BRIC_Team_Presentations.ppt

Impact of BRIC

Assessing Our Progress and Imagining Our Future in Health

Services Research

Purpose of BRIC

• Provide funding for implementation of an Institutional Research Infrastructure Development Plan

• Provide funding to support this development centered on a nationally competitive and timely research project

Institutional Research Infrastructure Development Plan• Develop the skills and abilities of faculty • Develop the infrastructure and resources for CHRP

research faculty • Prepare a nationally competitive application • Develop the processes that support forming and

maintaining an interdisciplinary health services research team

• Develop the processes that support timely dissemination of products

Research Project Aims• Develop a model to explain technology acceptance by

primary care physicians within the context of clinical decision support

• Describe the use and acceptance of technology by Nebraska and South Dakota primary care physicians

• Predict the likelihood of voluntary implementation of technology and clinical decision support

• Explore how the findings may be used with MEPS data to predict the potential impact on prescribing safety

• Translate the findings back to office-based practitioners for consideration in practice improvement decisions.

• Develop an external research grant proposal (R01)

Past, Present and Future

• Phase I - Formed of Creighton Health Services Research Program (CHRP)

• Phase II – Building Research Infrastructure Capacity (BRIC) Funding - development of CHRP Research Fellow Mentees, CHRP Leadership, Community Partnerships, University Relationships to build sustainable health services research

• Phase III – Contribution of the university to a sustainable CHRP infrastructure organization post BRIC award

Source – Phase Development GridPhase I Phase II Phase III

HFF CU HFF CU BRIC CU

Shared Infrastructure Support (partial)

Shared Mentorship Individual Expertise Skills Interprofessional Team Skills Project Development Skills Project Implementation Skills Project Dissemination Skills Community/Partner Relationships Competitive Research Projects

CU In Kind Sources of Infrastructure and Development Support

• Health Futures Foundation – launch monies• School of Pharmacy and Health Professions (SPAHP)

– Data Management/Analyst Position – 75%

– CHRP Administrator – 10%

– CHRP Administrative Assistant – 10%

– In kind salary/time for 2 faculty (Galt,Paschal)

• School of Nursing (SON)– In kind salary/time for 1 faculty (Abbott)

– Development expenses shared with CHRP

CHRP Foundation – BRIC Build Capacity 18 month Progress18 month Progress

Faculty Research Scientist Development

•Skills•Performance•Focus •Direction

CHRP Foundation – BRIC Build Capacity

18 month Progress18 month Progress Research Scientist Development

Training

CHRP Research Faculty and Practitioner Researchers

Successful Project Implementation and Completion

Mentoring

Internal Activities External

Activities

Brown Bag SeminarsCampus CoursesIT WorkshopsHSL/LR WorkshopsGrants Administration Workshops

Cyber SeminarsWorkshops and Conferences

College Courses


• Research Team Development


Research Team DevelopmentResearch Team Development

• Intra-team communication • Weekly meetings of prime importance• Shared mental models• Shared resource access• Structured roles and responsibilities• Alignment of individual and group goals• Individual leadership mutually respected• Unique expertise of individuals respected


Research Project DevelopmentResearch Project Development

• Research Project Implementation Plan• Complex research questions; complex project• Roles and Responsibilities of research scientists delineated,

refined as progressed through skill development and external influences on research itself

• Roles and Responsibilities of support staff professionals• Deadlines, revised deadlines, revised deadlines…!• Integration of emerging opportunities onto the project

roadmap…more revised deadlines.


Product Dissemination• Presentations, publications – shared products• Technical reports • News releases and publicity • Additional funding sources to extend research - more

opportunities• Progress in community and organizational partnerships – more

opportunities• Federal study section and special emphasis panel service –

more opportunities• State council and committee appointments – more

opportunities


• Engagement and Dissemination

This project is being supported in part by the grant "Enhancing Clinical Practices through the Adoption of Health Information Technology in Nebraska" through the Nebraska Medical Association and the Creighton Health Services Research Program grant no. 1P20 HS015816 Building Research Infrastructure Capacity from the Agency for Healthcare Research and Quality (AHRQ).

Scientific Leadership

Relationship Leadership

Translating Research to Service

Relationships Within the University - institutionalization?

• School of Nursing• School of Medicine• Within School of Pharmacy and Health Professions• School of Dentistry• College of Arts and Sciences• College of Business Administration• School of Law

Community and Government Relationships 18 month Progress18 month Progress

UNL – BUROS Institute

UNMC School of Allied Health

Creighton Health Services Research Program

Creighton Health Sciences Center

School of Pharmacy and Health Professions; School of Dentistry;

School of Medicine; School of Nursing;

Systems Engineering Initiative for Patient

Safety- University of Wisconsin School of Engineering

QIO – CIMRO of Nebraska

State of Nebraska Medicaid/MedicareOffice of Rural HealthArea Agencies on Aging

UNL – Qualitative and Mixed Methods

Department

*Consumer Board

Creighton Center for Health Policy and

Ethics

VAMCOffice of

Research

Professional Associations

Nebraska Center for Bioterrorism

Preparedness

Uninet

CHRP Foundation – BRIC Build Capacity Where we are at nowWhere we are at now

• Research Scientist Advancement– Expanding our External Engagement with Partners

and Scientist Network

– Identifying Research Streams for Individuals

– Identifying Research Platform for Research Team

• Developing Sustainability Plan– Future Vision

– Infrastructure Discussion and Plan

– Internal and External Visit Consultants

CHRP Foundation – BRIC Build Capacity

Where we are at nowWhere we are at now Infrastructure Impact and Needs

• We may be at the Tipping Point• HFF ends this spring of 2008• BRIC I ends this spring of 2008• Core group of Scientists Developing

– Content expertise

– Research methods expertise

– Research leadership with influence in and outside of Creighton University forming

BRIC Mentee Scientists

J.D. Bramble

Associate ProfessorCreighton Health Service Research ProgramSchool of Pharmacy and Health Professions

Creighton University

Background

• Degrees– Ph.D. in Health Services Organizations & Research

– MPH in Health Administration and Policy

• Research Interest– Influence of organizational issues on patient outcomes

• Teaching– Research Methods and Biostatistics

– Patient Safety Course

– Health Care Management

BRIC Accomplishments

• Research Team/Network• Publications

– Peer reviewed, book chapters and non-peer reviewed.• Grantsmanship

– Participation in AHRQ Special Emphasis Panel– Patient Safety Grant– California Health Care Foundation Grant

• Presentations• Skills

– Mixed Methods– Grant Management

Future Needs

• Continued Skill to Development– Intermediate/Advanced mixed methodology

– Survey design

– SAS/SPSS programming

• Funding/Research Support Opportunities – BRIC II

– R03

– R01

– and anyone else that will give me money

Karen A. Paschal, PT, DPT, MS

Associate ProfessorDepartment of Physical TherapySchool of Pharmacy and Health

Professions

Background• Physical Therapist

– BS (Biology), University of South Dakota – MS (Physical Therapy), Duke University– DPT (Physical Therapy), Creighton University

• Research Training– Doctoral level coursework in research methods with a

focus on qualitative methodology• Interdisciplinary Team Experience

– VA Geriatric Evaluation and Management ProgramClinical Assessment and Research

• IPE 410 Foundation in Patient Safety– Expertise in curriculum design, implementation,

assessment

BRIC as a Process

• Teamwork in research• Development of content knowledge

– Health services orientation– Health information technology

• Model to predict adoption of HIT by PCPs in ambulatory care• Consumer adoption

• Development of research skills in practice– Start to finish

• Development of external relationships– EHR Nebraska– HISPC (NE HHS)

BRIC Products

• Presentations (10)

• Publications (7)

• Grants/contract submissions (2)

Next Steps

– Enhance qualitative research skills• Mentorship in the context of ongoing project(s)

– Consumer security and privacy

– Consumer acceptance

– HIT adoption/interoperability across health care providers

• Interprofessional team member pursuing endeavors in mixed methods initially explored in BRIC I

– Contribute to building a culture of research • Participate on a Special Emphasis Panel as a reviewer

• Funding opportunities (BRIC II; K02)

Mark Siracuse, PharmD, PhD

Assistant ProfessorCreighton University

School of Pharmacy and Health Professions

Background

• Clinician Training and Experience

– B.S. in Pharmacy @ U. of Connecticut (1984)

– Pharm.D. @ U. of Michigan (1994)

– Professional career roles• Community/retail pharmacy practice (primary)

• Home infusion practice

Background (cont.)

• Research training/development (U. of Minnesota)

– Fellowship in Pharmacoeconomics (1996)• Aetna Pharmacy Management• Hoechst Marion Roussel

– M.S. in Social & Administrative Pharmacy (1997)• Thesis: “Impact of Restrictive Drug Formularies in a Large

Managed Care Organization”

– Ph.D. in Social & Administrative Pharmacy (2002)• Dissertation: “Your Pharmacy Future – Factors influencing the

career aspirations of pharmacy students”

What I bring to BRIC

• Faculty member @ Creighton for 5 years• Research skills (Quantitative)

– Research design

– Statistical analysis skills• Multiple linear regression

• Factor analysis

• Path modeling

• SEM using SIMPLIS command language (LISREL)

• Background in Economics & Management• Experience in Community Pharmacy

Accomplishments during BRIC

• Professional Presentations (16)– Lead author on 12 presentations

– Five BRIC related (2 directly)

• Manuscripts/ Publications (10)– Four published

– Four accepted

– Two under review – likely to be accepted

• Published Abstracts (6)• Grants/contracts submissions (4)

Accomplishments during BRIC

• Teaching – PHA442: Pharmacy Practice Management

– PHA452: Pharmacoeconomics

– PHA334: Parenteral Drug products

– PHA486: Dispensing & Pharm Care (2006 only)

– PHA535: Academic Rotation (2006 only)

– PHA399: Independent Research (2007only)

• Course developed: PHA452 (2006)

Personal Outcomes from BRIC

• Skills Developed– Further development of SEM knowledge– Basic understanding of Mixed Methodology– Patient Safety course (IPE410)

• Participation in AHRQ Review Panel (June 2007)– “Ambulatory Safety and Quality: Enabling Patient-

Centered Care Through HIT” • PI on Grant submission to CHCF with BRIC team for

support ($175,000)– “Evaluation of the ePrescribing Pilot project”– Competitive application

• Appreciation of Multi-disciplinary Research Team

Future Needs

• Tenure & Promotion at Creighton– Submit dossier by October 31, 2008– Receive final decision by April 1, 2009

• Skills to Develop and Enhance– Survey design (advanced)– Mixed Methodology (beginner to advanced)

• External Funding Opportunities to Explore– BRIC II (continuation of current BRIC effort)– K02 or K08 with AHRQ– R01 or R03 with AHRQ

Amy A. Abbott Ph.D. (c), RN

Assistant ProfessorCreighton University

School of Nursing

Launching of My Research Career

About Me

• BSN (1992) and MS in Nursing (1998) from CU• ICU RN for 15 years at Level I Trauma Center• Teaching in the SON since spring 1996• Expert witness consulting• Attained tenure Spring 2007• Clinical focus adult critical care and complex

medical-surgical nursing • Ph.D. candidate at University of Nebraska Medical

Center College of Nursing with focus in cardiovascular symptom management

• Limited research experience

BRIC Influences

• Multidisciplinary team experiences– Manuscript preparation– Manuscript reviews– Presentations– Qualitative research

• New knowledge-base– Patient safety– Electronic health records– Health information technology – Patient-physician relationship– Mixed methods research

• Networking and consultation

Development from BRIC

• CHRP membership• Faculty for IPE Patient Safety Course in 2008• Publication on privacy in health information

exchange• Survey development• Qualitative research exposure

Research Trajectory & Goals

• Obtain promotion at CU• Continue with BRIC team to address additional

patient safety concerns and extend into nursing• Cardiovascular patient safety avenues and other needs

related to symptom management• Disseminate research • Obtain external funding (BRIC II, K02 or K08)• Serve on review panel

Kevin Fuji, Pharm.D.

Research FellowCreighton Health Service Research ProgramSchool of Pharmacy and Health Professions

Creighton University

Life Before BRIC

• Graduated in May 2007 from Creighton SPAHP• No formal research training• Only prior research experience was during 4th year

clinical clerkships– Academic and research clerkships

• Wanted to pursue a career in research and academia

Personal Development during BRIC• CHRP Research Fellow (June 2007 – July 2009)• BRIC Project Coordinator• A lot of progress in a short period of time

– “Piggyback” on existing projects• Community infrastructure• Pharmacists for Patient Safety

– What to do with ideas• Authorship guidelines for multidisciplinary teams• Research skills in pharmacy curriculum

– Submitted a small grant application to ACCP• Related to BRIC grant work

– Review panel (Perspectives in Health Information Management)– Teamwork and multidisciplinary interaction– Co-Coordinator of IPE 410 Patient Safety Elective Course (2008)

Future Development

• Continued progress toward career in research and academia

• BRIC team and CHRP• K08 award

– Mentored Clinical Scientist Development Award• Goal of an independent health services researcher

– Research development support provided• Pursue a graduate degree

– Institution must show commitment to the candidate• Research infrastructure is needed• Strength of CHRP as a multidisciplinary program

Andjela Drincic, M.D.

BRIC is more than survey work !

Background: Life Before BRIC • Clinical endocrinologist (2 years of clinical

fellowship) • No formal research training • At Creighton University for 2 years before entering

BRIC • Assistant Professor of Medicine, Clinical educator

track – Developed busy clinical practice – As director of Clinical Diabetes Program developed

experience working within large administrative systems, outpatient and inpatient

• Limited academic activity resulting in a few abstracts, posters and two book chapters and a with a few research ideas

BRIC needs - basic stuff

• Learn basics of grant proposal planning and writing

• Understand principles of research methodology (all new terms): – quantitative

– qualitative

– mixed methods

BRIC life • Learning the basics of research

– Survey methodology – Quantitative data analysis – Basic understanding of qualitative research

• Learning to productively work together with other team members

• Gaining new core knowledge– Patient safety – RCA– Patient physician relationship

• Translating gained knowledge– Published paper in patient safety field – Teach in patient safety course (RCA) – Working on a review paper in HIT/patient physician relationship

• Taking Basic Statistics Course (UNL)

BRIC influences

• Successful grant application (PI) in investigator initiated grant, clinical research

• Co-PI on two other multidisciplinary grants (clinical research in diabetes and asthma field)

• Grant submission to CHCF with BRIC team for support ($175,000)– “Evaluation of the ePrescribing Pilot project”

Life outside of BRIC

• Teamwork influence • Associate Program Director, Endocrinology

Fellowship Program– Complete revision of the whole fellowship

– Developed new education curriculum with strong interdisciplinary approach to education

• Paper accepted • Currently working on two more papers

BRIC wants/hopes

• BRIC 2 – Need further education in research methodology

• To develop a sustainable and protracted research activity with other BRIC members with ties to clinical endocrinology – Patient safety – HIT – Patient–physician relationship

• Foundation for further professional/personal growth • Where to go next?

– KO8 ?

Kimberly A. Galt, PharmD

Final Thoughts

Personal Observations

• From Individual… to Group… to Team• Characteristics of Our Research Community – Stronger

than Individual• Team – Essential to Advancing Research on Complex

Questions• Reconciling Team Needs with

– Individuals

– larger CHRP network

– Community Partner Needs

• Team – addresses Isolation with Integration

Critical Relationships

• Kay Anderson - AHRQ• Consultants

– John Creswell

– Margaret Love

– Steven Fleming

• Dennis Berens – NHHS Office of Rural Health

Value of this Health Services Research Scientist Core

• Note the personal viewpoints of each core scientist today

• They see differently and with greater vision• Other leaders relate and want to have a solid support

system for the important research work (Drs. McQuillan, Gorby, others?)

Source – Phase Development GridPhase I Phase II Phase III

(Spring ’08)

HFF CU HFF CU BRIC CU

Shared Infrastructure Support (partial)

Shared Mentorship Individual Expertise Skills Interprofessional Team Skills Project Development Skills Project Implementation Skills Project Dissemination Skills Community/Partner Relationships Competitive Research Projects

How to Include?

• How do we sustain what we have developed?• How do we accommodate those who want and need

this support?• How do we provide others these opportunities?

Moving Forward – What Should our Future Look Like?

• “Imagination is the only key to the future. Without it none exists – with it all things are possible.” Ida M. Tarbell, American journalist (1857 – 1944)

• A sustainable health services research program:– What should BRIC II look like?

– What forms of involvement would you want to have with this effort?

– What research related needs might you want to have furthered with this effort?

BRIC_Team_Presentations.ppt

Education

Transcript of BRIC_Team_Presentations.ppt