The Center pursues large scale externally funded research projects related to quality and safety. This is a list of selected research grants led by Center faculty.
Understanding and Improving Inequities in Palliative Care for Older Adults with Advanced Dementia and Limited-English Proficiency: A Mixed-Methods Evaluation
Rashmi K. Sharma, MD, MHS
This NIA-funded R01 study uses a mixed-methods approach to: detect disparities in the quality of care for older adults with Alzheimer’s Disease and Related Dementias (ADRD) and limited-English proficiency (LEP) across palliative care domains using EHR data; advances our understanding of important and modifiable patient, family, provider, and system level factors driving these disparities using interviews with key stakeholders; and assesses community-level resources, capacity, and needs to support high quality palliative care for three diverse LEP communities (Latinx, Chinese, and Vietnamese). This contribution is expected to be significant because it will identify targets for the development of effective multi-level, culturally and linguistically-appropriate interventions to reduce inequities in palliative care for this vulnerable population.
Care Inequities in Advanced Cancer and Limited-English Proficiency
Rashmi K Sharma, MD, MHS
The goal of this study, funded by the American Cancer Society, is to apply a multi-level approach to identifying patient, family, clinician, system, and community-level targets for intervention to improve the quality of palliative care for patients with advanced cancer and limited-English proficiency (LEP) across five LEP communities at high risk of experiencing inequities in cancer care (Latinx, Vietnamese, Somali, Cambodian, and Ethiopian). The results of this study will inform the development of multi-level interventions that can be successfully implemented and adapted for patients with advanced cancer of different linguistic and cultural backgrounds, their families, clinicians, and the communities where they live. Ultimately, this work will help eliminate inequities in the delivery of high-quality, palliative care for patients with LEP and advanced cancer.
Large Scale Clinical and Economic Impact Analysis of Potentially Malignant Incidental Findings in Radiology Reports
Thomas Payne, MD, Meliha Yetisgen, PhD, Martin Gunn, MD
In this project, we will build natural language processing approaches to extract cancer-related incidentalomas (unsuspected findings) reported in radiology reports and create the first large-scale incidentaloma database for half-a-million patients who received radiologic imaging tests in University of Washington Medical Center, Harborview Medical Center, and Seattle Cancer Care Alliance between 2008 and 2018. This database will be used for clinical and economic analysis of incidentalomas.
Using EHR Content to Prevent Breast and Ovarian Cancer
Thomas Payne, MD
This study will characterize and quantify latent EHR risk factor information (information that exists within a patient's EHR record but which is not known by current treating providers) to determine scope and location of breast and ovarian cancer risk factor content within EHR records of women with notes, reports, orders, and scanned documents. A risk score will be developed using these EHR data to determine the value of the information in reducing disease risk. If this latent EHR risk factor information could be recognized and acted on, many more women may be recognized to have appropriate indications to receive genetic counseling as a preventative measure, and thus have better outcomes.
A Comparative Effectiveness Trial of an Information Technology Enhanced Peer-Integrated Collaborative Care Intervention for US Trauma Care Systems
Doug Zatzick, MD and Peter Thomas, JD
The randomized comparative effectiveness trial aims to evaluate two readily deliverable approaches to the care of injured patients; the two approaches to be compared are a team intervention approach that integrates front-line trauma center staff with peer interventionists, versus trauma surgery notification of patient emotional distress with recommendation for mental health consultation.
A Policy Relevant US Trauma Care System Pragmatic Trial for PTSD and Comorbidity
Doug Zatzick, MD
The overarching goal of this proposal is to work with the NIH Health Care Systems Research Collaboratory to develop and implement a large scale, cluster randomized pragmatic clinical trial demonstration project that directly informs national trauma care system policy targeting injured patients with presentations of Posttraumatic Stress Disorder (PTSD) and related comorbidity.
Building Research Capacity for Firearm Safety among Children
Doug Zatzick, MD, Frederick Rivara, MD and Carolyn McCarty, PhD
The overarching goal of the project is to reduce the number of firearm injuries occurring among children. The approach seeks to apply the science of injury prevention used in other injury fields such as motor vehicle crash to the field of childhood firearm injuries.
Late Career Practitioners: Balancing Patient Safety and Physician Autonomy
Thomas H. Gallagher, MD, Andrew White, MD, and Michelle M. Mello, JD, PhD
As of 2015, nearly a quarter of practicing physicians were over age 65. Older physicians bring the advantage of long clinical experience to patient interactions but are also at higher risk of experiencing declines in cognition and sensory abilities. There is a need for better tools and policies for late career practitioners, but little research currently exists to guide the development of this work. This study aims to characterize the approaches that the first late career practitioner programs have pursued, learn from late career practitioner leaders what has worked, and understand physicians’ perceptions of and willingness to participate in late career practitioner programs. If your healthcare organization has a late career practitioner policy that we can include in this research, or you are a physician without a late career practitioner policy in place at your organization who is interested in joining a virtual focus group in Seattle, Northern California, and Denver, please email email@example.com.
CRP Certification: Promoting Accountability and Learning After Adverse Events
Thomas H. Gallagher, MD
Communication and Resolution Programs (CRPs) represent a breakthrough in promoting patient-centered accountability and disseminated learning following adverse events, but physicians and healthcare institutions worry that using a CRP could trigger a punitive response by regulators such as state boards of medicine. We have developed the CRP Certification Program, in which a neutral review panel will determine if an adverse event was handled appropriately using the key principles of a CRP, in which case the state board of medicine will not pursue disciplinary action. The purpose of this project is to implement and evaluate the CRP Certification Program in 3 states and assess its suitability for national rollout.
Open Notes: Improving Health through a Culture of Transparency
Tom Delbanco, MD, Jan Walker, RN, MBA and Thomas Payne, MD
The goal of this project is to study the effects of note viewing and co-generating of notes by patients on patient and provider satisfaction and health outcomes.