Healthcare Research and Improvement

Baylor established the Institute for Health Care Research and Improvement (IHCRI) to encourage and facilitate research relating to clinical effectiveness and quality throughout the Baylor system. IHCRI has a wide variety of ongoing innovative research projects. Among these are:

• David J. Ballard, M.D., M.S.P.H., Ph.D., holder of Baylor Health Care System's endowed chair for health care research and director of the IHCRI, received more than $1 million from the American Diabetes Association, the PacifiCare Care Fund, the Agency for Healthcare Research and Quality (AHCRQ) and Pfizer, Inc., to conduct an 18-month randomized trial to determine the marginal cost-effectiveness of a diabetes resource nurse model within HealthTexas Provider Network.
• Dr. Ballard also collaborated with Haya Rubin, M.D., Ph.D., of Johns Hopkins University on an AHCRQ grant to clarify the methods for measuring medication errors and medication-related harm.
• IHCRI researchers are working with HealthTexas Provider Network (HTPN) to investigate the quality of care diabetes patients receive in a fee-for-service primary care setting and the effectiveness of utilizing a diabetes resource nurse to provide initial assessment, administration of screening tools, assistance with compliance to American Diabetes Association (ADA) standards and monitoring of clinical outcomes. This study was funded primarily by the ADA ($850,000) and Pfizer ($185,000) in collaboration with HTPN.
• Cody Arnold, M.D., a neonatologist on the staff at Baylor and an IHCRI clinical scholar, is leading a research effort to improve the care infants receive in the neonatal intensive care unit and prevent hospital-acquired infections. Several departments at Baylor University Medical Center including Pharmacy, Neonatal Intensive Care Unit, Epidemiology/Infection Control and Information Systems, are collaborating to create and implement an information system that provides real-time decision support for clinical practice guidelines to determine the proper use of antibiotics for infants, and generate compliance and target outcome reports.


In collaboration with Pediatrix Medical Group, Inc, - the nation's largest neonatal physician group - researchers will test the effectiveness and safety of the clinical practice guidelines and supporting information system in a multi-center randomized controlled trial in Pediatrix-staffed NICUs nationwide.
• Other neonatal research being conducted involves the appropriate use of neonatal oxygen therapy to prevent retinopathy of prematurity, the second most common cause of childhood blindness in the United States. Dr. Arnold is working with Baylor Information Systems to create an information system to monitor oxygen therapy in the NICUs and produce regular reports for clinicians, nurse managers and medical directors showing how consistently oxygen therapy is maintained within the target range. This will allow NICUs to monitor performance and evaluate programs designed to improve performance. The information system will also support future research to improve oxygen therapy and to determine optimal blood-oxygen level targets for newborns.
  
  The information system will be developed and tested in the Baylor University Medical Center NICU and other Pediatrix NICUs across the United States. Following adequate evaluation, the information system software will be made available to NICUs worldwide.
  
  This work will be funded in part by the Baylor Health Care System Foundation/Retina Foundation ($30,000), Nellcor/Tyco Healthcare ($20,000) and Fight for Sight ($15,000).
• Researchers are establishing a standardized autopsy laboratory at Baylor to allow autopsy information to be collected to show correlations between autopsy and clinical diagnoses. Once in place, specific disease diagnoses will be investigated and scientists can determine how often they are correctly diagnosed and treated. The goal of this project is to design and implement interventional studies that show autopsy information can be used to improve processes and outcomes and the overall quality of care.
• Baylor researchers are collaborating with the Texas A&M University Health Science Center to implement a web-based hospital quality of care benchmarking and case review tool in rural and small community hospitals to improve patient safety and quality of care. This is a 3-year randomized trial, funded by the Agency for Health Care Quality and Research (AHCQR) involving 60 hospitals throughout Texas, to evaluate the effects of technology and the incremental effects of an educational intervention on patient safety and quality.
• The Baylor Clinical Transformation program is working with HTPN to introduce an ambulatory electronic health record (AEHR) throughout HealthTexas practices. Researchers will investigate the effects of the AEHR on six dimensions of quality -- safety, timeliness, effectiveness, efficiency, equity and patient centeredness and on practice financial performance, based on clinical and administrative data already being collected within HTPN systems.
  
  This study will provide valuable information about AEHR's impact on quality of care in a primary care setting and on the financial effects for a physician practice implementing an AEHR.

Find more information on a research study at Baylor.