CHIDS 2015 Pilot Grants

Innovations in Childhood Chronic Illness Care Delivery: An Integrated Behavioral Health System Redesign to Improve Effectiveness, Efficiency and Safety - Dr. Ron-Li Liaw

Drawing on our experience with the CF screening initiative, we aim to conduct anxiety and depression screening with the large adolescent and young adult IBD patient population at Fink. We will also test the implementation feasibility and effectiveness of IBBT for anxiety and depression, utilizing existing, embedded Fink social work staff. Through this delivery system redesign, we aim to: 1) provide better medical care through the early identification of depression, anxiety, and psychosocial risks, 2) improve access to effective evidence-based mental health interventions, 3) improve health-related quality of life, treatment adherence, and psychosocial functioning, and 4) reduce healthcare utilization and cost.

The Colon Surgery Pathway:  A Truly Interdisciplinary, Integrated Care Plan for Colon Surgery Patients - Dr. Jonathan Austrian

Our intervention applies the best-practice protocols for elective colon surgery using a novel clinical pathway tools integrated into the EHR. Our objective is to demonstrate that E-pathways will result in high compliance with the protocols and lead to reduced length of stay and direct costs without compromising clinical outcomes including post-operative complications and mortality.

Implementation of the Score for Trauma Triage in the Geriatric and Middle-Aged (STTGMA) Orthopaedic Trauma Patient: A Randomized Trial Utilizing Palliative Care Consultations to Improve Quality and Efficiency of Care - Dr. Sanjit Konda

Our objective is to implement a validated inpatient mortality-risk score termed the Score for Trauma Triage in the Geriatric and Middle-Aged (STTGMA) for orthopaedic trauma patients evaluated in the NYU Tisch Hospital emergency department (ED), Hospital for Joint Diseases Immediate Care (I-CARE), NYU Lutheran ED, or patients transferred directly to the inpatient setting at any of the hospitals. Via the use of STTGMA, our goal is to show a reduction in net hospital costs by triaging patients whose inpatient risk of mortality is >3.0% to receive a palliative care consultation. The STTGMA will provide objective criteria for PCC that will emphasize the importance of PCC on improving quality of care and decreasing hospital costs.

Cardiology E-Consult Program - Dr. George Fernaine

The aim of the project is to test econsult proof of concept. The goal of the proposed intervention is to introduce use of electronic consultations (econsults). The program will meet or surpass our primary objectives of increasing econsult utilization compared to traditional referral by 10%. Secondary outcomes include: 30% of e-consults will not convert to a face-to-face visit to a cardiologist, quantifiable reasons for not complying with PCP referral recommendations, less inappropriate cardiology referrals, PCP and Cardiologist better organized work flow, shorter wait times, and that the econsult system will improve incomplete patient informational flow. PCPs will have a comprehensive view of patient care. Patients thus acquire education, and have support while becoming self reliant in managing their disease/condition.

Healthy Families: Transforming Care for Obese Children at NYU Lutheran Family Health Centers - Dr. Marisol Gonzales

This redesign project aims to test whether it is beneficial to routinize a multi-disciplinary pediatric weight management program within our highest volume clinic (NYU-LFHC Women, Adolescents and Children), and to add a home-visit component to reinforce teaching on food selection and preparation. We will compare this to standard of care, which includes referral to an NYU-LFHC nutritionist. The test intervention aims primarily to stabilize BMI and BMI z-score and this is what we will be comparing to the control group. Secondarily, we will compare pre-intervention and post-intervention data for cases for the following behaviors: physical activity, consumption of fruit, vegetables and sugar-sweetened beverages, and daily screen time.

Outpatient Antibiogram-Generated Education for UTI Treatment: Reducing Antibiotic Pressure & Facilitating Judicious Antibiotic Use - Dr. Vinh Pham

The aim of this project is to merge current Infectious Disease Society of America (IDSA) urinary tract infection (UTI) treatment guidelines with antibiotic resistance patterns using an EMR based information tool to help inform appropriate antibiotic prescribing, and to quantify the change in number of prescriptions, choice and dose of antibiotic used. Secondary measures of unintended collateral damage will also be quantified.