Scope of Research Activity
The School's research operations are organized into four divisions: Quality and Safety, Health Economics and Outcomes Research, Health Policy and Health Services Research, and Public Health.
Quality & Safety
The Division focuses on the measurement and improvement of quality and safety in healthcare. It has two lines of activity: conducting research on the development, testing, implementation and evaluation of quality measures and improvement strategies; and providing support for performance measurement and improvement in the Jefferson University Physicians (JUP) ambulatory care practices. Examples of work in the former area include:
- Work to develop new provider-type-specific measures of quality with Quality Insights of Pennsylvania, the Pennsylvania Quality Improvement Organization, and its parent organization, West Virginia Medical Institute, under contract to the Centers for Medicare and Medicaid Services (CMS)
- Develop and pilot-test a migraine care quality measurement set
- Catalog the existing measures of diabetes quality of care, and conduct qualitative interviews with measure developers, users, and evaluators, in order to develop policy recommendations for further development and implementation, as part of a national effort to improve care for people with diabetes.
The JUP performance measurement and improvement team conducts projects seeking to improve care for Jefferson patients and inform methods and policy on a national level. Sample projects include:
- Implement the Provider Practice Patient Safety Assessment (PPPSA), a tool developed by the Health Research Educational Trust (HRET), the Medical Group Management Association (MGMA), and the Institute for Safe Medication Practices (ISMP), across all JUP practices to:
- Determine a baseline level of ambulatory safety;
- Compare this performance to national benchmarks;
- Identify opportunities for safety improvement, and
- Track progress over time.
- Support JUP-wide implementation of CMS' Physician Quality Reporting Initiative (PQRI), and other pay-for-reporting and pay-for-performance systems, and using these measurement activities for quality improvement.
- Implement a JUP-wide smoking cessation initiative to ensure that all patients seeking care in a Jefferson ambulatory practice have a smoking history documented, and that current smokers are appropriately counseled and referred to smoking cessation programs.
In addition to these "JUP-wide" improvement initiatives, the Health Policy team provides support for individual departmental measurement and improvement initiatives.
Health Economics & Outcomes Research (HEOR)
The Division is housed in the new Doris N. Grandon Center for Health Economics and Outcomes Research on the 3rd floor of the Curtis Building. The HEOR team conducts a wide array of projects that examine the clinical, humanistic and economic outcomes of health care interventions. Recent projects include:
- National survey of hematology services and blood banks regarding the cost of blood collection, processing and transfusion in the United States
- Medical record review project to identify the incidence of opioid-related inpatient adverse events, and any associated economic consequences
- Comprehensive review of the literature to identify the direct and indirect (productivity) cost savings associated with appropriate use of pharmaceuticals for heart disease, migraine, asthma, depression, chronic obstructive pulmonary disease, and other chronic conditions
- Work with Jefferson's Center for Research in Medical Education and Health Care to examine costs and quality of care in the Emilia Romagna region of Italy
- A longitudinal prospective study of health outcomes and economic consequences of chronic episodic pain
The HEOR Division also serves as the home for three outcomes research fellowship training programs. Over the past 14 years, 31 Fellows have completed the program. The majority of Fellows work in management and leadership positions in outcomes research for industry and academia.
Health Policy & Health Services Research
The Division conducts projects related to the organization, delivery, and financing of high-quality and cost-effective care. Recent projects include:
- Gastroesophageal Reflux Disease (GERD) - Identification of disparities in prevalence of symptoms, and recognition and treatment of the disease across minority groups. A follow-up study is being conducted to evaluate tools designed to address these disparities
- Comprehensive literature review examining the effectiveness of pharmacologic, surgical, and behavioral interventions for obesity treatment. The findings, presented at national meetings, led to a new project to design best practices to incorporate obesity interventions into population-based approaches to health and disease management
- Evaluation of an interactive on-line training program designed to improve physician diagnosis and treatment of headache
- Collaborative project with Jefferson's Department of Family and Community Medicine to validate an automated blood pressure measurement device, in comparison with traditional ausculatory blood pressure measurement, using an evaluation protocol established by an international council on instrument validation
- Implement and evaluate a colorectal cancer screening program in collaboration with the Lehigh Valley Practice Network.
The Public Health Division focuses on delivering high-quality education through the Master of Public Health Program (MPH), but is also developing a population health and community-based participatory research agenda. The Division mentors students in their "Capstone" (thesis) projects. Project topics in 2007-2008 include a retrospective prevalence study of prescription drug use among pregnant women; evaluation of human papilloma virus (HPV) vaccine administration patterns; and understanding pharmacy students' views of tobacco use and cessation.
The Public Health Division also operates the Greater Philadelphia Schweitzer Fellowship Program, part of the national Albert Schweitzer Fellowship Program, which provides graduate students in health-related disciplines the opportunity to conduct community service projects while completing their education. In the first year of operation (May 2007-April 2008), 12 fellows from institutions throughout the Delaware Valley completed projects. An additional 12 fellows are currently enrolled in the program.