Intermountain Research and National Perspectives. Lucy A. Savitz, PhD, MBA

Transcription

1 Intermountain Research and National Perspectives Lucy A. Savitz, PhD, MBA Research Professor, Epidemiology, Adjunct Professor in Nursing, Pediatrics, and Family & Preventive Medicine, Director of Research and Education, Institute for Health Care Delivery Research, University of Utah Objectives: 1. Relate a shared understanding of research in practice 2. Describe the integral role of research in a learning health system 3. Recognize their role in the research process 4. Identify who to contact and what resources are available to support research This presentation will be uploaded following the conference.

2 Intermountain Research & Perspectives on Reach March 13, th Annual Research Summit Lucy A. Savitz, Ph.D., MBA Director of Research and Education Intermountain Institute for Health Care Delivery Research Research Professor, Epidemiology Director, CCTS Patient Centered Research Methods Core University of Utah, School of Medicine

3 Establishing Context Health Services Research (HSR) is a multidisciplinary field of inquiry that examines the use, costs, accessibility, delivery, organization, financing, and outcomes of health care services to increase knowledge and understanding of the structure, processes, and effects of health services for individuals and populations.

4 Establishing Context Health Services Research (HSR) is a multidisciplinary field of inquiry that examines the use, costs, accessibility, delivery, organization, financing, and outcomes of health care services to increase knowledge and understanding of the structure, processes, and effects of health services for individuals and populations.

5 Current Core Functions of the Institute 1. QI Training 2. Clinical Program Support for Clinical Integration 3. Delivery System Transformation Support for Shared Accountability 4. Conduct Operationally Meaningful Research 5. Dissemination & Collaboration for Shared Learning Embedding research capacity into the delivery system.

6 Evidence-Informed Decision Making What supports do health system organizations have in place to facilitate evidence-informed decision making? (Ellen et al., 2013) 57 interviews conducted in 25 organizations Decisions regarding the structure & process of care are often made without the input of timely and reliable evidence

7 What Was Learned Organizational efforts that can increase the use of evidence in decision making: Facilitate roles that actively promote research use within the organization; Establish ties to researchers & opinion leaders outside the organization; Support a technical infrastructure that provides access to research evidence Provision and participation in training programs to enhance staff s capacity building

8 Need for a Healthcare System that Learns We require a sustainable system That gets the right care to the right person at the right time and then Captures the results for making improvements and Knowing what works.

9 21 st Century Health Care Information-rich, patientfocused enterprises Evidence is continually refined as a by-product of care delivery 21 st Century Health Care Information and evidence transform interactions from reactive to proactive (benefits and harms) Actionable information available to clinicians AND patients just in time

10 IOM Roundtable on Value & Science Driven Health Care Fundamental concepts of a learning healthcare organization: Need CEOs to get all stakeholders involved as partners Manage limited bandwidth in terms of research they can support and institutional energy Create a culture that values rapidly deployed research that informs outcomes and efficiency Develop shared research assets to conduct studies and create a community of researchers and stakeholders who reuse resources

11 Case for Continuous Improvement Incorporating Innovation Disciplined QI Research Critical to finding new designs and solutions to close the gaps and meet the goals of optimizing: Patient experience Health of the population Controlling cost/reducing waste.

12 Case for Continuous Improvement Incorporating Innovation Disciplined QI Research How do we know what works? Critical to finding new designs and solutions to close the gaps and meet the goals of optimizing: Patient experience Health of the population Controlling cost/reducing waste.

13 Taking It to Scale The Learning Commons

14 Driving Health System Improvement: Role of the Learning Commons A Vital Resource to Support the Clinical Enterprise in Achieving Mission Critical Performance

15 Science of Large-Scale Change McCannon, Berwick, Massoud in JAMA, 298(16): , 2007 Innovation in Health Care Find or create practices (technologies) that are better than the prevailing ones Quickly make those improvements ubiquitous Failure to deploy improved technologies and practices widely and quickly is a form of waste Charge is to learn about the spread of innovations

16 Intermountain-led National Efforts Hospital Engagement Network (HEN) funded by CMMI Accelerating Change and Transformation in Organizations and Networks (ACTION) III funded by AHRQ

17 The High Value Healthcare Collaborative

18 Dubbed by Press as Dream Team 17

19 Founding Partners 1. Mayo Clinic 2. Intermountain Healthcare 3. Dartmouth Hitchcock Medical Center (The Dartmouth Institute (TDI) data center, convener) 4. Denver Health

20 Partners 5. Baylor Health Care System 6. Scott & White Healthcare 7. University of Iowa Health Care 8. North Shore-Long Island Jewish Health System 9. MaineHealth 10. Providence Health & Services 11. Sutter Health 12. UCLA Medical Center 13. Virginia Mason Medical Center 14. Beth Israel Deaconess Medical Center 15. Hawaii Pacific Health 16. Sinai Health System 17. Eastern Maine 18. University of California at San Diego Department of Defense Tricare (MOA signed)

21 All are integrated delivery systems (+/- insurance ownership vs. partnership) Currently represent ~15% of all care delivery in the U.S. Other systems showing active interest Core funding: Annual member payments supplemented by grants

22 Core Activities Voluntary collaborative projects o Developing a Unified Model for Dissemination, Spread, and Sustainability Supplemented with Arnold Foundation Award o Safety Program To be supplemented with CMMI HEN 2.0 AHRQ Delivery System Learning Laboratory o CMMI Innovation Challenge - ~$120MM Shared Decision Making hip, knee, spine, diabetes, heart failure Sepsis 3 QI projects in complex chronically ill patients o Other examples: Delirium in the ICU; Use of Patient Reported Measures

23 The World is Flat Example European Connections: Comparative Analytics with Sweden Exploring Collaborative Research with France Others

24 Long History of Collaboration in Learning Commons

25 Efforts to Increase the Use of Evidence Facilitate roles that actively promote research use within the organization; Establish ties to researchers & opinion leaders outside the organization; Support a technical infrastructure that provides access to research evidence Provision and participation in programs to enhance staff s capacity building

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