This section presents recent videos by CHSOR faculty and invited guests.
PCORI at 10 Years: Expectations and Reality
Dr. Joe Selby, former Executive Director of the Patient-Centered Outcomes Research Institute (PCORI), delivered the 2020 Sam Shapiro entitled: “PCORI at 10 Years: Expectations and Reality.” Looking ahead, Dr. Selby described a greater focus at PCORI on comparing costs of care, taking advantage of PCORnet, systematic reviews, dissemination, and implementation. An invited panel discussion followed, featuring leaders in patient-centered outcomes research: Mark Helfand, Professor, Oregon Health & Science University, Jodi Segal, Professor, JHSOM & CHSOR, and Elizabeth Stuart, Professor & Associate Dean, JHSPH.
Health care workers and adverse events: the golden moment
Too often, patients are harmed by medical care. However, the brief period of time that follows represents a “Golden Moment,” a window of opportunity to communicate with the patient, support involved healthcare staff, and improve patient safety. The Golden Moment can be lost due to the prevailing culture, with fear of punishment or litigation, lack of awareness, and inadequate training. As a result, incidents are not discussed with patients and families, clinicians do not received timely support, and opportunities to learn are missed. The webinar discussed how to foster a culture of safety, strategies to promote open conversations with patients and families, and an organizational mechanism to support healthcare staff.
Panel Discussion at Johns Hopkins: The Future of Health Services Research
The panelists: Darrell Gaskin, Claudia Salzberg, Stephen Shortell, Jonathan Weiner, Danielle Whicher (speaker), and Albert Wu (moderator) – addressed challenges and future priorities for the field of Health Services Research (HSR) at an important point. HSR faces weakening funding and needs to enhance its message to gain support from governmental and non-governmental entities. This situation calls for a dialogue within the HSR community to take a stock of priorities and reorganize itself. The panelists discussed aligning delivery of HSR findings with the needs and expectations of policy-makers and industry, translating findings to help organization-level decision making, communicating HSR impact to various audiences, drawing information out of data, and identifying needs for HSR education in the future.
Breakthrough Improvement in the U.S. Healthcare: Merging Evidence-Based Medicine and Evidence-Based Management
Dr. Stephen Shortell provided in his Sam Shapiro lecture real-world examples aimed to bridge the healthcare quality chasm. Inspired by the vision of high performing patient-centered teams and organizations that facilitate them, Dr Shortell employs rigorous quantitative and qualitative methods to understand organizational behavior. The lecture provides a needed road map connecting concepts of behavior and culture change, team dynamics, commitment to value in care, and learning health systems with healthcare redesign, patient engagement, and, ultimately, healthcare performance improvement. Video includes tribute to Sam Shapiro and an exploratory Q&A section.
The Future of Health Services Research: Confronting Determinants, Delivery and Data
In her 2018 Sam Shapiro Lecture, Dr. Lisa Simpson highlighted the importance of social determinants of health, innovations in healthcare delivery, and leveraging supporting data for health services research. The presentation’s guiding theme is #evidencematters. Through the lenses of evidence-based requirements, Dr. Simpson provides an overview of what works in healthcare, for whom it works, in what contexts, what are the associated costs, and how we can promote spread across settings. Specific examples include projects on housing, combating food insecurity, adverse childhood experiences (ACEs), state Medicaid-led payment innovations, and data collaborations. Even the ensuing Q&A session was evidence-based!
Selecting and Adapting Tools for Palliative Care Survey Research
Dr. Sydney Dy presented this webinar as a part of the Investigator Development series of the Palliative Care Research Cooperative. The webinar addresses the purposes of adapting tools for palliative care and describes the process for adapting survey tools using an illustrative survey example - Measuring and Improving the Quality of Palliative Care Survey. The webinar walks through the adaption of conceptual framework, determination of content and construct validity, evaluation of reliability and sensitivity, all the way to resolving practical issues. To view and download the slides, please use this link.
The Health Services Research Diaspora
Dr. Andrew Bindman dedicated his 2017 Sam Shapiro lecture to describing how the health services research agenda became dispersed and weakened and what can be done to resolve it. The presentation covers some of the history of the Agency for Healthcare Research & Quality (AHRQ), which Dr. Bindman directed in 2016-2017, and discusses how the crisis for AHRQ relates to the current state of health services research. The lecture introduces solutions to present a stronger story for the field and to invigorate efforts to narrow the gap between evidence and practical implementation in the healthcare sector. There was a robust discussion during the ensuing Q&A session with CHSOR and other Hopkins faculty.
Patient Safety & Patient Outcomes: Two Roads Taken
In his presentation, Professor Albert Wu shares lessons learned from his career and research collaborations. Dr. Wu describes why the first clinical trial conducted to assess the quality of life among people with HIV inspired him to measure patient outcomes more systematically. The speaker recollects skepticism encountered to his pioneering works on medical errors and their second victims – healthcare workers traumatized by adverse effects. Consequently, Professor Wu highlights the importance of being mentored, of cultivating a network of collaborators, and of practical implementation of one’s scientific passions through projects, teaching and dissemination. Wu’s story exemplifies that even unappreciated research questions can have impact beyond one’s imagination. This presentation provides both inspiration and guidance for young scholars entering the field of health services and outcomes research.
Thinking: Redefining Health Care Systems and Improving Health
Dr. Robert Brooks’ Sam Shapiro lecture urges the rethinking of the health care systems and their underlying values. Through disruptive change and the redefining of health care measurements, the speaker proposes the expansion of the role of medicine and the nurturing of the culture of health in society. Dr. Brooks illustrates his argument with personal anecdotes from his Baltimore scholarly and clinical practice. The presentation is spiced with thought-provocative queries about humane care, social isolation, multidimensional inequalities and our duty to the planet. To propel that revolutionary approach to health care systems redefining, the speaker explores collaborative and extracurricular ways of learning, the inclusion of social determinants of health in medical practice and the expansion of the agenda of health services and outcomes research.
The Ethics of Opioids
This presentation discusses key issues with end-of-life opioid use, including overuse of opioids and underuse of key accompanying elements of pain management. This can cause significant harms and burdens for patients and families. Existing palliative and hospice ethical frameworks for this important issue are limited in scope, and this perspective needs to be expanded.
The RISE - Resilience in Stressful Events
The RISE solution provides guidance on setting up the program, teaches a multi-disciplinary team of volunteers to respond and support a team member involved in an unanticipated patient event, stressful situation, or patient-related injury and who is himself or herself “traumatized” by the event, and provides ongoing support to organizations implementing the program.
The Patient Safety at the End of Life
This presentation discusses key issues in patient safety at the end of life, particularly the key area of improving documentation of patient preferences for life-sustaining treatment, including goals of care and advance care planning. The talk also discusses other issues, such as adverse effects from medications and procedures, including delirium, constipation and pain.