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Baystate Medical Center awarded two new AHRQ grants

SPRINGFIELD -- The Center for Quality of Care Research at Baystate Medical Center has received two new grants from the Agency for Healthcare Research and Quality (AHRQ) totaling nearly $2 million for research intended to help healthcare providers across the country better understand how to deliver high-quality and efficient care with minimal risk of complications. The awards will support principal investigators Dr. Michael Rothberg and Dr. Peter Lindenauer and their colleagues in two separate but related studies. AHRQ is a federal agency within the Department of Health and Human Services that is tasked with improving the quality, safety, efficiency, and effectiveness of health care for all Americans. Rothberg is leading a study, funded at $1.1 million over three years, into the epidemiology and treatment of healthcare-associated pneumonia (HCAP), a newly identified disease entity that affects patients who recently came in contact with the healthcare system. Rothberg and his team are comparing the care for and outcomes of pneumonia patients who had spent time in hospitals, nursing homes, and other medical settings with those who had not been in the healthcare system to determine the extent to which physicians are adhering to treatment guidelines for HCAP, and how administering the proper treatment for the resistant bacteria affects the outcomes of patients who are exposed. Better understanding of HCAP could result in a significant improvement in pneumonia care overall. Bacteria associated with HCAP are often more dangerous than those of pneumonia acquired outside of the healthcare setting, but patients with HCAP often do not receive the correct antibiotics to fight the condition. "It is estimated that healthcare-acquired pneumonia may sicken as many as 300,000 people per year in the U.S., many of those gravely and some fatally," said Rothberg. "We're hopeful that our research into this illness can help doctors choose the correct treatment, saving lives while minimizing harms from antibiotic side effects." The second study, on which Lindenauer is principal inves-tigator, is receiving $885,000 over three years. Lindenauer is applying concepts from the business world to examine the processes through which hospitals implement new treatments and technologies into routine practice, in hopes of identifying the factors and strategies that lead some hospitals to be more successful than others in improving the quality of their care. In this study, a team of investigators including doctors, health researchers, health economists and management experts, as well as consultants from Dartmouth College and the University of Iowa, are examining the results of 175 U.S. hospitals' participation in Premier Inc.'s QUEST, a collaborative effort to improve hospital performance in reducing complications like hospital-acquired infections and associated mortality rates. The study aims to determine whether collective work in quality improvement like that of QUEST does indeed lead to real improvements in quality and if so, what steps taken during the QUEST process had a particularly strong influence in improving quality of care. "Examining processes of improvement to learn broadly applicable lessons is something that's common in the business world, but much less so in healthcare at least until now," said Lindenauer. "We're excited that, by answering certain questions, we may be able to start to identify concrete ways that hospitals everywhere can do a better, safer and more efficient job taking care of their patients." For example: Does enlisting a physician champion to lead quality-improvement efforts make a difference for hospitals trying to deliver better care? Does the degree to which staff feel engaged in the quality-improvement process affect results? The answers to these questions have the potential to form the beginnings of a road map for quality improvement that could be used by hospitals large and small to improve their patients' outcomes and deliver safer and more efficient care. The new federal grants nearly triple the center's cumulative endowment since its launch in 2008, to just shy of $3 million, and further establish Baystate's position as a national leader in the area of healthcare quality research.

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