Grant-Funded Clinical Trials and Research Projects
Current Grants | Completed Grants
Current Grants
Illinois Surgical Quality Improvement Collaboration Conference
Funding Source: Agency for Healthcare Research and Quality (AHRQ)
Project Period: 02/01/11-01/31/12
Total Award: $45,625
P.I.: Mark Eskandari, MD, FACS
This year long grant is funded by AHRQ’s small conference grant mechanism. The grant will support a conference for the Illinois Surgical Quality Improvement Collaboration (ISQIC). The conference, scheduled for November 5, 2011, will be a forum for dissemination and implementation of a state-wide quality improvement effort targeting venous thromboembolism (VTE). Throughout this conference emphasis will be placed on sharing evidence-based interventions and best-practices toward VTE prevention through a symposium to include national expertise, educational syllabi, and literature review. We also want to identify realistic QI interventions to be adopted and tracked at hospitals through breakout workshops that address a multidisciplinary team approach. It is hoped that the conference will lead to the measuring and review of risk-adjusted outcomes over time with follow-up of specific variables not captured by ACS NSQIP. Dr. Mark Eskandari of Northwestern Memorial Hospital is the PI for the grant.
Explore Risk Adjustment for Claims Data for Surgical Outcome Measures Developed by the American College of Surgeons (ACS)
Funding Source: Center for Medicare & Medicaid Services (CMS)
Project Period: 09/01/10-08/31/11
Total Award: $95,000
P.I.: Clifford Ko, MD, FACS
To provide the public with a broader spectrum of quality measures, CMS plans to expand the domains of the measures posted on Hospital Compare (HC) to include surgical outcomes, preferably outcomes based on clinical data. The American College of Surgeons (ACS) has developed five risk-adjusted Surgical Outcome Measures using clinical data collected by the ACS’ National Surgical Quality Improvement Program (NSQIP). The five measures are listed below.
- Risk Adjusted Lower Extremity Bypass Surgery Outcomes
- Risk Adjusted Colorectal Surgery Outcome Measure
- Risk Adjusted Case Mix Adjusted Elderly Surgery Outcomes Measure
- Risk Adjusted Surgical Site Infection Outcome Measure
- Risk Adjusted Urinary Tract Infection Outcome Measure
CMS is considering adopting these measures for public reporting on HC since they met CMS’s program need for outcome measures that are based on clinical data. The ACS will elucidate whether risk adjustment embedded in the ACS measure methodology can be preformed using a hybrid database (i.e., a mix of chart and claims data) or a database with claims data only. The findings will be important to inform CMS decision making on public reporting of the ACS surgical measures in HC.
Understanding and Reducing Variation in the Outcomes of Cancer Surgery
Funding Source: National Cancer Institute (NCI)
Project Period: 09/01/08-08/31/11
Total Award: $1,505,407.00
P.I. John Birkmeyer, MD, FACS
Wide variations in mortality rates across both hospitals and surgeons suggest that the safety of cancer surgery could be improved substantially, but quality improvement efforts are currently limited by a lack of understanding about mechanisms underlying variations in hospital performance. In this context, our project has two specific aims: 1. To determine the causes of excess operative deaths at hospitals with high cancer surgery mortality. Using data from the National Cancer Database, we will identify 20 hospitals with among the lowest cancer surgery mortality rates in the United States (approximately 1.5%) and 30 hospitals with the highest mortality rates (approximately 10%). Based on clinical chart review, we will first compare these two groups of hospitals with regard to cause-specific mortality rates. We will then examine whether differences in cause- specific mortality rates are attributable to differences in the incidence of complications or failure to rescue rates. 2. To identify resources and processes of care that account for differences in complication rates and mortality. With a better understanding of the clinical causes of excess deaths at high mortality hospitals, we will then examine specific structural variables and processes of care that underlie differences in outcomes between the 2 hospital groups.
We will use an empirically-derived composite quality measure to rank hospitals based on information from the NCDB. Best and Worst hospitals will be selected from the top and bottom of the list, respectively, until sample size requirements are satisfied. We will calculate the composite measure using two inputs: 1) the risk-adjusted mortality with cancer surgery and 2) the overall cancer surgery volume.
Collaboration for Improving and Promoting Standarized Cancer Staging Using the Collaborative Staging System
Funding Source: Centers for Disease Control & Prevention (CDC)
Project Period: 09/30/08-09/29/13
Total Award: $1,710,095
P.I. David P. Winchester, MD, FACS
The American Joint Committee on Cancer (AJCC), headquartered at and staffed by the ACS, provides the program management for the development and maintenance of the Collaborative Staging (CS) System: a Tumor, Node and Metastasis coding system used by cancer registries to collect information on the extent of disease for cancer patients seen at their facility. The ACS received a five-year CDC cooperative agreement to provide staff and committee support to revise the current CS System and release a Version 2 compatible with the new AJCC 7th edition Cancer Staging Manual. The agreement is currently in its third year of funding. The second year progress report and application for funding request for year 3 was submitted; for year three we received $422,019, an increase of $100,000 over the previous year. Dr. David P. Winchester is the Principal Investigator for the project.
EMSC Targeted Issue Grants
Funding Source: Health Resources and Services Administration (HRSA)
Project Period: 09/01/10-08/31/13
Total Award: $896,426
P.I. J. Wayne Meredith, MD, FACS
Injury is the leading cause of death and disability in children above the age of one. HRSA’s EMS for Children program, through the performance measures associated with its state partnership grant program, encourages the designation of all emergency departments in each state according to their ability to care for childhood emergencies. This performance measure is also consistent with the recommendations framed in the Institute of Medicine’s work titled EMS for Children – Growing Pains. Several states have achieved some level of compliance with this performance measure. Criteria for emergency department recognition in pediatrics involve both equipment and personnel measures. In a similar process, many states have designated acute care facilities according to their capacities to care for injured patients, including pediatrics, as part of inclusive and integrated trauma systems. The impact of emergency department recognition in pediatric on injury outcomes in pediatric populations has not been measured. Likewise, the degree of overlap and integration between emergency department recognition in pediatrics and trauma center designation has not been confirmed or described. Through this grant we hope to fulfill two objectives. First, determine the impact of statewide emergency department pediatric recognition programs on the care of injured children. And second, determine the degree of integration of systems and resources in a state with both ED pediatric recognition and trauma center designations. The grant is sub-awarded through Wake Forest University and J. Wayne Meredith MD, FACS will serve as PI for the grant.
Revised June 15, 2011