Center for Surgery and Public Health

TRAUMA AND INJURY PREVENTION

CSPH Health Policy & Practice focuses on the evaluation of questions and outcomes that are meaningful and important to patients and caregivers, and crafting policies that are respectful and representative of these individual patient preferences.

• Conducting national, multisite mixed method study to identify barriers, facilitators, and outcomes of Advanced Care Planning, including examination of unique needs of patients with dementia
• Multisite project studying the feasibility of transmitting Unique Device Identifiers (UDIs) from clinical Electronic Health Record (EHR) systems to insurance claims to promote transparency for patients, allowing timely warning in case of an implant’s defect or failure, and support evaluations of device effectiveness
• Leading a national expert consensus process to define hospital-level metrics indicating disparities in access, treatment and outcomes to guide quality improvements

HEALTH POLICY AND PRACTICE

• Studying long-term functional and psychosocial outcomes of trauma patients (FORTE) and identifying potential opportunities for intervention
• Identifying and ranking research priorities in long-term functional outcomes and injury prevention as part of the National Trauma Research Action Plan (NTRAP) multi-institutional collaboration
• Designing and testing effectiveness and retention of bystander hemorrhage control training
• Understanding the role of healthcare practitioners in preventing and mitigating firearm injury
• Developing and testing interventions to improve mortality and morbidity resulting from emergency general surgery procedures

CENTER FOR GERIATRICS AND SERIOUS ILLNESS IN SURGERY

Research in this area focuses on improving care for traumatically injured geriatric and seriously ill patients, with an emphasis on integration of palliative care and shared decision-making.

• Collecting patient-reported outcome measures for older Emergency General Surgery (EGS) patients with secondary data analysis to describe the 12-month healthcare trajectory and hospice utilization among older trauma and EGS patients
• Identifying best practice guidelines for older injured adults
• Developing Quality of Life and functional measures for older patients and incorporating them into the National Surgical Quality Improvement Program (NSQIP)
• Conducting qualitative research study on patient-perception of shared decision making prior to traumatic surgery

• Developing and studying the implementation of a Non-Technical Skills for Surgery (NOTSS) curriculum in variable-resource settings to improve surgical safety and quality
• Studying surgical site infections, antimicrobial resistance, and cesarean section delivery in rural Rwanda to improve postoperative care
• Coordinating surgical faculty for the Rwanda Human Resources for Health Program (2012-present)
• Analyzing global indicators for access to essential surgical care in the U.S. and Mexico

SURGICAL CULTURE

The Surgical Culture Program aims to improve patient outcomes by understanding how the non-technical skills of surgeons and surgical teams affect performance in and out of the OR.

• Developing simulation-based countermeasures to mitigate team and system vulnerabilities during medical event management on long duration space missions
• Conducting a multicenter trial at academic medical centers across the U.S. and Canada, evaluating the effectiveness of a novel curriculum called the Provider Awareness and Cultural Dexterity Toolkit for Surgeons (PACTS) in improving surgical residents’ knowledge, attitudes, and skills in caring for patients of different cultural backgrounds
• Conducting mixed methods study of the experience of women during surgical residency, including pregnancy and parenthood

CANCER & COMPARATIVE EFFECTIVENESS

This program aims to improve the value and effectiveness of cancer care by identifying drivers of high and low-value care. We focus on policy and health systems-based changes to better understand how to improve access to high-quality cancer care that makes a difference, including:

• Studying racial disparities in screening, treatment, and outcomes for different cancers, including bladder, prostate, and colorectal
• Evaluating the relationship between health literacy, shared decision-making policies, and cancer screening
• Analyzing the impact of accountable care organizations on cancer screening and costs of cancer care
• Assessing how the ACA has impacted cancer screening and detection of early stage cancers
• Studying cost-effectiveness of innovative technologies