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Christiana Care Value Institute Newsletter | Issue 4, WINTER 2015-2016
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Tabassum Salam, M.D., Director of Care Link; Patricia Curtin, M.D., Chair of Geriatrics; Ina Li, M.D., Director of the Independence at Home Demonstration Project; Eric V. Jackson, Jr., M.D., MBA, Director, Health Care Delivery Science, Associate Director, Value Institute; Tim Gardner, M.D., Medical Director of the Center for Heart and Vascular Health and the Executive Director of the Value Institute; Keynote Speaker Mary Naylor; Rhonda Combs, RN, MSN, BC, (former) Chief Operations Officer of the Christiana Care Visiting Nurse Association; Sharon Anderson, RN, BSN, MS, FACHE, Senior Vice President of Quality, Patient Safety and Population Health.
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Value Institute Hosts Fall Symposium on Transitional Care
Improving care transitions for adults is central to achieving value in health care, and to be most effective, those improvements must take into consideration outcomes that matter most to patients and their families.
That was the message Mary D. Naylor, Ph.D., RN, FAAN, one of the nation’s leading experts in transitional care, delivered to an audience of nearly 250 people at the Christiana Care Value Institute Fall Symposium, Oct. 5 at the John H. Ammon Medical Education Center at Christiana Hospital.
At the symposium, titled “Transitional Care: Bridging the Gap for At-Risk Populations,” Christiana Care staff learned about Naylor’s extensive research in the field of transitional care and showcased the Independence at Home Demonstration Project and Care Link, two innovative transitional-care programs piloted at Christiana Care.
“The work we’re engaged in today is about advancing The Christiana Care Way, making sure our neighbors achieve optimal health, have exceptional experiences and that we, as an organization, have the vitality we need to give back to the community,” said Janice E. Nevin, M.D, MPH, president and CEO of Christiana Care.
Naylor, the Marian S. Ware Professor of Gerontology and director of NewCourtland Center for Transitions and Health at the University of Pennsylvania School of Nursing, created the Transitional Care Model, which offers high-quality, evidence-based, cost-effective solutions to the unique problems faced by chronically ill, at-risk patients as they move from one care setting to another.
Those problems often include high rates of medication errors and other safety issues, serious unmet patient and family caregiver needs, and poor patient care experiences, all of which lead to high rates of preventable rehospitalizations and tremendous human and cost burdens.
“The Transitional Care Model addresses root causes of poor outcomes, with a focus on longer-term value,” Naylor said. The model emphasizes engaging patients and caregivers as partners in their own care and creating care continuity between settings.
Naylor said streamlining and simplifying the coordination of care, including assigning patients a single contact person supported by their whole health care team, helps improve patient adherence and outcomes.
“In multiple clinical trials funded by the National Institutes of Health, the Transitional Care Model consistently has demonstrated improvements among at-risk, chronically ill older adults as well as reductions in total costs of care, relative to standard care,” Naylor said. “We demonstrated we can increase access to care, reduce errors and symptoms, and enhance the care experience and quality of life.”
Within Christiana Care, two programs accomplish similar goals.
During the symposium, Ina Li, M.D., associate director of Geriatrics and medical director of the Visiting Nurse Association at Christiana Care, spoke about the Independence at Home Demonstration project. Christiana Care was one of 16 sites chosen by the U.S. Centers for Medicare and Medicaid Services to pilot the home-based primary care program, which focuses on keeping frail elderly patients in their homes as long as possible.
Tabassum Salam, M.D., medical director of Care Link, spoke about the innovative care-management teams established as part of Christiana Care’s Bridging the Divides initiative. The teams provide patients with a multidisciplinary care team to help with coordination of care, discharge planning and post-hospitalization patient advocacy.
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National Science Foundation Smart and Connected Health Program Funds “S.E.P.S.I.S.: Sepsis Early Prediction Support Implementation System”
The National Science Foundation has awarded Christiana Care a prestigious grant so the health system can build on its intensive efforts to improve early identification and intervention of sepsis.
The National Science Foundation, which is an independent federal agency that promotes the advancement of national health, awarded Christiana Care a three-year grant for “SEPSIS: Sepsis Early Prediction Support Implementation System.” This $1.2 million initiative is part of a research collaboration between the Value Institute, Mayo Clinic and North Carolina State University.
The grant includes funding for four computer science and industrial engineering Ph.D. candidates from NC State and summer students from Delaware to work with Christiana Care and Mayo Clinic to develop machine learning, predictive analytics, and systems optimization algorithms to detect patients at risk for sepsis.
Sepsis, a deadly combination of infection and inflammation, is a considerable burden on health care services throughout the world, with far-reaching human and economic costs. The disease is present, or develops, in approximately one of every 23 hospital admissions and, with increasing incidence and a high case-fatality rate, accounts for nearly half of all hospital deaths according to the U.S. Agency for Healthcare Research and Quality.
Muge Capan, Ph.D., associate director of Health Systems Optimization at the Value Institute, will serve as principal investigator for the project, funded by the National Science Foundation’s Smart and Connected Health program to accelerate the development and use of innovative approaches that are person-centered and proactive.
The initiative, Capan stated, builds on current efforts to integrate electronic health records and clinical expertise to provide an evidence-based framework to diagnose and accurately risk-stratify patients within the sepsis spectrum. In addition, the initiative develops and validates intervention policies that inform sepsis treatment decisions.
“Sepsis often goes undiagnosed in its early stages, when aggressive antibiotic treatment has the potential to reverse the course of infection; this project seeks to address that issue,” Capan said. “For every one-hour delay in antibiotic treatment of severe sepsis or septic shock, there is an incremental decrease in patient survival – a five-hour delay decreases survival by 50 percent.”
Early diagnostic and therapeutic response to sepsis has the potential to significantly improve the patients’ health trajectory. Specifically, the ability to determine the risk of sepsis-related deterioration due to delayed intervention “is crucial to ensuring high-level patient care and safety,” Capan said.
The goals of the SEPSIS project are to:
- Develop data-driven models to classify patients according to their clinical progression to diagnose sepsis and predict the risk of deterioration, thus informing therapeutic actions.
- Develop personalized intervention policies for patients within the sepsis spectrum.
- Develop decision support systems for personalized interventions focused on resource implications and usability within a real hospital setting.
Researchers propose to achieve these goals by analyzing patient records across two large-scale health systems – Christiana Care and Mayo Clinic – in two geographically and demographically different study populations in order to inform clinical decision-making while simultaneously advancing engineering knowledge and educating care providers.
“The establishment of these models of disease can be discovered from electronic health records,” Capan said. “The statistical model of competing discovery algorithms promises to shed new light on the nature of sepsis.”
Team Champions: Muge Capan, Ph.D., Associate Director, Health Systems Optimization, Value Institute; Ryan Arnold, M.D., MS, Emergency Medicine and Clinical Investigator, Value Institute; Kristen Miller, DrPH, Associate Director, Human Factors, Value Institute; Eric V. Jackson, Jr., M.D., MBA, Director, Health Care Delivery Science, Associate Director, Value Institute.
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Clinical Innovations
Electronic Nurse Screening Assessment Goes Live in 25 Units to Help Detect Early Signs of Physiologically Deteriorating Patients
Nurses in 25 units across Christiana and Wilmington hospitals are using an innovative electronic Nurse Screening Assessment to help identify patients at risk of physiologic deterioration.
The electronic Nurse Screening Assessment was tested during a three-month pilot of the Christiana Care Early Warning System (CEWS) that took place in early 2015. The CEWS study, a collaboration between the Value Institute and the Department of Quality, Patient Safety and Population Health, uses the electronic Nurse Screening Assessment to augment traditional vital-sign monitoring included in electronic health records to identify declining patients earlier and more reliably.
The assessments collect nurses’ first-hand observations of various clinical symptoms that may be indicative of a patient’s health, rather than depending solely on clinical interpretation of vital signs to flag patients who are deteriorating physiologically.
The Nurse Screening Assessment targets various health assessment categories and integration into the nursing workflow. The nursing assessments, which are updated regularly during a hospital stay, go beyond vital signs to focus on clinical variables in patients’ electronic health records that are reflective of their health condition. For example, the assessments show whether a patient has adequate nutritional intake or is chewing and swallowing without difficulty. Such characteristics make the nursing assessment data particularly important in detecting early signals of physiologic deterioration in hospital settings.
The form was developed by a team of critical care experts, nurses, respiratory therapists, industrial engineers and health information technology experts. It includes multiple-choice statements that focus on food, respiratory, neurological, musculoskeletal, gastrointestinal, genitourinary, and electronically pulled elements. The form was integrated into the institutional electronic health records system and activated for the pilot units during the study period. Nurses are required to complete the forms three times daily.
During the CEWS pilot, nurses in four units were asked to use the new electronic Nurse Screening Assessment form. Based on the success of the pilot, the electronic Nurse Screening Assessment went live Dec. 1.
“Our findings showed that adding each Nurse Screening Assessment category separately improved the performance of the Christiana Care Early Warning System in predicting patient outcomes such as the need for Rapid Response Teams and Code Blues, and the likelihood of death, all within 24 hours,” said Muge Capan, Ph.D., associate director of Health System Optimization at the Value Institute.
Health Care Delivery Science
Solutions to Sepsis Presented at International Conference
Two abstracts authored by a team of Value Institute researchers were presented at The UK Sepsis Trust’s
“Sepsis Unplugged” conference, held May 21 and 22 in Nottingham, England.
Kristen Miller, DrPH, MSPH, associate director of Human Factors for the Value Institute, attended the conference as a representative of the Value Institute and a member of Christiana Care’s Sepsis Value Improvement Team, a multidisciplinary group working to find ways to improve the recognition and response to serious infections. The conference brought together health professionals, patient groups and policymakers in pragmatic sessions focused on novel solutions to the challenges care providers face in identifying and treating sepsis.
“The Value Institute is dedicated to the development and evaluation of early warning systems for deteriorating patients,” Miller said. “By providing timely, patient-focused care, and by making sepsis care more affordable and effective through early interventions, we expect to achieve reduced resource use and complication rates that support the Triple Aim of improving health, improving care and reducing costs.”
The conference demonstrated that health care providers around the world face the same challenges Christiana Care is trying to address and overcome related to early identification and rapid response to sepsis. Sessions specifically addressed human factors, early warning systems and the importance of recognizing and responding to sepsis in the Emergency Department – all topics that relate directly to work under way at the Value Institute.
The two Value Institute abstracts Miller presented at the conference were “Implementing a Sepsis Process of Care Assessment to Provide Patient-Specific Feedback to Clinicians” and “A Human Factors Framework for Optimizing Sepsis Alert Design for Clinical Decision Support,” the latter of which was a finalist for a £1,000 grant from the UK Sepsis Trust.
Team Champions: Kristen Miller, DrPH, MSPH, Associate Director, Human Factors, Value Institute; Muge Capan, Ph.D., Associate Director, Health Systems Optimization, Value Institute; Pan Wu, Ph.D., Senior Biostatistician, Value Institute; Eric V. Jackson, Jr., M.D., MBA, Director, Health Care Delivery Science, Associate Director, Value Institute; Ryan Arnold, M.D., MS, Emergency Medicine and Clinical Investigator, Value Institute.
Center for Quality & Patient Safety
Christiana Care Redesigns Safety Procedures to Eliminate Wrong-Site Surgeries
Fifteen health service areas within Christiana Care recently redesigned their safety procedures to promote patient safety and eliminate harm caused by wrong-site surgeries through the reduction of variation and the promotion of new safe surgery and procedure practices.
Overseen by the Value Institute’s Center for Quality and Patient Safety, the project examined the use of Universal Protocol, a Joint Commission requirement created to prevent wrong person, wrong procedure, wrong site surgery in hospitals and outpatient settings.
The process consists of three steps:
- A pre-operative/ pre-procedure verification process.
- A marking of the operative/procedure site.
- A Time Out performed immediately before starting the operation/procedure.
The Center for Quality and Patient Safety partnered with Kathleen Harder, Ph.D., director of the Center for Design in Health and director of Graduate Studies for the Human Factors Program at the University of Minnesota, on the project. Using observational status, Harder, who created the Joint Commission-endorsed Safe Surgery process, determined that wrong-site surgical events at Christiana Care stemmed from causes that are similar to causes at other health care organizations she has helped.
As a leadership imperative, the redesign project was endorsed and initiated in January 2014. Sixteen interdisciplinary teams from the 15 service areas worked with Harder to analyze their current processes, identify gaps and customize new processes to fit their respective workflows.
The following teams participated in the project:
- Breast Center.
- Cancer Multidisciplinary Care Center.
- Emergency Medicine.
- Endoscopy Suites.
- Family & Community Medicine.
- Heart & Vascular Interventional Services.
- Labor & Delivery.
- Medical Group of Christiana Care.
- Medicine.
- Oral & Maxillofacial Surgery and Hospital Dentistry.
- Pediatrics.
- Perioperative Services.
- Psychiatry.
- Radiation Oncology.
- Radiology.
- Surgery.
The service lines and essential services involved in the redesign have since trained physicians and staff in the new processes, allowing full implementation of the redesigned safety procedures in October.
Team Champions: Kenneth Silverstein, M.D., MBA, Chief Clinical Officer, Christiana Care; Mike Eppehimer, MHSA, FACHE, Senior Vice President, Service Line Operations; Judy Townsley, MSN, RN, CPAN, Vice President, Perioperative Services; Gerard Fulda, M.D., FACS, FCCM, FCCP, Chair, Surgery; Ann Principe, MSM, RN, Center for Quality and Patient Safety, Value Institute.
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Current Events
The Advanced Quality and Safety Improvement Science Program has reached its halfway point and will conclude in May 2016.
The newly-expanded Resident Research Training Program is entering the fourth month of a two-year program under the leadership of Christiana Care Infection Prevention Officer and Hospital Epidemiologist and Value Institute Scholar Marci Drees, M.D., MS, FACP, DTMH, with 25 participants representing numerous residency programs.
2016 Upcoming Value Institute Academy programs
Quality TIPs: Teams Improving Process
Third Thursday of every month
11:30 a.m. – 1 p.m.
Sessions that provide insight and consultation on project design, process flow analysis, and how to measure effectiveness and quantify improvement. Lunch is provided.
IHI Open School Modules
Sessions are on-going
The IHI (Institute for Healthcare Improvement) Open School for Health Professions is an interprofessional educational community that gives learners the skills to become change agents in health care improvement and is free of charge to Christiana Care employees. Modules may be completed online at your convenience. The IHI Open School currently offers a range of online, on demand courses in the areas of quality improvement, patient safety, patient- and family-centered care, the management of health care operations, leadership, teamwork and communication, and population health.
TeamSTEPPS: Developing Effective Clinical Teams
Fourth Wednesday & Thursday of every month
11:30 a.m. – 1 p.m.
TeamSTEPPS* (Team Strategies & Tools to Enhance Performance & Patient Safety) is an introduction to TeamSTEPPS* strategies and tools under the framework of patient-centered care to enhance clinical team effectiveness and build high performing teams. The program is evidence-based and designed to improve communication and teamwork skills.
IHI Expeditions
An IHI Expedition is a topic-specific, action-focused, online program, lasting three to five months, designed to help front-line teams make rapid improvements in key areas. Think of it as an intensive virtual support system, enabling widespread uptake of an important hospital improvement. The Value Institute Academy sponsors Christiana Care’s IHI Passport membership, which allows Christiana Care staff to access these programs at no additional charge. Participants access these interactive topic-specific webinars from their own computers and Christiana Care workstations.
Implementing a population-based approach to prevent injuries from falls
January 20, 2016
Building upon experience with both falls and the Triple Aim, IHI faculty experts will help participating hospitals apply both general and population-specific approaches. During the six sessions of this web-based program, teams that take part will learn about valuable tools, strategies, and patient engagement practices to keep patients safe long after the Expedition has ended.
Improving care transitions to reduce readmissions
February 4, 2016
Over the course of five sessions, expert faculty will teach participants to reassess how they handle all hospitalizations (not just readmissions). Successful organizations will share how they improved care coordination processes within and across settings.
Improving communication to enhance cultural competency
March 10, 2016
Over the course of five web-based sessions, participants will learn to avoid the misunderstandings, stereotyping, and weak collaboration that occurs when health care providers fail to recognize their patients' backgrounds, beliefs, languages, and cultures. We will use brief case studies and patient stories to help illustrate the practical implications of improving cultural competency.
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Rama Bah, PCT, Katie Heller, RN, Michelle Maurer, RN, Sharon Simeone, RN, Lisa Stoltz, RN, and Lenore Porter, RN, discuss the care of patients during a shift change brief, an initiative that came out of a Black Belt project known as “Transform Nursing Care Delivery."
Center for Organizational Excellence
Center for Organizational Excellence Awards Black Belt Certification to Eight Employees
Eight employees have completed certification to become the first improvement science leaders at Christiana Care to earn Lean Six Sigma Black Belts.
The yearlong program is a customer-focused model of quality improvement that both trains and coaches staff in performance improvement science. Candidates have been taught a systematic method for applying data-driven analysis to focus on a problem while enlisting allies within Christiana Care to bring about lasting improvement.
“The Lean Six Sigma Black Belt program is a rigorous experience that builds on earlier Green Belt training and prepares candidates to be quality improvement leaders by preparing them to identify and initiate projects that will make patient care better, safer and more efficient,” said
Vernon Alders, MHCDS, MBA, MSW, corporate director of Organizational Excellence and director of the Center for Organizational Excellence at the Value Institute.
Earlier this year, Christiana Care received an Everest Award, an honor bestowed on a prestigious group of 17 hospitals setting national benchmarks for the fastest five-year rate of improvement. Quality management, such as that fostered by Lean Six Sigma, has a role to play in achieving this level of excellence, said Alders.
Those completing the new Black Belt certification are the following:
- Luz Reyes-Laureano, MLS, ASCP, a medical laboratory scientist; and Kevin Hawkins, a senior business analyst. Their project dealt with “Improving the Wound Care Packing Communication Process.”
- Michelle Collins, MSN, RN-BC, ACNS-BC, director of Nursing Development and Education, as well as Wound Ostomy and Continence Nursing; and Adrian Fedyk, medicine finance manager, whose project improved “Inter-unit Transfers.”
- Susan Mascioli, MS, BSN, RN, CPHQ, NEA-BC, director of Nursing Quality and Safety; and John Emberger, BS, RRT, FAARC, a respiratory therapist recently named performance improvement program manager for the Department of Medicine. Their team worked on a project to “Reduce the time from Decision to Admit to Bed Ready.”
- Janet Cunningham, MHA, RN, NE-BC, CENP, former vice president of Professional Excellence and former associate chief nursing officer; and June Estock, MSN, RN, CPHQ, LBB, a senior consultant in Organizational Excellence. They worked to “Transform Nursing Care Delivery.”
Value Institute Academy
Three Christiana Care Physicians Selected as Institute for Healthcare Improvement Scholars
 The Value Institute Academy has named three Christiana Care physicians to participate in the 2015-16 Institute for Healthcare Improvement (IHI) Scholars Program, offered in collaboration with the Alliance of Independent Academic Medical Centers.
The three scholars, who represent diverse areas within Christiana Care, are the following:
- Mitchell Saltzberg, M.D., FAHA, FACC, medical director, Heart Failure Program.
- Stephen Eppes, M.D., director of Pediatric Infectious Disease and associate infection prevention officer.
- Julie Cooper, M.D., Emergency Medicine.
Over the course of the six-month program, the three physicians will lead quality improvement projects within Christiana Care while meeting face-to-face and virtually with other Improvement Scholars from around the country.
Through the program, they will advance their knowledge of improvement methods, network with IHI leaders and faculty, and gain hands-on improvement experience.
In addition to learning how to conduct rigorous quality and safety projects, scholars will have the opportunity to publish and present their improvement work.
The work of the scholars is aimed at improving quality and safety. For example:
- Dr. Cooper’s project is on initiating Emergency Department screening for patients who may benefit from Palliative Care services to facilitate earlier consultation.
- Dr. Eppes’ project is on reducing hospital-acquired Clostridium difficile infections through improved diagnostic testing and environmental cleaning.
- Dr. Saltzberg’s project is on standardizing and streamlining diuretic therapies for heart failure patients.
Past participants include the following:
- Marci Drees, M.D., M.S., FACP, DTHM, infection prevention officer and hospital epidemiologist, who focused on the impact of ventilator settings on ventilator-associated conditions.
- Kate Groner, M.D., Emergency Medicine physician, who studied the impact of care coordinators in the Emergency Department.
- Surekha Bhamidipati, M.D., of Christiana Care Hospitalist Partners, who looked at improving interdisciplinary rounding team communication by testing and measuring a series of interventions.
The Value Institute funds tuition costs for the program with sponsoring service lines supporting travel expenses for participants.
Team Champions: Timothy Gardner, M.D., Executive Director, Value Institute, Medical Director, Center for Heart & Vascular Health; Eric V. Jackson, Jr., M.D., MBA, Director, Health Care Delivery Science, Associate Director, Value Institute; Neil Jasani, M.D., MBA, FACEP, Chief Academic Officer, Vice President of Medical Affairs, Chief Learning Officer, Learning Institute.
Roshni Guerry, M.D., Medical Director of Palliative Medicine and a Value Institute scholar, helped University of Delaware junior Dunia Tonob on an INBRE project that explored the value of palliative medicine in Christiana Care’s Medical Intensive Care Units.
Education Spotlight
INBRE Scholars advance Value
Twelve Delaware undergraduates assisted Christiana Care Health System staff during this past summer in gathering data on important research topics that may one day lead to improved treatments and greater efficiencies in the delivery of care.
The undergraduates took part in lively oral and poster presentations at the 2015 Scholars Research Day & Luncheon Aug. 14 at the John H. Ammon Medical Education Center, where student scholars summarized their research in PowerPoint talks and answered audience questions about their findings.
Ten scholars worked with Christiana Care mentors through the Delaware Institutional Development Award (IDeA) Network of Biomedical Research Excellence (INBRE) program in collaboration with the Value Institute, and two students participated through the Value Institute’s Harrington Fund Student Summer Research Scholarship.
“These are talented students asking vital questions that those of us who are clinicians would like answers to, as we focus on improving the quality of care for our patients,” said Sandra P. Medinilla M.D., MPH, trauma surgeon and medical director of violence prevention. “I think it’s also great for Christiana Care to be invested in the community and to help train the future generation of clinicians and researchers.”
This year, Christiana Care made a concerted effort to include low-income students, first-generation college students and students from ethnic and racial groups that are often under-represented in research funding, said Delaware INBRE principal investigator Scott Siegel, Ph.D.
The Delaware INBRE program is funded through the National Institute of General Medical Sciences, part of the U.S. National Institutes of Health, and the Delaware Economic Development Office, the state’s lead economic development organization. The broad aims of Delaware INBRE are the following:
- To foster a statewide network of biomedical research.
- To develop individual researchers and research institutions.
- To cultivate biomedical initiatives while enhancing the state’s knowledge base and collaborations within the field.
For the scholars, the 10-week INBRE program is a rare opportunity to research medical issues from clinical and public health perspectives. They also have a chance to work closely with Christiana Care providers in ways that help students assess future careers as graduate researchers or health care providers.
University of Delaware junior Dunia Tonob worked under the guidance of Roshni Guerry, M.D., medical director of Palliative Medicine and a scholar in the Value Institute.
Tonob compared a sample of patients in the Medical Intensive Care Unit who received palliative medical consults with those who did not. In the study, Tonob explored the value that palliative medicine adds to patient care. She found that patients with palliative consults tend to receive treatment that aligns with their goals, are more likely to be discharged to hospice care and less likely to be readmitted to the hospital.
“The summer program is very rewarding and gives us the chance to assist very gifted doctors,” said Tonob, who is considering pursuing a career as a pediatrician. “I loved working with Dr. Roshni Guerry.”
Seema Sonnad, Ph.D., the former director of the Value Institute’s Health Services Research who tragically passed away in May, was recognized during the program for the significant role she played in selecting scholars and supporting INBRE.
New Staff at the Value Institute
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Pete Lodato, MPH
Research Associate
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Liz Brown, M.D., MSHP
Harrington Clinician Scholar
Value Institute and Dept. of Family & Community Medicine
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New Scholars at the Value Institute
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Christopher Martin, M.D.
Department of Psychiatry
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Joanne McAuliffe, DNP, MSN/BA, BSN, RN, OCN, NEA-BC
Vice President of Patient Care Services
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Laura McLafferty, M.D.
Department of Psychiatry
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Scholar Spotlight
Trauma Surgery Chief Mark Cipolle Partners with Value Institute
Mark Cipolle, M.D., Ph.D., FACS, FCCM, earned his bachelor's degree in biology from Augustana College, Rock Island, Illinois. He earned a master's and doctorate degree in physiology and biophysics from the University of Illinois, Urbana-Champaign. His medical degree was also obtained from the University of Illinois, Urbana-Champaign. He completed a residency in general surgery at the University of Illinois Chicago, Cook County and West Side VA Medical Center. Dr. Cipolle also completed fellowships in trauma/surgical critical care surgery and critical care research at the University of Minnesota.
He is a fellow of the American College of Surgeons and the American College of Critical Care Medicine. Dr. Cipolle's special interests are in management of complex abdominal hernia, venous thromboembolism, and the development of practice management guidelines in trauma and critical care.
Getting Involved
The Value Institute is built on a model of high-level collaboration. The Value Institute partners with academic institutions, corporations, health care professionals, and thought leaders who share our commitment to improving health care value and delivery by turning evidence into reality. We cultivate relationships with patients, clinicians, sponsors, and professional colleagues who recognize the importance of improving health care delivery and health outcomes, organizational excellence, and quality and safety.
You can partner with the Value Institute on collaborative research, including clinical trials, database studies, and demonstration projects. Christiana Care providers can connect with the Value Institute by submitting a Consultation Request. One of our team members will then contact you to discuss your research plans. Value Institute staff members are actively involved in 89 research projects in a variety of disciplines.
Awards
Educator and Researcher Recognition Awards
Tze Chiam, Ph.D., associate director of Research Informatics at the Value Institute, received a Delaware CTR Mentored Research Development Award for his research project “Development of a Prediction Model for Clinical Outcomes and Costs Associated with Cardiac Surgery." Chiam will be mentored by William Weintraub, M.D., MACC, FAHA, FESC, John H. Ammon Chair of Cardiology at Christiana Care and director of the Value Institute’s Center for Outcomes Research.
Muge Capan, Ph.D., associate director of Health Systems Optimization at the Value Institute; Kristen Miller, DrPH , associate director of Human Factors at the Value Institute; Ryan Arnold, M.D., Emergency Medicine and clinical investigator at the Value Institute; and Pan Wu, Ph.D., senior biostatistician at the Value Institute, received a Delaware CTR Pilot Program Grant for the project “Sepsis Visual Risk Profiling Model." The team will be mentored by William Weintraub, M.D., MACC, FAHA, FESC, John H. Ammon Chair of Cardiology at Christiana Care and director of the Value Institute’s Center for Outcomes Research, and J. Sanford (Sandy) Schwartz, M.D., Leon Hess Professor in Internal Medicine at the Perelman School of Medicine and Professor of Health Care Management at The Wharton School of the University of Pennsylvania.
Selected Publications
Capan M, Ivy J, Rohleder T, Hickman J, Huddleston J. Individualizing and optimizing the use of early warning scores in acute medical care for deteriorating hospitalized patients. Resuscitation. 2015 Aug; 93:107-12. PMID: 25597597..
Elliott DJ, Williams KD, Wu P, Kher HV, Michalec B, Reinbold N, Coletti CM, Patel BJ, Dressler RM. An Interdepartmental Care Model to Expedite Admission from the Emergency Department to the Medical ICU. Joint Commission Journal on Quality and Patient Safety. 2015 Dec; 41(12):542-9. PMID: 26567144.
Kramer C, Appelbaum E, Desai M, Desvigne-Nickens P, DiMarco J, Friedrich M, Geller N, Heckler S, Ho C, Jerosch-Herold M, Ivey E, Keleti J, Kim D, Kolm P, Kwong R, Maron M, Schulz-Menger J, Piechnik S, Watkins H, Weintraub W, Wu P, Neubauer S. Hypertrophic Cardiomyopathy Registry: The rationale and design of an international, observational study of hypertrophic cardiomyopathy. American Heart Journal. 2015 Aug; 170(2):223-30. PMID: 26299218.
Selected Presentations
Chiam T, Miller K, Ingraham Lopresto B, Pal C, Arnold L, McNicholas K, Curtin P. Data-driven and Analytical Approaches to Hospital Quality and Patient Safety. Presented at: INFORMS Annual Meeting; 2015 November 1-4; Philadelphia, PA.
Bacon A, Mosby D, Jurkovitz C, Ingraham Lopresto B, Drees M, Panwalker A, McGraw P. Relapsing Clostridium difficile Associated Disease Followed by a Registry and Fecal Microbiota Transplant Attitudes Questionnaire. Poster presented at: ID Week; 2015 Oct 7-11; San Diego, CA.
Sonnad S, Chiappardi-Williams D, Doorey A, Williams KD. Patient Knowledge and Preferences Surrounding Interruption of Anticoagulation Therapy for Minor Procedures. Poster presented at: Society for Medical Decision Making 37th Annual North American Meeting; 2015 Oct 18-21; St. Louis, MO.
Tanaka L, Khan O, Jackson E, Miller K, Chiam T. Choosing Wisely in Delaware: Rationale for Evidence-Based Diagnosis of Low Back Pain. Poster presented at: Delaware Orthopaedic Symposium; 2015 Oct 31; Newark DE.
Collaborations is a quarterly release of Value Institute news and events. Visit our website to read our 2014 annual report, watch our video and learn more about the Value Institute. Christiana Care providers can connect with the Value Institute by submitting a Consultation Request. To subscribe to Collaborations, please send an e-mail with “Subscribe to Collaborations” in the subject line.
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