Alumni Interview: Donna Farley (cohort '89)

After 14 years as senior researcher at RAND Health, PRGS alumna Donna Farley (cohort '89) retired in September 2010. Although she still serves as an adjunct RAND staff member, Donna has made time for herself to smell the proverbial roses. She recently spoke with Jeffrey Wasserman (cohort '85), Assistant Dean for Academic Affairs at PRGS, and reflected upon her experiences both as a PRGS student and a RAND researcher.

JW: What brought you to a career in health policy research?

DF: Well, I guess by most people’s standards, it wasn’t exactly a straight path. But each step contributed to getting me to where I needed to be professionally.

In high school I fell in love with biology. I majored in biology in college, but didn’t do much with it, in part because options for women were limited back then. I then did some volunteer work in public health and loved it. So I went back to grad school to get an MPH.

I worked in health care administration for more than 15 years, mostly in the hospital sector. The time came when I knew my next job would be running a hospital or small hospital system, and I knew I did not want to do that. I confronted the requisite mid life crisis, and decided what I really wanted to do was health policy research. So at age 46 I went back to school—to what was then just the RAND Graduate School, and finished four years later in 1993. After I graduated, I worked for three years in Washington, then was hired back to RAND in 1996.

JW: I guess the next obvious question is why did you choose PRGS?

DF: Because of its policy focus, and also because of methodological strength. I already had a lot of field experience, so I wasn’t looking for health care content knowledge. I needed to build a methodological tool set so that I could ask, and answer, health policy questions. A major shift for me was to realize that I was no longer making decisions from the perspective of a hospital administrator. I still remember being advised by one of the PRGS faculty that it was now OK to sit in my office and think about a decision or issue rather than moving in real time based on partial data.

JW: What kind of methodological tool kit did you build?

DF: It includes a wide range of quantitative and qualitative approaches, making it possible for me to choose the tool to fit the question at hand. To me, a policy project is a three-tiered endeavor. First, you have to figure out what the client wants to learn--and that may not be immediately apparent. Second, you need to define what kinds of questions must be asked to provide that information. And only then do you dig into your tool kit to design the most appropriate data collection and analytic strategy. Often a project requires both qualitative and quantitative approaches.

JW: Can you give an example of a project that demanded a marriage of qualitative and quantitative methods?

DF: The Patient Safety Evaluation project comes immediately to mind. I created an overarching framework for that 6-year project to pull together all the parts of the evaluation, but we used a different approach to address each question within the framework. In effect, the framework described the forest, but we used different techniques to examine each of the project “trees.”

JW: What advice do you have for others who are considering similar career paths?

DF: I would strongly recommend getting some real world experience first. And if you decide to pursue a PhD, be sure you are clear what you want to get out of it. Of course PRGS is set up to accommodate students who are starting down the PhD path after having been down some other professional roads. I’ve always thought a PRGS education was designed to be a lever. It assumes you have some content knowledge and/or real world experience when you arrive. The point of the curriculum is to help you leverage that knowledge and to give you sharp methodological tools to ask and answer policy questions. Many of the best methodological people in the country are to be found in PRGS.

JW: Tell us about your time and work in the RAND Pittsburgh office.

DF: I view the mentoring I did in the Pittsburgh office as one of my major professional achievements. I was motivated to relocate from Santa Monica because it was an opportunity to do something creative and to make a meaningful, and if successful, enduring contribution. RAND Health had made a commitment to developing capacity in Pittsburgh, and I wanted to support that commitment. Between my arrival in 2002 and my formal departure in 2010, we worked together to hire 2-4 people a year. I had several large research projects during that time, and I hired new staff onto them, which gave me an opportunity to provide on-the-job mentoring. It was a great experience for me, and I hope for some of them.

JW: Of all the things you’ve done during this varied and rich career, which do you think that the biggest impact on people’s lives?

DF: To my pleasure, several come to mind. First, my mentoring in the Pittsburgh office. That was a direct investment in people and I think it has paid substantial and long-term dividends. Second, the Patient Safety Evaluation, which encouraged the Agency for Healthcare Research and Quality to pursue stronger dissemination work, including toolkit development. Third, the hospital Quality Indicator toolkit project, which is one of AHRQ’s toolkit projects. More than 1,100 people attended our two webinars introducing those tools, so they are resonating with those responsible for improving hospital care. Finally, the evaluation of the Arkansas tobacco master settlement agreement. Unlike other states, Arkansas invested all of its MSA funds in health-related programs. We were able to help the programs strengthen their operations, and we showed that they have been a force behind the state's downward trend in smoking rates, especially among vulnerable populations.