Scholarly & Quality Improvement Work
Topics of Focus
- Characterizing clinical deterioration preceding transfer to the Intensive Care Unit
- Improving processes of care related to RRTs (rapid response teams)
- Improving clinicians’ awareness of costs of common diagnostic tests
- Developing risk models for patients hospitalized with acute myocardial infarction
- Evaluating variation in hospital costs for common medical condition
- Improving care transitions into, within, and out of the hospital setting
Inpatient Care Escalation
Drs. Christopher Sankey and Sarwat Chaudhry are conducting analyses of data from patients at YNHH transferred from non-ICU beds to MICU over the past two years to characterize onset of clinical deterioration prior to transfer. The ultimate goal of this work is to improve the timeliness of response to clinically deteriorating patients in the hospital setting.
With the recent establishment of the Center for Healthcare Innovation, Redesign, and Learning (CHIRAL), made possible through funding by the Agency for Healthcare Research and Quality (AHRQ), the Yale Academic Hospitalist Group is poised to lead national efforts to address safety and quality threats to hospitalized patients. CHIRAL’s focus is on care transitions, encompassing the full range of care transitions into, within, and out of the hospital setting.
Hospital Onset Sepsis
Drs. Fogerty and Sankey are co-Primary Investigators on an award from MCIC Vermont. The aim is to improve the early identification of hospital onset sepsis in medical inpatients using the electronic health record to expedite identification and treatment of these high risk situations.
Dr. Sarwat Chaudhry is the Principle Investigator of a multi-center observational study, SILVER-AMI, which focuses on risk stratification for adverse outcomes after hospitalization for AMI in older patients. This study integrates principles from both geriatrics and cardiology to develop post-AMI risk models specifically designed for patients 75 years of age and older.
At the Center for Outcomes Research and Evaluation (CORE), the Yale Academic Hospitalist Group leads a cost stream of analysis whose goal is to estimate the variation in payments for Medicare patients based on care decisions at the hospital level. Currently the team is estimating payments in acute myocardial infarction, congestive heart failure, and pneumonia. They compare payments at the hospital-level to quality of care at the hospital-level to construct a sense of the relative value of care across hospitals. Given the unsustainable rise in healthcare costs, understanding the value of care plays a critical role in finding successful solutions to challenging healthcare needs.