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Innovation Grant Winners Announced

Center for Healthcare Delivery Science Awards $150K to Staff Projects

In April of 2012, Beth Israel Deaconess Medical Center launched the Center for Healthcare Delivery Science (HDS) to lead the medical center's efforts in applying rigorous, high-quality science to the evaluation of real-world innovations aimed at improving the quality, safety and value of health care. Now, after reviewing 15 wide-ranging applications, HDS is announcing the winners in its first-ever Innovation Grants Program.

Three one-year grants totaling nearly $150,000 have been awarded to Brett Simon, MD, PhD, Chair, Anesthesiology, Critical Care and Pain Medicine; Daniel Leffler, MD, Director of Clinical Research, The Celiac Center at BIDMC, and Sheila Barnett, MD, Director of Gastrointestinal Anesthesia; and Ali Poyan Mehr, MD, Fellow, Nephrology. The proposals seek to improve OR scheduling, improve methods for moderate sedation, and improve care of patients with chronic kidney disease.

Details of the grant proposals »

"One of the things we quickly realized is that there are a tremendous number of really good ideas out there - ideas about how to make care better, and about how to rigorously study these ideas in the process," said Michael Howell, MD, MPH, Executive Director of HDS and Director of Critical Care Quality. "We at the Center want to encourage and help develop those ideas so my only regret is that we're not able to fund more proposals this year."

Through this leadership, HDS seeks to become a regional and national leader in the emerging field where recognizable science and health care delivery intersect. The Innovation Grants are funded by support from a private philanthropic group, and the Office of the Chief Academic Officer Vikas Sukhatme, MD, PhD, matched a substantial portion of these funds.

"My office is delighted to offer partial support for the Innovation Grants as they jive nicely with BIDMC's strategic vision for research, namely to promote a culture of innovation, accelerate translation, and to cultivate the careers of new investigators," said Sukhatme.

The application review process was a rare opportunity for BIDMC's world class researchers and top administrators to work collaboratively on a project around the same table, said committee member Marsha Maurer, RN, Interim Chief Operating Officer.

"I am particularly impressed with how the selected projects align with our strategic goals," said Maurer. "The OR Access and Resource Utilization project will help to make one of our most expensive assets, our ORs, run more efficiently. The Moderate Sedation project aligns with our goal of ensuring an excellent patient experience, and the Kidney Tracker project will support our ability to manage this chronic disease population across the continuum of care."

Under the umbrella of the Silverman Institute for Health Care Quality and Safety, HDS serves as a shared resource for BIDMC investigators interested in the scientific evaluation of operational innovations and will work with them to pursue high-value projects that benefit patients and improve the value of health care both locally and nationally, said Ken Sands, MD, MPH, Senior Vice President, Health Care Quality. Over the next year HDS will recruit a nucleus of core faculty with experience and significant expertise in health care delivery science, and develop Center capacity in biostatistics, analytics, information technology and project management, he said.

"Our lived experience at BIDMC is that the best ideas for improvement come from our staff," said Sands. "Our goal now is give more of those ideas the chance to be tested and implemented. Some will undoubtedly lead to sustainable change; all will provide learning opportunities that will make us a better organization."

Simon said the Innovation Grant will enable his group to take its pilot work - a collaboration between perioperative services and the Leaders for Global Operations program at MIT - to the next level. "The application of innovative processes used by industries like the airlines and Amazon to increase access and optimally utilize our ORs is an exciting opportunity to improve patient and provider experience while increasing efficiency and financial performance," said Simon.

Grant Proposals

Vivek Farias (MIT); Brett Simon, MD, PhD, Chair, Anesthesiology, Critical Care and Pain Medicine; Ryan Graue (MIT); Elena Canacari, RN; and Dorothy Sarno, RN (not pictured: Peter Panzica, MD)

Peri-operative care: Innovative Tools to Optimize OR Access and Resource Utilization

Brett Simon, MD, PhD and team
In spite of the fact that tens of thousands of operations are performed at BIDMC each year, and that O.R. time is one of the most expensive resources in the modern hospital, the process for scheduling surgical cases has been essentially unchanged for over 30 years. This situation results in underutilized O.R. time during some periods, increased overtime required for staff during other periods, and even the inability to confirm some patients' procedures until literally the day prior to surgery. This project represents a collaboration with quantitative operations research scientists at MIT; it will implement leading-edge decision support tools to predict future O.R. availability and staffing needs, allow managers to dynamically visualize differently optimized O.R. schedules, and market available O.R. time to surgeons in need of scheduling cases outside their usual block time.

Non-operative interventional procedures: Moderate Sedation - the final frontier for quality in procedural areas

Daniel Leffler, MD, Director of Clinical Research at The Celiac Center; and Sheila Barnett, MD, Director of Gastrointestinal Anesthesia

Daniel Leffler, MD and Sheila Barnett, MD
Every year at BIDMC, about 30,000 patients receive moderate sedation during invasive procedures. Surprisingly, no validated tools exist to allow monitoring of moderate sedation quality from the provider's or patient's perspective. Even small improvements in this area could have major impacts on quality, satisfaction, and throughput, but we have no standard way to measure this common and costly intervention. This project addresses this need by developing standardized tools that can be used to assess the quality of sedation in procedure areas from both the patient's and provider's viewpoints; defining benchmarks for moderate sedation quality; and studying procedural, physician, nursing, medication, and patient factors associated with sedation-related outcomes.

Chronic disease management: KidneyTracker, a patient-centered approach to improve care of patients with Chronic Kidney Disease

Ali Poyan Mehr, MD, Fellow, Nephrology

Ali Poyan Mehr, MD
Up to 8% of the U.S. population has moderate to severe chronic kidney disease (CKD); these patients are at high risk for progressing to dialysis, have high one-year mortality rates, and have extremely high health care costs. BIDMC performance on several quality measures in this population shows tremendous opportunity for improvement: for example, the rate of fistula placement (the recommended type of vascular access in patients beginning dialysis) is only 30%, which is reported to be one of the lowest rates in the Northeast and well below the national average. This project proposes to develop a CKD-specific, automated visit summary (KidneyTracker) that is shared with CKD patients and providers at the beginning of their renal visit to drive practice in this arena. The KidneyTracker focuses on four key elements of care in this population and performance will be compared both to historical controls at BIDMC and, to assess for BIDMC-specific effects unrelated to the intervention, to the Harvard Vanguard CKD population.

Posted July 2012

Contact Information

Center for Healthcare Delivery Science
Michael D. Howell, MD, MPH, Director
Beth Israel Deaconess Medical Center
330 Brookline Avenue
Boston, MA 02215

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