Increasing Influence through papers and books
Situation: Dr. Boustani was an accomplished physician and researcher when we first met. An expert on brain health, he had participated in several successful activities related to treating dementia and Alzheimer’s disease, including a clinical trial demonstrating the benefits of collaborative dementia care and starting the Healthy Aging Brain Center in Indiana. Through his experiences and from rigorous study, he also developed a method for implementing real and sustainable change in a healthcare setting, and he wanted more than anything to disseminate the information so that others could benefit from what he had found.
Result: During our first year together we wrote and published five separate papers in peer-reviewed journals detaling his work in brain health and implementation science. Subsequently, we wrote and published his first book: Agile Implementation, which describes his methodology and explains the theories from behavioral economics and network science upon which his work is based. He has found it to be an extraordinary way to share and disseminate what he feels is crucial information for incorporating evidence-based solutions into healthcare delivery systems. It was such a good collaboration, in fact, that we are currently working on another book together.
Economic evaluation of QI Projects
Situation: An organization who had previously received funding to carry out several quality improvement projects wanted to understand the economic benefits their projects produced. They were curious to identify which projects produced the largest net monetary benefit and which aspects of those projects were the main drivers of those benefits. This would allow them to laud current successes and would provide the necessary information to estimate the potential economic impact of new opportunities needed to solicit federal funding.
Result: Using details of each project provided by the organization, I summarized the quality improvement activities and their impact, and then estimated the relevant impact on specific health metrics, care utilization, adverse events, and medication usage. Upon completion, this organization had a detailed report estimating the potential economic impact of their quality improvement efforts, and when possible, a breakdown of which activities produced the largest benefits.
Situation: An organization with federal funding coordinated quality improvement efforts of several other organizations. Over the previous few years, these organizations had implemented and tracked a number of quality improvement initiatives that had resulted in better care and value for thousands of patients across a wide geographic area. The coordinating organization sought to find a way to laud these successes in a quick summary that was visually appealing and yet informative.
Result: I designed and created a number of “infographics” for several of the specific quality improvement interventions this organization wanted to highlight. Using information they provided, I developed relevant data displays, icons, and graphics to be displayed along side descriptive text and representative quotes of those affected. The organization was able to share these infographics both with their funding agency but also the other organizations and even some of the groups who participated in the individual interventions.
NIH Grant Proposal
Situation: A professor of Medicine at a University was pursuing better treatment for critically ill patients who experience acute respiratory distress. His initial research lead him to believe that future study was warranted, and he needed to obtain funding for a specific experiment. Specifically, he wanted to perform mass-spectrometry on the bronchoalveolar lavage fluid of patients in an attempt to identify specific molecular endotypes that may signal pathway targets to treat the disease.
Result: Together we worked to develop two documents: the first was a manuscript to be submitted to a peer-reviewed journal that would serve as a primary source of documentation of prior work in the topic; the second was an application for an R01 NIH grant to collect the samples perform the necessary analysis. Within a few short months we had produced both documents in time for the desired submission.
Public Health Initiative for Advance Care Planning
Situation: A statewide public health initiative received legislatively appropriated grants to help communities raise awareness about the importance of Advance Care Planning (ACP). At various locations throughout the state, they initiated and lead events aimed at educating community members and helping them think about, talk about, and write down their choices for future health care decisions. As part of a pilot program, multiple locations collected data from participants regarding the community events to assess how the events affected their knowledge of and comfort level regarding ACP. The public health initiative needed to summarize this information and present it in a way that clearly communicated their impact to not only the participating communities, but also to the state that appropriated the grants that funded the events.
Result: Over several meetings and phone calls, we discussed the lessons they had learned and the messages they felt were important to relay, and together developed a vision for what could be presented in a summary report. The final drafts use text and data displays to demonstrate a notably improvement in how participants viewed ACP. After the events, they felt more comfortable talking about end of life choices, and were more likely to complete a healthcare directive and to have conversations with their loved ones. Many participants expressed gratitude for having attended the events and encouraged the program to continue.
Federal Reimbursement Policy
Situation: A national trade association of physicians wanted to understand how proposed policy changes to reimbursement methodologies could affect their member physicians. They had concerns regarding how care providers would be evaluated and compared to determine reimbursement levels, and intended to draft a letter to federal policy makers outlining their concerns.
Result: Using publicly available national data, I explored several hypothetical scenarios to compare current reimbursement criteria with the proposed criteria, to evaluate differences and potential issues associated with these differences. Together with the trade association, we developed a full description of what was done and pointed to specific hypothetical examples with graphs to illustrate the potential issues as we saw them. This analysis was included in a letter to policy makers in an attempt to draw their attention to potential drawbacks of their proposed methodology.
American Medical Association (AMA) • Stratis Health • Oklahoma Foundation for Medical Quality • Optum • University of Minnesota • Indiana University • American Society of Clinical Oncologists (ASCO) • ICSI • Kidney Care Quality Alliance (KCQA) • Medtronic • NYU • Boston Scientific • Harvard Medical School • MPRO • Telligen • E4 Enterprise • Lee Branding • MetaStar