Learning Health Systems

Learning Networks are organizational structures that facilitate collaboration at scale to improve health, care, and cost. In the past year, the Anderson Center has received funding from the Patient-Centered Outcomes Research Institute (PCORI) to learn how to scale-up the learning health system model nationally. Networks increasingly serve as a platform for clinical research. There is increasing interest from pharmaceutical companies, device companies, and other stakeholders in using the data from learning networks for real-world, novel trials. In addition, our model of learning network development is of interest as a tool for other sectors, such as education and social services, to improve outcomes.

Patient and Employee Safety

Our National Institutes of Health (NIH) and Agency for Healthcare Research Quality (AHRQ) funded research on safety continues to contribute nationally, with funded patient and staff safety projects in hospital medicine, patient-centered care, ambulatory care, occupational safety, neonatal care, and others. Dr. Nancy Daraiseh, PhD, received a Place Outcomes award to identify common causal factors for patient and employee injuries in healthcare. Dr. Stu Goldstein, MD, FAAP, FNKF, led the successful spread of a Nephrotoxic Injury Negated by Just in Time Action (NINJA) patient safety intervention from Cincinnati Children's Hospital Medical Center to eight additional hospitals. In collaboration, Drs. Goldstein, Heather Kaplan, MD, MSCE, and Kathleen Walsh, MD, MSc, led one of the first studies to identify modifiable factors that facilitate or impede the spread of NINJA. Dr. Patrick Brady, MD, MSc, working with Drs. Carole Lannon, MD, MPH; Kathleen Walsh, and Samir Shah, MD, MSCE, learned from qualitative interviews with families of children with complex chronic illness how families identify worrisome signs in their child’s illness and communicate to the hospital-based doctors and nurses, and is now testing family co-designed communication tools to ensure family-stated goals are explicit and prioritized. Dr. Amanda Schondelmeyer, MD, through funding from the AAMI Foundation, convened a national expert panel to determine consensus recommendations for the use of continuous monitors (e.g., heart rate/respiratory rate and oxygen level monitors) in a variety of clinical scenarios, such as a child hospitalized with mild asthma. This is important as overuse of continuous monitors contributes to alarm fatigue, an important patient safety threat, where clinicians become desensitized to alarms and thus may respond slowly to a critical alarm.

Health Services Research

In the past year, Anderson Center researchers made progress in several areas of health services research, including the use of N-of-1 trials, data drawn directly from the electronic health record (EHR) for research and quality improvement, and patient-centered research. Dr. Adam Carle, MA, PhD, provided methodologic expertise as a principal investigator and collaborator on multiple local and national studies of patient reported outcomes. Drs. Lisa Opipari and Heather Kaplan have used multicenter N-of-1 trial to engage patients in the study of a specific carbohydrate diet for inflammatory bowel disease using a novel mobile health platform. Drs. David Hartley, Kathleen Walsh, and Keith Marsolo, PhD, are using data drawn from the EHR at 12 health systems to improve the efficiency and validity of healthcare quality measurement and benchmarking.