Value Institute 2013 Annual Report
Innovating Care,
Maximizing
Impact
christiana care health system | Value Institute
Value Institute Fundamental Commitments Vision Statement
To lead the way to better health, better care and better value.
Mission Statement
The Value Institute mission is to develop, deliver and evaluate innovative solutions impacting population health, patient experience, system performance and policy development.
Differentiation Statement
The Value Institute is a diverse team of experts collaborating in the discovery and delivery of value-centered knowledge to improve health.
Value Institute Centers The Center for Health Care Delivery Science The emerging field of health care delivery science research applies implementation science to patient-centered health care. This approach to understanding value implements new technology, health care practice and policies while simultaneously evaluating their impact on patients, health care providers, practices and systems. The resulting paradigm has the potential to transform how patients receive, experience and benefit from health care.
The Center for Outcomes Research The long-standing success of the Center for Outcomes Research provided a foundation for the Value Institute. This center has an established track record of conducting clinical trials, population health and epidemiological studies, and cost effectiveness research. It also functions as a data coordinating and statistical center for nationally funded multi-center research projects.
The Center for Quality and Patient Safety
111 quality improvement projects
The Center for Operational Excellence
14 Lean Six Sigma process improvement projects across Christiana Care
22 Lean Six Sigma Green Belt candidates
100+ project team members
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From the Executive Director When I first heard President and CEO Dr. Bob
We understand the value that patients derive from
Laskowski describe his plan for a Value Institute
shared decision-making, patient autonomy and
at Christiana Care in early 2011, I struggled a bit to
attention to communication, trust and respect in
understand his concept of value as the institute’s
all aspects of their health care. For other decision-
goal. Were we to focus on defining value in the
makers, such as policymakers and payers, value in
traditional way where value in health care denotes
health care is essential for the sustainability of our
quality over cost? Or should we concentrate on
care delivery system. For the Value Institute team
established cost-effectiveness studies or perhaps
and our collaborators at Christiana Care, our patients’
undertake more contemporary comparative
expectations energize our work and inform our
effectiveness research? It is no coincidence that
goal of defining value across the full range of Value
at the same time that he was making plans for a
Institute investigational and educational programs.
Value Institute, Dr. Laskowski was articulating “The
We also know that understanding how to reliably
Christiana Care Way,” which has become a directional
deliver efficient and affordable medical care must be a
beacon for the health system:
central component of this work.
“We serve our neighbors as respectful, expert, caring partners in their health. We do this by creating innovative, effective, affordable systems of care that our neighbors value.”
Three pre-existing centers of excellence with their accompanying teams formed the foundation and infrastructure of the Value Institute. The Center for Outcomes Research, established here in 2005
This statement, rich with words such as expert,
and led by Dr. Bill Weintraub, contributes an
effective, affordable and innovative, offers insights
experienced team of clinical outcomes researchers,
into the meaning of value for us at Christiana Care.
biostatisticians and data analysts along with their
The most important aspect of The Christiana Care
academic sophistication and reputation. The center’s
Way in defining value for us, however, is the central
principal focus is studies that accurately define the
focus that it places on our neighbors, our patients
impact of disease and the effectiveness of medical
and their families. Our neighbors and what they
care. Seema Sonnad, PhD, was recruited during the
expect from their medical care are the defining goals of our work in the Value Institute.
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past year from the University of Pennsylvania to join these investigators as director of health services research. Sharon Anderson, RN, MS, leads the Center
We know that patients and their families expect
for Quality and Patient Safety and brings to the Value
high-quality and effective medical care they can
Institute not only her team of Quality Assurance
afford. This is what they value. We know that medical
and Performance Improvement professionals but
expertise is fully effective for our patients only
also her passionate leadership as a patient safety
when it is provided with respect and compassion.
and quality champion. The Center for Quality and
Patient Safety conducts work focused on creating a safe culture, achieving high reliability and leveraging technology. Vernon Alders, MBA, MSW, leads the third foundational component of the Value Institute, incorporating his team of specialists in the Center for Operational Excellence, contributing expertise in system analysis, rapid cycle improvement programs and Lean Six Sigma projects to improve the efficiency of the processes used to deliver care. The fourth Center of Excellence envisioned at the outset of the Value Institute in 2011 has been operationalized this past year. Dr. Eric Jackson, Jr. came to Christiana Care Health System from Johns Hopkins one year ago to direct the Center for Health Care Delivery Science and serve as associate director of the Value Institute. This center, under Dr. Jackson’s innovative leadership, will take a new path toward defining value for our patients. Combining performance improvement projects with evaluative science methodology, his Center for Health Care Delivery Science will create and analyze systembased processes of care that our patients value.
Timothy Gardner, M.D., Executive Director, Value Institute; Medical Director, Center for Heart and Vascular Health
His team will work in the new and highly relevant area of implementation science, a contemporary
goals for the Value Institute were jointly developed
investigative space emphasizing pragmatic and
and the essential patient- and family-focus of our
innovative solutions to challenging clinical issues.
work was accepted by all. The Value Institute team
Much has been accomplished this past year. Existing teams have been strengthened through relocation and realignment in some instances and expansion in other cases. New investigators and
is ready and eager to move forward with confidence in our ability to increase value for our neighbors and patients while following the guiding principles of The Christiana Care Way.
program leaders have been recruited to the Value Institute, with backgrounds and expertise in health policy, health economics, information technology and data analytics along with traditional clinical research. This new team was brought together for
Tim Gardner, M.D.
the development of a strategic plan. In that process,
Executive Director, Value Institute 03
Innovating Care People, Places, Spaces Location on the hospital campus paved the way to expanding the Value Institute. The additions of the Center for Health Care Delivery Science and the health services research teams complement the pre-existing strength of the Center for Operational Excellence, the Center for Quality and Patient Safety and the Center for Outcomes Research. New positions encompassing economics, law, sociology, public health, IT and biostatistics have been filled in our first year, almost doubling the size of the existing core team.
27 employees to date
U.S. Sen. Tom Carper of Delaware (center) visited the Value Institute in August 2013.
Value Institute Scholars Inspired by The
Value Institute Scholar Edmondo Robinson, M.D., MS, MBA, Associate Chief Medical Officer and Physician-in-Chief of Wilmington Hospital, speaks on access to health care at the opening of the new Wilmington Hospital South Tower.
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Added this year
6/3
Our employees originate from 6 different countries on 3 continents
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17
departments
22
specialties
48 scholars
Christiana Care Way, “to serve our neighbors as respectful, expert, caring partners in their health,” Value Institute Scholars apply their clinical experience to produce highquality, high-impact research. Our Research Scholars have training and skills in clinical and health services research, and our Clinical Scholars use their daily interactions with patients to generate research ideas and to implement projects.
value institute scholars by the numbers
32 8 1 mDs
phds
1
DMD PharmD
1 16 JD Master’s Degrees
Grants Obtaining a broad
Consultations The Value Institute receives requests for
range of grant funding allows the Value Institute to create knowledge that improves patient care and outcomes.
collaboration and research assistance from departments throughout the Christiana Care Health System and from our external partners. Alignment with annual operating plan goals and staffing capabilities allows us to prioritize projects and respond to our collaborators in a timely fashion.
25 16 13
million dollars in active grants
Requester completes consultation request web form
active grants
Request received by administrative team for documentation
Discussed at project Governance Meeting
Returned to requester for additional information
different sponsors an Infinite Number of Lives Changed and Families Touched
National sponsors include
Assigned to team member
Utilization of this process has allowed us to review 103 consultation requests from 40 investigators across 18 departments in 10 months.
Projects The Value Institute pursues an ambitious research agenda with the long-term goal of positively impacting patients and the community while extending Christiana Care’s research presence on a national and global level.
• Agency for Healthcare
Research & Quality
Women’s & Children’s Health
• Centers for Disease
Prevention and Control • Centers for Medicare &
kidney disease
Systems & Process Improvement
Medicaid Services • Department of Defense • National Institutes of Health
_NHLBI (National Heart, Lung, and Blood Institute)
Global Health
_NIGMS (National Institute of General Medical Sciences) PRIVATE SPONSORS INCLUDE • AstraZeneca • Daxor • Osler Fund
Home Care
Cardiovascular Disease Infectious Disease
• Sanofi-Aventis
• Simons Foundation
Pain Infrastructure Grants
Substance Abuse
70 DIVERSE AND HIGH-IMPACT VALUE INSTITUTE RESEARCH PROJECTS IN THE LAST YEAR
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Maximizing Impact Publications The Value Institute is engaged in building evidence-based health care innovations, representing a new way of measuring patient and system outcomes. Our goal is to apply rigorous science to expand knowledge that will improve outcomes for individual patients and populations. Making these advances available to other clinicians, health systems and ultimately patients across the globe drives the Value Institute’s goal of increasing Christiana Care’s contributions to the peer-reviewed literature.
100+
Publications by Specialty
10
Women & Children
publications since August 2012
19
medicine specialties
15
10
9
27
social sciences, quality & safety
other
Cardiology
13
emergency & trauma
Surgery
Conference Presentations
29 11
Value Institute Scholars
leveraging technology Recognizing that the process
from
different departments
of managing information during the publication
have brought both the innovative
process is challenging, the Value Institute worked with the Medical Libraries of
work we are doing, and the Value
Christiana Care to acquire two supporting technologies. Mendeley® functions as
Institute itself, to the attention
a reference manager, PDF organizer and collaboration network. PubsHub™ provides
of researchers and clinicians
valuable data, including time to publication and journal influence helping researchers decide which journals and conferences are the best outlets for their work.
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through
50
unique conference
presentations in
4
countries .
Education Expanded Value Institute Academy classroom and online courses, student research opportunities and a growing group of investigators allow a broad range of formal, experiential and mentoring based learning opportunities.
the value institute Academy and Value institute scholars
29
students
17
universities
INBRE Students
vi based summer students
Learning networking research
vi academy classroom sessions
816
new learners
vi academy online learning
The Value Institute co-sponsored the annual INBRE Scholars Research Day. Above, VI summer intern Leslie Carandang presents her research. Below, Tom Bauer, M.D., Section Chief of Thoracic Surgery and a Value Institute Scholar, opens the 2013 event.
Value Institute team members offer mentoring-based learning opportunities. Here, long-time Chair of Surgery and Senior Consultant for Advances in Medicine, Michael Rhodes, M.D. (center), addresses Value Institute staff including Beth Ivey, Senior Systems Analyst (left) and Pan Wu, PhD, Senior Biostatistician (right).
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Increasing Value Collaborating beyond Christiana Care Value Institute researchers have established partnerships with collaborators representing the continuum of corporate entities, health care providers and research associations.
COLLABORATORS Delaware Partners • AI DuPont/Nemours • Delaware Bioscience
Association • Delaware Health Sciences
Alliance • University of Delaware
Universities • Duke University • Johns Hopkins University • Medical University
of South Carolina • Northwestern University
Global Engagement Value Institute investigators are
• Thomas Jefferson University
engaged in collaborative global health initiatives on the continents of Africa and Asia. Team members are playing key roles in the study of cardiovascular outcomes in China and the implementation and evaluation of innovative anesthesiology technology in low resource countries in Africa.
• University of Pennsylvania • University of Virginia • Wake Forest University
Industry Partners • Booz Allen Hamilton, Inc.
Mobile provider training lab in Sierra Leone uses simulation to teach safe use of Universal Anesthesia Machine (developed by Gradian Health Systems®).
• ColdLight Solutions, LLC • Gradian Health Systems® • HealthCore, Inc.
• Medecision® • Swets National Research Networks • HOMERUN (Hospital Medicine Re-engineering Network) • SHEA (Society for Healthcare Epidemiology of America)
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20,000
1,400+
PATIENTS ENROLLED IN AN EPIDEMIOLOGICAL SURVEY ON CARDIOVASCULAR DISEASE AND ITS RISK FACTORS IN CHINA WITH INVESTIGATORS FROM CHRISTIANA CARE AND BEIJING UNIVERSITY
PATIENTS ENROLLED IN A PILOT STUDY BEING CONDucted IN SIERRA LEONE WITH INVESTIGATORS FROM CHRISTIANA CARE AND JOHNS HOPKINS UNIVERSITY
Guest speakers The Value Institute invited local and national subject matter experts to provide new insights to Christiana Care clinicians and researchers. These speakers serve as a conduit to external collaborations, while their talks reinforce the urgent need, shared by all stakeholders, for value-based research in the health care industry.
Robert Laskowski, M.D., MBA, President and CEO, Christiana Care, leads a Value Symposium panel discussion with Don Berwick, M.D., MPP, President and CEO, Institute for Healthcare Improvement; Bettina Riveros, JD, Health Policy Advisor to Gov. Jack Markell and Chair of the Delaware Health Care Commission; former Delaware Gov. Pierre S. “Pete” du Pont IV, board member of the Delaware Public Policy Institute; Stephen Kushner D.O., President of the Medical Society of Delaware and a physician at the Medical Group of Christiana Care’s Hockessin Family Medicine Office; and Timothy Gardner, M.D., Executive Director of the Value Institute.
Here with Value Institute Associate Director Eric Jackson, Jr., M.D., MBA (left), quality-based health care expert Don Berwick, M.D., MPP, delivered the keynote address at the May 2013 Value Symposium: “Transforming Health Care in America: Making the Triple Aim a Reality.”
Lynn Sha (right), Senior Health Policy Advisor to U.S. Sen. Tom Carper, learns about the Value Institute from James Williams, an INBRE summer intern; Sudhakar Satti, M.D., a Christiana Care neurointerventional surgeon and Value Institute Scholar; and Value Institute Research Associate Jennifer Goldsack, MChem, MA (Oxon), MS.
20
11
9
different lectures hosted by the Value Institute
lectures from external subject matter experts representing academia, industry and government
additional subject matter expert presentations from our Christiana Care colleagues
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Value Institute Christiana Care Health System John H. Ammon Medical Education Center 2nd Floor, Suite 2E55 4755 Ogletown-Stanton Road Newark, Delaware 19718 302-733-4380 | Phone 302-733-5884 | Fax TheValueInstitute@ChristianaCare.org www.ChristianaCare.org/ValueInstitute
Value Institute Leadership Team Timothy Gardner, M.D. Executive Director Eric Jackson, Jr., M.D., MBA Associate Director Vernon Alders, MBA, MSW Sharon Anderson, RN, MS Claudine Jurkovitz, M.D., MPH Paul Kolm, PhD Michael Rhodes, M.D. Herbert Scherrer Seema Sonnad, PhD William Weintraub, M.D. Christiana Care is a private, not-for-profit regional health care system and relies in part on the generosity of individuals, foundations and corporations to fulfill its mission. To learn more about how you can support our mission, please visit christianacare.org/donors.