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System wide Efforts to Improve Everyday Clinical Practice and Health Equity in an Accountable Care Environment

Project Description: Saint Francis Research Council and Senior Leadership have endorsed a new Research Strategic Plan that focuses on studying efforts to improve everyday clinical practice. Saint Francis has free-standing residency and fellowship programs, and is a teaching hospital affiliated with the University of Connecticut School of Medicine. Last year, we developed a Healthcare Delivery Science curriculum for residents that integrates quality improvement, research, and communication. Our move toward accountable care and population health management has positioned us for developing system-wide improvements to enhance capacity for conducting quality improvement research, health equity research, and research that utilizes data from the EHR. More specChrifically: We created the Innovation + Learning Center at Saint Francis, which encompasses Education, Leadership Development, Value-Driven Design, Innovation, Research and Health Equity, with responsibility for improving the art and science of healthcare delivery across the entire enterprise. The overarching goal of these efforts is to build research capacity by implementing a fully integrated, interdisciplinary model that aligns research development, performance improvement, and health equity. This goal will be realized through the following aims: 

Aim 1: To align and integrate distinct programs and resources in research, performance improvement and health equity toward a common agenda for scholarly activity. Aim 2: To shift the organizational focus on research from isolated clinical trials to collaborative research focused on everyday clinical practice. Aim 3: To develop comprehensive tools and strategies to facilitate uptake and adoption of the model. Aim 4: To promote adoption of the SQUIRE Guidelines within the interdisciplinary framework. Aim 5: To build data mining and evaluation tools into the new EHR for the purposes of interdisciplinary research.

2014 UPDATE: The BestCare grant program gives preference to proposals that integrate research, performance improvement, and health equity.  We received 16 Letters of Intent, all of which propose prospective and/or interventional studies. The current LOIs also propose department-level or out-patient/in-patient care collaboration, and focus on a variety of issues and health concerns, such as: utilizing community-based participatory research to identify and integrate patient health priorities into policy and practice. 

Our efforts have added a systems focus at the clinical level, and a clinical focus at the systems level. The Simulation Studio has been crucial to this effort. We are scheduled to repeat a successful longitudinal simulation focused on safe transitions of care across departments in early November. This hands-on experience – which includes researchers, clinicians, trainees and mentors, has prompted discussion about how a small event or workflow issues early in the scenario plays out relative to patient experience, performance, and quality of communication further down the line. We are building a regional research collaborative with local universities to leverage opportunities for research and education. The plan will be completed by the end of December.

Primary contact: Rebecca Crowell, Ph.D.; Manager, Research Development
Institution: Saint Francis Hospital and Medical Center

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