Quality & Saftey
Our investigators aim to improve the quality, safety and equity of healthcare delivery, experience and outcomes. Faculty within the center employ expertise across a variety of initiatives in developing and deploying risk assessment methods; the redesign of systems and processes of care to improve care safety reliability; quality and safety epidemiology; measures development; process improvement; leading quality collaboratives; and the development and analysis of process and outcome measures data collected through local, regional and national quality and safety databases and repositories. Faculty come from a variety of disciplines, including engineering, healthcare management and communications, and from a wide range of medical specialties and settings (including surgery, emergency medicine, obstetrics, pediatrics and endocrinology) as well as healthcare professions (physician medicine, nursing, pharmacy, physical therapy, etc.).
Active Projects
Charlesnika Tyon Evans, PhD, MPH
Evaluating equity in antibiotic stewardship and disparities in appropriateness of antibiotic treatment
Antibiotic overuse is a serious public health crisis and is associated with adverse events including allergic reactions, Clostridioides difficile infection, and antibiotic resistance. New accreditation standards recommend integration of health equity into activities to improve antibiotic prescribing. We propose to conduct a mixed methods study that will evaluate implementation of AS and equity standards and disparities in antibiotic prescribing to close the knowledge gap on understanding drivers of inequity and identify strategies to facilitate equitable antibiotic prescribing in resource-limited settings that treat vulnerable patients.
Improving Safety, Patient Experience, and Equity through Shared Decision-making Huddles
To evaluate the effectiveness of an existing quality improvement (QI) training program known as TeamBirth, using a randomized stepped-wedge hybrid type II study design, to (a) decrease nulliparous term singleton vertex (NTSV) cesarean birth (CB) across all birthing people, and specifically for Black birthing people, and (b) increase shared decision-making (SDM), (c) improve patient experience of respectful care. TeamBirth uses a train-the-trainer model to implement patient-participatory shared decision-making on Labor and Delivery (L&D) units, with the goal of decreasing unwanted and unnecessary interventions and improving patient experiences and outcomes for labor and birth.
Patient-reported health-related quality of life as complex patient outcomes in stroke survivors
In the U.S., approximately 700,000 Americans experience a stroke each year, resulting in substantial morbidity and mortality. Multiple domains of health-related quality of life (HRQoL) are affected in stroke survivors, and in an aging America, we are likely to see an increase in stroke because the risk of stroke increases with age. The rising incidence of stroke and persistent disabilities suggests an urgent need to reduce the burden of stroke. The standard measures for patient outcomes after stroke is the modified Rankin Scale (mRS) which heavily focuses on patient mobility and is less discriminating for other domains of HRQoL (e.g., cognitive function, depression, fatigue). However, patients often have complex patient outcomes with varying degrees of abnormal HRQoL across multiple domains, and not much is known about how these HRQoL scores cluster together. Reductions in HRQoL other than mobility remain difficult to predict, limiting patient outcomes assessment and management. To address this need, we will identify complex patient outcomes after stroke that incorporate multiple domains of HRQoL and determine if variables collected during a patient’s index hospitalization enables prediction of an individual’s complex patient outcome at three-month follow-up. The study’s objectives are to assess differentially identified HRQoL domains as the driver of complex patient outcomes and inform target care improvements that meet the needs of unmeasured and under-treated HRQoL domains.