2023-2024 COHORT
Yian Chen, MD
Dr. Yian Chen is an Assistant Professor in the Department of Anesthesiology and Pain Medicine, where he is an interventional pain physician and anesthesiologist. He attended college at Yale University in Connecticut before pursuing medical school at Johns Hopkins University. He completed residency in anesthesiology and pain fellowship at Johns Hopkins Hospital. He is interested in procedural outcomes for pain and their relationship to patient etiological factors.
Project Overview: This project involves developing a prospective registry for fluoroscopic or ultrasound-guided interventional pain procedures in order to assess outcomes and improve safety. The first part of the project entails design and creation of a registry for patients undergoing procedures at the Center for Pain Relief. Afterwards, patients can be followed for their response to different therapeutic procedures and thus demographic or technical factors (age, sex, indication for procedure) can be used to guide future treatment.
Hannah Hunter, MD
Dr. Hanna Hunter is an Assistant Professor in the Department of Rehabilitation Medicine at the University of Washington, and Medical Director of Cancer Rehabilitation at Fred Hutchinson Cancer Center. Prior to this, she completed her residency training in Physical Medicine & Rehabilitation at New York Presbyterian Hospital - Columbia/Cornell and fellowship in Cancer Rehabilitation at Memorial Sloan Kettering Cancer Center. Her scholarly interests focus on optimizing mobility and physical function before, during and after cancer treatment.
Project Overview: Patients with cancer are at particularly high risk for physical deconditioning during hospitalization due to muscle wasting syndromes and side effects of treatment. The goal of this project is to integrate mobility assistants into routine clinical care for patients admitted to the UWMC bone marrow transplantation service, to increase episodes of walking and exercise. The project aims to improve functional outcomes of patients during their hospitalization for bone marrow transplantation and increase likelihood of safe discharge home.
Gina Kim, MD, MPH
Dr. Gina Kim is a Clinical Assistant Professor in the Division of Gerontology and Geriatric Medicine and Associate Medical Director of the Senior Care Clinic at Harborview Medical Center. Prior to medicine, she worked as a senior project manager within the Quality and Clinical Initiatives Division at the Greater NY Hospital Association. There, she collaborated with hospitals throughout the Tri-State area on various initiatives, policies, and payor models to improve quality and delivery of care. She attended medical school at Albert Einstein College of Medicine in the Bronx, NY and completed a primary care/social internal medicine residency at the Cambridge Health Alliance in MA and fellowship in Geriatrics at the University of Washington. Her interests are in health disparities and improving access-to-care for older, vulnerable patient populations across multiple settings.
Project Overview: Language barriers for people with limited English proficiency (LEP) are associated with poor health outcomes and higher healthcare costs. However, there is a paucity of information on professional interpreter service (PIS) availability, access, utilization and impact on outcomes or quality for LEP patients in skilled nursing facilities (SNFs). This project aims to identify barriers in consistently using PIS and to assess the feasibility of using available technology with LEP patients for basic assessments and brief interactions in SNFs.
Catherine Kling, MD, MPH
Dr. Catherine Kling is an Assistant Professor in the Division of Transplant Surgery, where she is an abdominal transplant surgeon. She is also the Program Director for the Abdominal Transplant Surgery Fellowship. She completed her residency at Vanderbilt University Medical Center and her abdominal surgery fellowship at University of Washington. Her scholarly interests focus on the outcomes of transplant allocation policy, expanding the donor pool and optimizing access for marginalized populations.
Project Overview: This project involves developing a real-time system to track biliary complications after liver transplant, as part of a larger effort to improve tracking of post-transplant outcomes.
Ny-Ying Lam, MD
Dr. Lam is a board-certified physiatrist and assistant professor of Rehabilitation Medicine at UW School of Medicine. Dr. Lam is the Director of rehab consult services and Service Chief at UW Medical Center.
Project Overview: Cardiac surgery postoperative mobility restrictions known as “sternal precautions” have been traditionally used to prevent wound dehiscence and sternal malunion. Sternal precautions impose both weight and range of motion restrictions that limit how patients can move in bed, stand from a chair, and perform activities of daily living like dressing or toileting. Reduced independence at discharge increases the need for post-acute services or assistance from others at home. A new mobility guideline advising on biomechanics of movement without weight or range of motion restrictions called “Keep your Move in the Tube” has been researched and validated for safety in patients after median sternotomy. Studies have shown no increase in sternal wound complications but have shown increased discharge to home and increased independence at discharge. In our project, we will implement a hospital-wide change at UWMC Montlake from traditional sternal precautions to “Keep your Move in the Tube” mobility guidelines for all patients undergoing cardiac surgery. We hypothesize that this will reduce length of stay thus providing financial benefit to the hospital system while providing functional benefits to the patients as they are afforded more independence at discharge.
Garbo Mak, MD
Dr. Garbo Mak is a Clinical Assistant Professor in the Division of Pulmonary, Critical Care, and Sleep Medicine. Prior to joining UW, she was faculty at the University of Texas Health Science Center at Houston where she completed a Certificate Program in Patient Safety and Effectiveness and led quality improvement initiatives in the outpatient clinic. Dr. Mak spends most of her time providing pulmonary outpatient care at the University of Washington Northwest Respiratory Clinic where she focuses on asthma.
Project Overview: As part of the QI Scholars program, Dr. Mak will be working to improve the referral process at the asthma clinic. Timely and appropriate assignment to subspecialty clinics ensures high quality care. Inappropriate scheduling results in delayed consultations and poor experiences for patients and clinicians alike. In the project, the aims are to 1) Characterize the current patient referral process and 2) Develop and implement interventions to increase the number of correct referral assignments and reduce time to initial consult appointments.
Ali Ravanpay, MD, PhD
Ali Ravanpay is an associate professor in the department of neurological surgery. He earned his bachelor's degree in molecular and cellular biology, and near Eastern art and archeology from University of California, Berkeley. He completed medical scientist training program at University of Washington with a thesis focusing in neurobiology and behavior. He completed neurosurgical residency training at University of Washington. He is currently deployed at the Puget Sound VA and Harborview Medical Center. Quality analysis and improvement in neurosurgical education and care of neurosurgical patients have evolved as two important themes in his career. Neurosurgical pathologies often impact patient's cognitively and functionally resulting in complex psychosocial and medical comorbidities. Such comorbidities impact patient's postoperative recovery profoundly. Identification and optimization of such variables preoperatively can result in significant improvement in postoperative care clinically, economically and socially.
Project Overview: Dr. Ravanpay is working on a project with Dr. Wiseman. At Harborview Medical Center, on average, nearly 50% of elective Neurosurgery cases exceeded length of stay (LOS). Patients undergoing spine surgery are the majority of these patients, however, patients having large tumor resections and vascular procedures are also represented. The ability to identify surgical patient populations that are likely to go over length of stay has been well studied. Effective interventions aimed at addressing the myriad array of factors that result in prolonged length of stay within these populations, however, are lacking. Furthermore, consulting firms hired to “solve” this issue at UW have failed in their attempts. The HMC Neurosurgery LOS committee have identified and examined 9 medical/social factors strongly associated with prolonged LOS. We hypothesized that addressing these factors prior to admission would positively impact LOS, improve the patient, family, provider experience and workflow efficiency. These 9 factors apply to all surgical services.
Joseph Reno, MD
Joseph Reno attended medical school at Case Western Reserve University and then served in the US Air Force. In 2016 he attended Ohio State University for residency in anesthesiology, followed by a fellowship in obstetric anesthesiology. In 2020 he joined the anesthesiology faculty at University of Washington Medical Center.
Project Overview: This is a project to help obstetric anesthesiologists implement more routine and useful screening to predict which people are at higher risk for poor pain relief after cesarean section. It follows a preliminary project which identified local inequities according to patient race. The eventual goal is to increase the frequency of personalized and more effective pain-relieving strategies in this Labor & Delivery setting.
Molly Rosenthal, MD
Dr. Rosenthal is a faculty member in the University of Washington Division of General Internal Medicine and works on the Hospital Medicine service at both Montlake and Harborview campuses. She provides clinical care on the faculty medicine service and as an attending for the residency teaching services. She also works as a Capacity Management Physician (CMP) to assist in flow and care coordination across the hospital network. Her quality improvement interests stem from this work and has involved numerous projects over the last 6 years to improve care for psychosocially complex patients at a safety net institution. This began with the ED Social Medicine program at San Francisco General Hospital, and now in her work as CMP at Harborview Medical Center. Project Overview: This project will focus on the process of guardianship and how it varies across institutions, including within University of Washington Medical Centers. The hope would be to use this information to streamline the process and improve the care team and patient experience via transparency and a reduction in length of stay.
Diana Barrett Wiseman, MD, MBA
Diana Wiseman is a clinical associate professor in the department of neurological surgery. She earned her bachelor's degree in molecular and cellular biology from the University of California, Berkeley. She received her MD from the Uniformed Services University and completed neurosurgical residency training at the University of North Carolina. She completed her spine fellowship at the University of Washington. Dr. Wiseman served in the Navy, retiring in 2015 and then went on to complete her MBA at Duke University Fuqua School of Business. She has completed a graduate certificate in Palliative Care at the University of Washington and is a certified Epic physician builder with added certifications in analytics/registry build as well as patient entered data (outcome measures). She has served as lead for the Neurosurgery Length of Stay Committee, developing a program to tackle the multitude of medical and social determinants that affect elective surgical patients' length of stay.
Project Overview: Dr. Wiseman is working on a project with Dr. Ravanpay. At Harborview Medical Center, on average, nearly 50% of elective Neurosurgery cases exceeded length of stay (LOS). Patients undergoing spine surgery are the majority of these patients, however, patients having large tumor resections and vascular procedures are also represented. The ability to identify surgical patient populations that are likely to go over length of stay has been well studied. Effective interventions aimed at addressing the myriad array of factors that result in prolonged length of stay within these populations, however, are lacking. Furthermore, consulting firms hired to “solve” this issue at UW have failed in their attempts. The HMC Neurosurgery LOS committee have identified and examined 9 medical/social factors strongly associated with prolonged LOS. We hypothesized that addressing these factors prior to admission would positively impact LOS, improve the patient, family, provider experience and workflow efficiency. These 9 factors apply to all surgical services.
2022-2023 Cohort
Nate Benner, MD
Dr. Nate Benner, MD is one of the University of Washington Department of Orthopedics third year residents in Orthopedic Surgery. His interest in quality improvement began in medical school with a project specifically designed at improving quality of education in the operating room for medical students. Continuing this interest during residency, he was awarded the position of QI resident for the 2022-2023 academic year for the Department of Orthopedics.
Project Overview: Hip fractures in the elderly are common injuries with high morbidity and mortality. Generally accepted standard of care is treatment within 48-72 hours to reduce mortality at one year. The timeframe between injury and operation is unknown at UW sites. We are working to understand our institutions ability to meet these standard of care guidelines with the hope of improving the care of hip fractures in the geriatric population.
Anna Halpern, MD
Dr. Anna Halpern is an Assistant Professor in the Division of Hematology at the University of Washington and an Assistant Professor in the Clinical Research Division at the Fred Hutchinson Cancer Center. Her clinical focus is on myelodysplastic syndromes, myeloproliferative neoplasms and acute myeloid leukemia. She also does clinical and outcomes research in myeloid malignancies evaluating novel care strategies and therapeutic approaches. Dr. Halpern completed undergraduate and medical school at Brown University in 2009, residency in Internal Medicine at the University of Chicago in 2013, and fellowship in Hematology-Oncology at the Fred Hutchinson Cancer Research Center/ University of Washington in 2017.
Project Overview: The goal of this project is to decrease hospital readmission for gram positive bacteremias in patients with AML treated with intensive chemotherapy. To accomplish this aim, this project will evaluate thel use an “oral-skin bundle” compromised of standardized oral and central catheter care education, chlorhexadine wipes, and chlorhexadine oral rinses.
Nicole Shoals, MD
Dr. Nicole Shoals is a chief fellow in the Division of Gastroenterology at the University of Washington. Prior to this, she completed her residency training in Internal Medicine at New York Presbyterian Hospital- Columbia University. Dr. Shoals has a particular interest in social determinants of health within the field of gastroenterology.
Project Overview: As part of the QI Scholars program, Dr. Shoals will quantify quality metrics for screening colonoscopies among general gastroenterologists at the University of Washington.
2021-2022 Cohort
Arvin Akhavan, MD, MPA
Arvin Akhavan, MD, MPA, is an emergency physician and the current Assistant Medical Director for Operations at the Harborview Emergency Department. Prior to taking this role, Dr. Akhavan completed a two-year fellowship program in ED Operations at New York University. Having completed his emergency medicine residency training at the University of Washington/Harborview, Dr. Akhavan looks forward to working to improve care for HMC's patients.
Project Overview: As part of the QI Scholars program, Dr. Akhavan is working with Dr. Chipman to better characterize restraint use in UW Medicine emergency departments. The goal of their project is to develop data-driven initiatives that improve the safety and equity of physical restraint use for patients in the ED.
Anne Chipman, MD, MS
Dr. Anne Chipman joined the University of Washington Department of Emergency Medicine in 2014. In 2015, she completed the UW Patient Safety Certificate Program. She has served as a member of the HMC Department of Emergency Medicine Quality Assurance Committee since 2014 and as a member of the HMC Department of Emergency Medicine Safety Committee since 2015. From 2017-2021 she served as an Assistant Program Director for the UW Emergency Medicine Residency Program. Beginning in 2021, she was appointed as the Assistant Director of Quality Improvement and Patient Safety for the Harborview Medical Center Emergency Department. Her scholarly focus is on the development of educational and operational programs that advance the quality and safety of healthcare delivery in the Emergency Department.
Project Overview: Dr. Chipman and Dr. Akhavan will be undertaking a project that seeks to improve the use of restraints in the UW Medicine Emergency Departments. This project will consist of two parts: 1.) Characterizing the current use of restraints in the UW Medicine EDs with specific attention to patient demographic characteristics, restraint characteristics and clinical outcomes. 2.) Using this data to develop and implement improvement strategies with the aim of ensuring a more appropriate, equitable use of restraints and other agitation management strategies for ED patients.
Katherine Heller, MD
Dr. Katherine Heller is an Assistant Professor in the UW Department of Anesthesiology and Pain Medicine, where she works as a general anesthesiologist and critical care physician. She is the medical director of the UWMC-ML Surgical Intensive Care Unit. Katherine grew up in the Seattle area and attended medical school at the University of Washington, then completed anesthesiology residency at Emory University before returning to the UW for critical care fellowship. She is interested in resident and fellow education, point of care ultrasound training, and quality improvement work related to surgical critical care.
Project Overview: This project focuses on standardizing and improving the response to suspected sepsis developed in inpatients on the acute care floors at the UWMC-ML. Once criteria and workflow for the suspected sepsis response are established (working in coordination with the Sepsis Committee and departments across the hospital), education and involvement across a broad range of departments will be essential. The second phase of this project will focus on the addition of a critical care advanced practice provider (APP) to our sepsis response for patients at risk of or meeting criteria for septic shock on the acute care services. The goals of this project include increasing the proportion of adult inpatients developing sepsis after admission to UWMC-ML who receive rapid, appropriate care as defined by SEP-1 sepsis metrics. Secondarily, the aims of the project are to significantly reduce length of hospital stay (days), proportion of patients who require ICU admission, and in-hospital mortality for patients who develop sepsis during a hospital admission.
Elizabeth Parsons, MD, MS
Dr. Parsons is an Associate Professor of Medicine within the Division of Pulmonary, Critical Care, and Sleep Medicine. She completed an MS in Epidemiology at the UW School of Public Health in 2011, followed by a fellowship in Health Services Research and Development at VA Puget Sound Health Care System. She works at VA Puget Sound Health Care System where she spends most of her time providing clinical sleep care to veterans. She also has roles in medical education for UW trainees and VA providers, as well as QI scholarly work to improve veterans’ access to sleep care services. Dr. Parsons is the Medical Director of the Sleep VA-ECHO telementorship program, which provides evidence-based webinar education to practicing VA healthcare providers across the nation; in FY 2021, Sleep VA-ECHO distributed >5400 CME hours of accredited medical education to a multidisciplinary group including physicians, nurses, advanced care providers, pharmacists, and psychologists. Dr. Parsons also serves as the Medical Director of the Puget Sound VA Behavioral Sleep Medicine program, which offers evidence-based therapies in the treatment of sleep apnea/PAP intolerance, insomnia, and nightmares.
Project Overview: Behavioral therapies are safe and effective treatments for many sleep disorders, including insomnia and PAP therapy intolerance, and are recommended as first-line therapy in some instances. Yet few patients receive behavioral sleep therapies due to poor awareness, limited number of providers, and challenging referral logistics. In this project, we aim to improve access to behavioral sleep services for veterans enrolled at VA Puget Sound by optimizing staffing, team structure, and referral processes.
Pingping Song, MD, MS
Pingping Song, M.D., M.S., is an assistant professor in Anesthesiology and Pain Medicine at University of Washington Medical Center. Dr. Song specializes in cardiothoracic anesthesiology, critical care medicine and interventional echocardiography. As the interim medical director of the cardiothoracic intensive care unit (ICU), Dr. Song has led a series of quality improvement projects both in the operating room and the ICU. Her research interests include enhanced recovery after cardiac surgery, right ventricular dysfunction and patient safety.
Project Overview: Enhanced recovery after surgery (ERAS) is a patient-centered care delivery model, aiming to promote patients’ early return to their normal activities after surgery. In cardiac surgery, the practice of ERAS has not been widely adopted due to the perceived complexity and unique surgical stress imposed on patients from cardiopulmonary bypass. However, early adopters of enhanced recovery after cardiac surgery (ERACS) have reported promising results, including reduced postoperative complications, ICU length of stay and greater patient satisfaction. As a result, several hospitals in Washington state have already adopted ERACS and the practice has become increasingly common nationwide. Our primary aim is to develop and implement an ERACS care bundle based on current best evidence and with collaboration from a multidisciplinary team amongst a cohort of cardiac surgical patients at UWMC-ML (Montlake) campus. Our goal is to monitor the compliance with the ERACS care bundle over a 6-month period and evaluate its impact on patient outcomes.