Linda Aiken receives Institute of Medicine's 2014 Lienhard Award

The Institute of Medicine today presented the Gustav O. Lienhard Award to Linda Aiken, Claire M. Fagin Leadership Professor of Nursing at the University of Pennsylvania School of Nursing, for her rigorous research demonstrating the importance of nursing care and work environments in achieving safe, effective, patient-centered, and affordable health care. Consisting of a medal and $40,000, the award recognizes Aiken's research documenting that nurses' education, patient workloads, and work environment are associated with patient outcomes, as well as her work to translate those findings into practice and policy in the U.S. and other nations.

"By illuminating the key role nursing care plays in patient safety and health and identifying concrete ways to support that role – such as maintaining staffing levels and encouraging high levels of education for nurses – Linda Aiken has made tremendous contributions to the quality of health care here and abroad," said Victor Dzau, president of the Institute of Medicine.

Aiken's pioneering research showed that nurse staffing differences were an important factor in whether patients with serious complications could be "rescued" and discharged from the hospital. She found that each patient added to a nurse's workload was associated with a 7 percent increase in the odds of mortality after common surgical procedures. Her research influenced the determination of state-mandated nurse-to-patient ratios in California hospitals and prompted other states to require public reporting about these ratios in hospitals.

In other groundbreaking research, Aiken demonstrated that a better-educated nurse workforce is associated with better patient outcomes, a finding that has impacted the quality of health care by significantly increasing the number of nurses with at least a bachelor's degree (BSN). Aiken documented that each 10 percent increase in the proportion of bedside care nurses with BSN degrees was associated with a 5 percent to 7 percent decline in risk-adjusted mortality in patients. She established a causal link between increased employment of BSNs and lower mortality in hospitals over time, giving hospital leaders confidence that investments in BSNs will yield value to their organizations. Based largely on Aiken's research, the IOM Committee on the Future of Nursing recommended that 80 percent of U.S. nurses hold a BSN by 2020. Her subsequent research in other countries influenced the European Parliament's decision in 2013 to recommend university education for nurses in the European Union.

Aiken also pioneered empirical study of how the organizational context of clinical practice affects patient outcomes. She demonstrated that many promising strategies to improve care quality and patient safety do not have their intended results because poor work environments disrupt clinicians' adherence to best practices. As president of the American Academy of Nursing in 1979, Aiken led the search for evidence-based interventions to improve clinical work environments, a search that resulted in the successful development of a voluntary accreditation program, Magnet Recognition. Aiken's extensive research documenting the superior outcomes for Magnet hospitals has prompted wider use of the Magnet intervention, an evidence-based cluster of management practices. Nearly 10 percent of the nation's hospitals have achieved Magnet status, a marker of quality now used by Leapfrog and U.S. News and World Report in rankings of health care institutions.

Aiken is the 29th recipient of the Lienhard Award. Given annually, the award recognizes outstanding national achievement in improving personal health care services in the United States. Nominees are eligible for consideration without regard to education or profession, and award recipients are selected by a committee of experts convened by the IOM. This year's selection committee was chaired by Claire Pomeroy, president of the Albert and Mary Lasker Foundation.

The Lienhard Award is funded by an endowment from the Robert Wood Johnson Foundation. Gustav O. Lienhard was chair of the foundation's board of trustees from the organization's establishment in 1971 to his retirement in 1986 – a period in which the foundation moved to the forefront of American philanthropy in health care. Lienhard, who died in 1987, built his career with Johnson & Johnson, beginning as an accountant and retiring 39 years later as its president. Additional information about the Lienhard Award can be found at http://www.iom.edu/lienhard.

Provided by National Academy of Sciences