Rapid Prospective Evaluation (RapidEval) Unit

The RapidEval Unit features the unique opportunity for investigators to be supported in generating high-quality new evidence on healthcare practices. The unit focuses on and fosters rapid, iterative learning that builds upon the natural innovation taking place within the healthcare system. The activities of the RapidEval Unit are aimed at and designed to increase adoption of best practices. The unit features a semi-annual “Call for Proposals” for new research projects. RapidEval is led by Mike Usher, MD, PhD and Joe Koopmeiners, PhD and receives project management support from Maya Peters, MPH.

RapidEval Semi-Annual Call for Proposals

The  Fall 2022 RapidEval Call for Proposals is now closed. Please email CLHSS@umn.edu with any questions.

The RapidEval Call for Proposals (CFP) is an opportunity for health care professionals and investigators to submit their idea for improving healthcare practice. If accepted into the research program, the RapidEval unit provides investigators with:

  • Mentorship & research design expertise
  • Project management, implementation & dissemination support
  • Statistical analysis
  • M Health Fairview projects include data and technology support

The RapidEval CFP takes place twice a year, once in the Spring and once in the Fall. Research proposals that are best suited for the RapidEval program have the following qualities:

  • Feasible implementation of intervention within 2-3 months
  • Significant frequency for research to be completed in ~6 months
  • Potential for positive impact on healthcare delivery or health equity
  • Alignment with health system priorities
  • Low risk/likely cost-effective intervention
  • Encourage established best practices
  • Improve outcomes already captured in routine care

The RapidEval CFP process occurs over a period of 2 months. The steps in the process are outlined below:

  • Submission of an application
  • Selected proposals will be notified and invited to a final round of interviews
  • Final selection of proposals for acceptance into the RapidEval research program
  • Project kickoff
Frequently Asked Questions

Does the RapidEval research program provide funding?

The RapidEval Unit does not provide investigator funding, but does offer the following services if accepted into the research program:

    • Mentorship & research design expertise
    • Project management, implementation & dissemination support
    • Statistical analysis
    • M Health Fairview projects include data and technology support

Is previous research experience required?

No previous research background is required. The RapidEval Unit aims to help guide new investigators in study design, statistical analysis, and implementation and dissemination strategies.

What is the timeline for a RapidEval project?

The timeline from application to completion of an accepted RapidEval research project varies, but a rough estimate is:

    • Application phase: 2 months
    • Planning phase: 3 months
    • Implementation phase: 6 months
    • Dissemination phase: 3 months
    • Total: 14 months

Can the RapidEval team review my project idea when the call for proposals is not open?

Yes! At any time you can request a RapidEval consult by completing the applicable CLHSS Intake Form.

Current Rapid Eval Research Projects

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Using decision aids to improve utilization of cardiac monitoring (Fall 2021)

Using decision aids to improve utilization of cardiac monitoring (Fall 2021)

Investigator: 

Brian Hilliard, MD

  • Assistant Professor of Medicine, Division of General Internal Medicine, University of Minnesota
  • Co-chair, Quality Committee, Hospital Medicine Domain, M Health Fairview

The problem: 

Within M Health Fairview hospitals, patient flow is critical for exceptional patient experience, clinical safety and cost efficiencies. We have observed that the cardiac monitoring (or telemetry) bed capacity is a bottleneck for patient flow in our system. Wide variation still exists among sites, units and physicians on what is considered appropriate use for telemetry. This inappropriate use leads to suboptimal uses of our staff time, skill sets, equipment and facilities, and limits access to telemetry for patients who need it.

The intervention:

The intervention will use a multi-faceted approach that incorporates decision aids into the electronic health record. First, clearer indications for use of telemetry, with links to evidence based literature, will be provided within the cardiac monitoring order. Second, best practice alerts (BPAs) will be displayed at the end of the guideline-supported duration for use. 

Outcomes:

This intervention aims to improve quality and safety by removing patients who don’t need telemetry, thus improving capacity and access for patients who need it. It can also improve the total cost of care by reducing patients’ length of hospital stay, financially benefiting both the health system and the patients.

Status:

In Progress

Reducing chemotherapy toxicity in older adults with cancer (Fall 2021)

Reducing chemotherapy toxicity in older adults with cancer (Fall 2021)

Investigator:

Arjun Gupta, MD

  • Assistant Professor of Medicine, Division of Hematology, Oncology and Transplantation, University of Minnesota

The problem:

Every year, over 30,000 Minnesotans are diagnosed with cancer, and cancer is the leading cause of death in Minnesota. Older adults with cancer have vulnerabilities (e.g., issues with function, comorbidity, cognition, and nutrition) that place them at high risk of chemotherapy toxicity. Unfortunately, busy oncologists do not have the time, resources, or infrastructure in clinic to assess or address these vulnerabilities in a systematic manner. This leads to higher rates of chemotherapy toxicity in older adults with cancer. 

The intervention:

The intervention will involve an on-screen electronic alert which will pop-up during the first clinic visit of eligible patients with their oncologist. The alert will inform the oncologist that the patient is at a high-risk of chemotherapy toxicity due to their age and comorbidities, and link to a free, online tool which calculates the risk of chemotherapy for individual patients (https://www.mycarg.org/?page_id=2405). 

Outcomes:

Incorporating chemotherapy toxicity tools into the electronic health record can inform patient-oncologist decision-making about whether and what chemotherapy to pursue, and decrease toxicity, primarily unplanned hospitalization. The intervention aims to improve patient outcomes, decrease burden on the healthcare system, and result in cost savings.

Status:

In progress

Improving management of septic patients with a micro educational tool (Fall 2021)

Improving management of septic patients with a micro educational tool (Fall 2021)

Investigator:

Ben Webber, MD

  • Assistant Professor of Medicine, Division of General Internal Medicine

The problem:

Sepsis remains the leading cause of in-hospital mortality at MHealth Fairview despite a push for more standardized care. Process measures aimed at improving care involve early identification of patients at risk for sepsis and subsequent evaluation and treatment. Despite these processes being in place for over 5 years at MHealth Fairview, provider compliance remains poor. It is well established in the literature that antibiotic timing is associated with inpatient mortality, length of stay, and complication rates following diagnosis. Developing strategies to improve efficiency in recognition of sepsis and delivery of disease altering treatment is a priority across the country and the target of a national public health campaign.

The intervention:

This study will involve micro-educational interventions delivered to physicians, advanced practice providers, residents, students, and nurses who can impact clinical outcomes through increased awareness, knowledge, and clinical information that the intervention targets, i.e. sepsis recognition, treatment, and outcomes. As the education pieces disseminate, the interventions themselves will change and adapt to better cater to the new clinical reality and scenario that the previous intervention helped create. In the process, creating a replicable framework for iterative education to impact future clinical outcomes or targets.

Status:

In progress

Communication tool designed to tailor post op pain control to reduce opiate overuse/dependency (Fall 2021)

Communication tool designed to tailor post op pain control to reduce opiate overuse/dependency (Fall 2021)

Investigator:

Sagar Deshpande, MD

  • Surgical Resident, University of Minnesota Medical School

The problem:

It is no secret that post-surgical opiate counseling is often suboptimal. But even with ideal counseling, the deck can be stacked against patients. Patients must remember instructions weeks-to-months later, despite being in great pain or already on opiate medications at the time of counseling. At baseline, patients have poor and inaccurate memories for medical advice, especially with regard to treatment, and the very pain that necessitates opiate medication only exacerbates that issue. The confluence of these factors potentiates patients towards addiction. To overcome these barriers, a partnership is necessary between the care team and patient in a co-productive initiative to use and discontinue opiate medication usage. 

The intervention:

Behavioral economics offers a novel perspective to the problems of opiate overutilization and diversion rather than the existing medical approach. By harnessing the natural tendencies of populations, changes in behavior and decision-making can be induced. We are developing a “chatbot”- type artificial intelligence (AI) application (“OPY”) which counsels patients on appropriate opiate usage and delivers timely information to patients who are prescribed new opiate medications. Using insights from behavioral economics, we have designed and tested various “nudges,” or informational framing schemes, regarding information on opiate weaning and disposal. These nudges will instruct patients on how to optimize their pain control, maximize their ability to wean off their opiates, and dispose of their medications safely and legally.

Status:

In progress

Improving utilization of medication therapy management services for patients with economic instability (Spring 2022)

Improving utilization of medication therapy management services for patients with economic instability (Spring 2022)

Investigator: 

Shana Steinbeck, PharmD, BCPS

  • Clinical Pharmacy Manager, Residency Program Director, M Health Fairview, Woodwinds Health Campus

The problem: 

The inpatient pharmacist assesses all patient admission medication histories, inpatient medications, and discharge medications for indication, effectiveness, safety, and convenience.

Currently, a medication therapy management (MTM) referral is placed for M Health Fairview patients with certain high-risk disease states and/or polypharmacy based on an Epic formula.

Research has shown the benefit of MTM pharmacist inclusion on care teams through alleviating chronic disease risk factors and monitoring patients for clinical care needs. 

Unfortunately, there are currently no pharmacist assessment questions nor an Epic formula that can identify patients with potential economic instability who would benefit from MTM care. The inclusion of social determinants of health, such as economic stability, can directly impact a patient's ability to afford their medications, and, therefore, maintain adherence and reduce disease progression.

The intervention:

This proposal aims to identify patients with potential economic instability and refer them to MTM services. The hypothesis is that the inclusion of patients who may not be able to afford their medications in the MTM referral process will ultimately reduce medication non-adherence, which will impact patient morbidity and health care utilization in the long-term.

Status:

In Progress

Expanding specialist telestroke care for all hospitalized MHFV stroke patients (Spring 2022)

Expanding specialist telestroke care for all hospitalized MHFV stroke patients (Spring 2022)

Investigator:

Christopher Streib, MD

  • Associate Professor, Department of Neurology; Vascular Neurology Fellowship Director, University of Minnesota; Cerebrovascular Director, M Health Fairview

The problem:

Stroke is the fifth leading cause of death and number one cause of long-term disability in the United States. For patients presenting to the hospital with acute ischemic stroke, urgent diagnostic stroke evaluation and immediate initiation of targeted secondary stroke prevention is essential. 

However, due to a severe shortage of stroke neurologists, timely specialist stroke care is often unavailable. This is problematic because fragmented and inconsistent stroke care reinforces known racial and geographic healthcare disparities.

The intervention:

It is our intent to utilize telemedicine ("telestroke") to facilitate urgent stroke specialist care for all hospitalized M Health Fairview stroke patients regardless of geographic location.

We aim to test the impact of this care model on multiple relevant stroke care outcomes, including the percent of acute ischemic stroke patients who receive an urgent telemedicine stroke, recurrent stroke rate, and readmission rate among other outcomes.

Status:

In progress

Fall 2022 Rapid Eval Program Awardees

The Center for Learning Health System Sciences is pleased to announce the selected applications from the Fall 2022 RapidEval Call for Proposals. Two University of Minnesota investigators will receive support to test their ideas for enhancing healthcare delivery in the areas of surgical site infection prevention and optimizing prescribing for HIV preexposure prophylaxis. Read More!