriatrics in their programs.

To further the academic training of nurses, five centers of geriatric nursing excellence were established – 300 trainees had received pre- and postdoctoral fellowships through 2015, and as of 2012, 95% were part of nursing school faculties.  Not done

Social Work (sub-sub-header)

• The foundation focused on enhancing the capability of schools of social work to train aging-competent social workers through the Geriatric Social Work Initiative in the late 1990s. There were three core goals for the initiative: (1) work with the Council on Social Work Education to incorporate geriatrics into the curriculum; (2) offer scholarships and fellowships to faculty and students to fund their pursuits in geriatric social work; and (3) provide practical exposure by placing upper-level social work students in field experiences.  Not done

• References supporting changes: 2. John A. Hartford Foundation. "About The John A. Hartford Foundation". Retrieved 2013-06-14.6. Regenstreif, Donna I., Christopher A. Langston, and Corinne H. Rieder. "Decades of focus: Grant making at the John A. Hartford Foundation." Health Affairs 23.2 (2004): 258-264.

7.^ The John A. Hartford Foundation. “Priority Areas.” Retrieved 1 September 2021. Institute of Medicine . 2008. Retooling for an aging America: Building the health care workforce. Washington, DC: The National Academies Press. 8. ^ Reuben, David B., et al. "Building academic geriatric capacity: an evaluation of the John A. Hartford Foundation Centers of Excellence initiative." Journal of the American Geriatrics Society 52.8 (2004):1384-1390 9. ^ Hazzard, W.R., Woolard, N., & Regenstreif, D.I. "Integrating geriatrics into the subspecialties of internal medicine: The Hartford Foundation/American Geriatrics Society/Wake Forest University Bowman N. Gray School of Medicine Initiative." Journal of the American Geriatrics Society 45.5 (1997): 638-640.

Care Models (sub-header)  Not done

• Specific text to be added: Another priority area at JAHF has been the delivery of care. Ranging from programs centered on different care settings to care team dynamics, the foundation has spent many years funding the evaluation of models that strive to be both clinically effective and cost-efficient.

Community-Based Care (sub-sub-header)

• Specific text to be added: Programs of All-Inclusive Care for the Elderly (PACE) has long been championed by JAHF. Providing services for approximately 40,000 people, the model allows persons older than fifty-five to receive health and social services in their homes, instead of resorting to long-term care facilities. Despite being reimbursed by Medicare and Medicaid, PACE still only covers a small portion of those who are eligible.

Team Care (sub-sub-header)

• Specific text to be added: Separate from the foundation’s support of geriatric training, there were multiple studies done on promoting the interdisciplinary nature of care teams. Beyond just physicians and nurses, these teams were also comprised of social workers and others, and were especially effective for managing those with complex conditions and multiple comorbidities.

Transitions (sub-sub-header)

• Specific text to be added: Transitions in care can often result in adverse events and worsened health outcomes due to lost clinical information and miscommunication. JAHF has helped to fund programs that lead to improved coordination for older adults undergoing care transitions. The Care Transitions Intervention, the Transitional Care Model, and Guided Care are some examples that have shown improved clinical results and lowered costs.

Hospital and Home Care (sub-sub-header)

• Specific text to be added: For some older adults with serious illness, the preferred place of treatment is their home. The Hospital at Home program allows this option for conditions such as congestive heart failure. The foundation has also invested in other innovative delivery models, such as Acute Care of the Elderly (ACE), which focuses on structuring age-appropriate hospital rooms, and Nurses Improving Care for Healthsystem Elders (NICHE), a framework for age-friendly nursing care in hospitals and other healthcare settings.

Palliative Care (sub-sub-header)

• Specific text to be added: Originating in 2006, JAHF’s support of the Center for Palliative Care at Mount Sinai Medical Center has been one of its most significant projects. Despite difficulty in securing Medicare reimbursement, palliative care has expanded significantly, with almost 75% of all hospitals offering it in some capacity.

Leadership and Policy (sub-header)

• Specific text to be added: JAHF has avidly supported thought leaders in policy, from funding National Health Policy Forum seminars to investing in various reports by the National Academies. The foundation continues to engage in the policy sphere through its various partnerships with governmental agencies. Done

Special Grants (sub-sub-header)

• Specific text to be added: The foundation has made rare special grants, including grants in response to the 911 terrorist events, and Hurricanes Katrina and Rita. The grants have often focused on better disaster preparation and relief policies for institutionalized older adults.[14]  Done

Grantee Communication (sub-sub-header)

• Specific text to be added: Beginning in 2006, the foundation has made efforts to communicate with its grantees and other stakeholders, sponsoring grantee perception surveys by the Center for Effective Philanthropy[15] and released in part to the public.[16] (A 2010 Grantee Perception Report is not currently publicly available.) It has circulated an e-newsletter to its stakeholder community since at least 2004, and has launched an online blog, Health AGEnda.[17]  Done.

• This will replace the current Activities body of text.
• Reasons for changes: This is reflective of the foundation's current priorities.
• References supporting the changes: 14. ^ Hyer K, Brown LM, Polivka-West L, Berman A. Helping nursing homes prepare for disasters. Health Affairs (Millwood). 2010;29(10):1961-5. doi:10.1377/hlthaff.2010.0665. 15. The Center for Effective Philanthropy. CEP.org. Retrieved 1 September 2021. 16. ^ "Grantee Perception Report" (PDF). Jhartfound.org. Retrieved 2013-09-02. 17. ^ "Health AGEnda | The John A. Hartford Foundation Blog". Jhartfound.org. Retrieved 2013-08-03.

Impact (header)  Not done. I did not see all of the information on the main page. If you can provide reliable sources independent of the foundation in addition to specific links on the foundation's site supporting the Impact section details, I will be happy to add the information. Thanks, Heartmusic678 (talk) 11:21, 28 December 2021 (UTC)

• Specific text to be added: When JAHF entered the space of aging and health, there were very few funders, and often with limited scope. The Veterans Health Administration and the Bureau of Health Professions were the only ones involved in geriatrician training. The Gerontological Society of American and the American Geriatrics Society, both created in the 1940s, helped to finance research and clinical work in aging. And in 1974, the National Institute of Aging was established, also with the primary intent to fund clinical research.

At that time (late 1970s), there were less than 750 geriatricians in the entire United States. Since then, JAHF has helped make tremendous progress, with more than 7,000 geriatricians certified by 2010 and geriatrics integrated into almost all medical curricula and board certification requirements across the country. Geriatrics exposure has also significantly changed in nursing education, with 90% of bachelor’s-level nursing programs incorporating geriatrics into their required coursework by 2003. This training is not just limited to physicians and nurses, JAHF has sought to bring geriatrics into the professional education of all health workers on some level. Through its funding of work on care models, the foundation has helped to foster various experiential care delivery methods that show promise clinically and economically. As more evidence proves the effectiveness of these models, the spotlight is now on the policy work needed to secure reimbursements and scale up these programs.

• Reason for change: There was an absence of impact-related information on the foundation.
• Reference supporting the change: https://www.johnahartford.org/

Governance (header)

• Specific text to be added or removed: No changes

Please provide citations for the highlighted sections, including all parts of the Care Models section. Thanks, Heartmusic678 (talk) 14:01, 10 December 2021 (UTC)