Past Delivery System Redesign Pilot Projects
NYU Langone’s Center for Healthcare Innovation and Delivery Science funded the following past pilot projects that test ideas for redesigning our healthcare delivery system.
Using Patient-Centered Education to Shorten Waiting Time to Kidney Transplant
The aim of this project is to increase rates of kidney donation and use of kidneys from deceased donors by giving patients lay-friendly educational material to help them comprehend complex concepts related to organ transplant. Bonnie E. Lonze, MD, PhD, and Nicole M. Ali, MD, are the principal investigators.
Evaluating the Utility of a Diet Quality Screener in Clinical Practice to Improve Quality of Preventive Care
This project implements an office-based dietary screener to help refer patients to dietary counseling, improve their health, promote cost-effective care, and prevent cardiovascular disease. Jeannette M. Beasley, PhD, MPH, and Eugenia Gianos, MD, are the principal investigators.
Promoting In-Hospital Mobility: A Randomized Controlled Trial
This project aims to identify a minimum number of steps hospitalized patients with or without assistive devices should take each day to prevent further hospitalization associated with functional decline. Gavriil Ilizarov, DO, is the principal investigator.
Improving Access to Behavioral Therapy for Pain Conditions in Patients
This project assesses whether smartphone behavioral therapy that has been proven effective in traditional outpatient settings for migraine and post-traumatic headaches can be delivered in the emergency department, primary care practices, and neurology treatment to improve pain outcomes and decrease the need for further care. Mia T. Minen, MD, MPH, is the principal investigator.
Providing Personalized Health and Individual Lifestyle-Enhancing Solutions in Cardiovascular Disease
This project evaluates the usability and acceptability of a lifestyle and behavioral self-tracking and ePersuasive mobile technology tool and web-based app aimed at improving patients’ adherence to diet, physical activity, and sleep guidelines. The tool helps close the loop connecting patients, electronic health records (EHRs), and providers through mobile technology. The study uses this technology for hypertension and comorbid diseases, but it can also be used for other cardiovascular diseases, addiction, and mental illnesses. Azizi A. Seixas, PhD, is the principal investigator.
Feasibility Study of Telemedicine for Dialysis Patients Awaiting Transplant
To improve waiting time between follow-up visits for patients awaiting kidney transplant, this study tests the use of telemedicine tools to conduct routine assessments at dialysis. We monitor indicators of clinic efficiency, including missed and rescheduled visits and estimated healthcare delivery cost. Nicole M. Ali, MD, is the principal investigator.
A Novel Use of Low-Cost Prostheses to Improve Upper Extremity Function in Children with Cerebral Palsy
This study investigates the use of three-dimensional printing to create prostheses of the hand for cerebral palsy patients. This innovation could enable patients to have grasp and release capability. It would particularly help children with spastic cerebral palsy and poorly functioning upper extremities, who have very few options to recover use of their arms. Alice Chu, MD, is the principal investigator.
Health System Integration of an Electronic Health Record–Based Health Literacy–Informed Intervention to Reduce Parent Medication Errors
This project tests the effectiveness of integrating a tool called HELPix into Epic EHRs to help parents reduce errors when giving medication to their children. The tool uses a bilingual English and Spanish pictogram-based set of instruction sheets. Shonna Yin, MD, is the principal investigator, in collaboration with the Department of Pediatrics, Ronald O. Perelman Department of Emergency Medicine, and NYU Langone’s Medical Center Information Technology (MCIT).
A Pain Management Greaseboard: A Novel Approach to Pain Management
The aim of this project is to improve real-time pain scores reported by patients by using a centralized, coordinated pain management status board. We predict that better pain scores will also translate to an improvement in our institution’s pain management Hospital Consumer Assessment of Healthcare Providers and Systems scores. We also aim to improve efficiency by using best practices to standardize and coordinate pain management within the institution. Our project will result in the creation of a new intervention called a “greaseboard” that displays real-time information about patients’ pain scores by hospital unit. Sudheer K. Jain, MD, is the principal investigator and is collaborating with representatives from NYU Langone’s MCIT.
Pleural Disease Pathway: An Integrated, Multidisciplinary Algorithm to Ensure Effective Management of Both Benign and Malignant Pleural Disease
The goal of this project is to institute a pathway that ensures appropriate, effective, and efficient management and follow-up of patients with pleural disease, so they receive the right care, at the right time, in the right place. Lack of standardization in evaluating new or recurrent pleural pathway disease results in delays in care, confusion on the part of patients and providers, reductions in quality of life, decreased patient and provider satisfaction, institutional leak, inefficient procedure space allocation, and potentially additional unnecessary procedures. Jamie L. Bessich, MD, and Gaetane C. Michaud, MD, are the principal investigators.
Palliative Care via Telemedicine
The goal of this project is to develop a framework for offering telemedicine in oncology care that avoids costly pitfalls by conducting a needs assessment and simulation. By analyzing interpersonal, technical, financial, organizational, and patient needs, we hope to achieve the triple aim of improving the health of populations, reducing costs, and improving the patient experience. Paul A. Testa, MD, is the principal investigator.
The Colon Surgery Pathway: A Truly Interdisciplinary, Integrated Care Plan for Colon Surgery Patients
This intervention integrates a novel clinical pathway tool into EHRs to encourage healthcare providers to apply best practice protocols for elective colon surgery. The goal is for high rates of compliance that lead to reduced length of stay for patients and reduced direct costs without compromising clinical outcomes, such as postoperative complications and mortality. Jonathan S. Austrian, MD, is the principal investigator.
Implementation of the Score for Trauma Triage in the Geriatric and Middle-Aged Orthopedic Trauma Patients: A Randomized Trial Utilizing Palliative Care Consultations to Improve Quality and Efficiency of Care
This is a study of a validated score called the Score for Trauma Triage in the Geriatric and Middle Aged (STTGMA). The program uses STTGMA to triage orthopedic trauma patients whose risk of mortality is more than 3 percent for a palliative care consultation. The goals are to improve quality of care and decrease hospital costs. It takes place in the Ronald O. Perelman Center for Emergency Services, NYU Langone Orthopedic Hospital, the Emergency Department at NYU Langone Hospital—Brooklyn, and other inpatient settings at NYU Langone hospitals. Sanjit R. Konda, MD, is the principal investigator.
Cardiology E-Consult Program
This project aims to use electronic consultations (e-consults) to educate patients to become self-reliant in managing their cardiac conditions. Our primary objective is for e-consults to surpass traditional referral by 10 percent. Secondary goals are to reduce the need for a face-to-face visit with a cardiologist by 30 percent, reduce inappropriate cardiology referrals, better organize workflow between the primary care specialist and the cardiologist, create shorter wait times for appointments, and improve incomplete patient informational flow. George Fernaine, MD, MBA, is the principal investigator.
Healthy Families: Transforming Care for Obese Children at Family Health Centers at NYU Langone
This project tests the success of a multidisciplinary pediatric weight management program in our highest-volume clinic, the Family Health Centers at NYU Langone, to reinforce teaching about food selection and preparation. The intervention, which includes home visits, is compared with the standard of care, which includes referral to a nutritionist in the clinic. Our primary aim is to stabilize children’s body mass index as compared with the control group. We also compare participating children’s physical activity; consumption of fruit, vegetables, and sugar-sweetened beverages; and daily screen time from before and after the program. Marisol Gonzalez, MD, is the principal investigator.
Outpatient Antibiogram-Generated Education for Urinary Tract Infection Treatment: Reducing Antibiotic Pressure and Facilitating Judicious Antibiotic Use
This project merges current urinary tract infection treatment guidelines from the Infectious Diseases Society of America with antibiotic resistance patterns using a tool in EHRs. The primary goals are to encourage appropriate antibiotic prescribing and to quantify the change in number of prescriptions and the choice and dose of antibiotic used. Vinh P. Pham, MD, PhD, is the principal investigator.
The Greater New York City Practice Transformation Network (GNYC-PTN), funded by the Center for Medicare and Medicaid Innovation from 2015 to 2019, provided approximately 1,800 clinicians at NYU Langone and elsewhere with the tools, information, and support they needed to improve quality of care, increase patients’ access to information, and spend healthcare dollars more wisely. Through redesign of clinical practices and technical support, the GNYC-PTN helped providers in the greater New York City region reduce wasted hours, improve staff morale, and create more time for direct patient care. Leora Horwitz, MD, MHS, is the principal investigator.