New Initiative Will Focus on Improving Care Outcomes

Oct. 23, 2013

A $1.2 million grant from the New York State Empire Clinical Research Investigator Program will support new research teams in the URMC Departments of Surgery, Neurology, and Medicine. The project – titled Patient Outcomes with Surgical Interventions – will provide training in clinical research and seek to address variations in adherence to care guidelines that can significantly impact outcomes. 

“Surgical care and medical-based procedures are one of the largest components of the U.S. health care system, with more than 230 million performed annually for various conditions including cancer, cardiovascular disease, and stroke,” said Mark Taubman, M.D., dean of the School of Medicine and Dentistry. “This project will support research by junior faculty and trainees in several departments and will focus on identifying variations in care and risk factors, eliminating complications, and developing cost-effective models for seamless care that can be replicated across New York State.”

The project will involve a two-year long training fellowship that will include 5 research fellows per year and will focus on three surgical and medical interventions.  Trainees with work with the multi-disciplinary teams across the continuum of care and supportive services provided to patients before, during, and after their procedures.

Colorectal Cancer – Department of Surgery and Surgical Health Outcomes and Research Enterprise

Colorectal cancer is the second most common cause of cancer death in the U.S. While highly effective treatment options have been developed over the last three decades, the vast majority of patients do not receive guideline-based care leading to complications including hospital readmission. An estimated 30 percent of hospital readmissions for colorectal surgical care are avoidable. This project will identify the modifiable factors responsible for poor adherence to clinical practice guidelines and develop pilot interventions to overcome these barriers in real practice settings. 

Acute Brain Injury – Departments of Neurology and Neurosurgery

Stroke and head trauma are leading causes of death and disability. However, little is known about the current state of end-of-life care in the U.S. and New York State for these patients. This project will focus on variation in the use of invasive procedures and surgical approaches to treat and manage patients with acute brain injury.   The objective of this project is to identify predictors of life-sustaining interventions and hospice utilization in these patients and develop pilot approaches to reduce unnecessary practice variation and to optimize the delivery of patient-centered outcomes.   

Heart Disease – Department of Medicine and Heart Research Follow-Up Program

Ventricular assist devices (VADs) and cardiac resynchronization therapy are primarily intended to increase survival in patients with advanced heart failure. However, VADs have been associated with complications such as bleeding and thrombosis, particularly in patients who have undergone chest radiation and chemotherapy for breast and other cancers. This project will study the underlying mechanisms responsible for bleeding in patients with VADs and the impact of cardiac resynchronization therapy on improving outcome in patients with chemotherapy or radiation-induced cardiomyopathy.