The Partnership for Innovation:
2010 Grant Projects

Countdown to Healthy Living, Phase 1

Project Leads: Nalini Gupta, MD; Cicely White, MD; and Beth Barton, RN, BSN; Pediatrics

Award: $100,010 (October 2010)

Challenge: Group Health does not have a chronic care model or medical home-based programs to address pediatric obesity. Primary care providers often find it overwhelming to address lifestyle issues in routine office visits. These factors lead to services which are fragmented due to lack of standardized and comprehensive treatment plans.

By combining existing medical home and chronic care tools with evidence-based pediatric obesity treatment, this pilot will help to cohesively implement the Group Health Pediatric Weight Management Guideline with the help of primary care team efforts that are supported by a structured multidisciplinary intervention.

Potential benefits:

  • Improved quality of care through the establishment of a new standard in treating pediatric obesity
  • Increased staff, provider, and patient engagement through the optimization of the medical home model

Improving Chronic Illness Care

Project Lead: Elizabeth Lin, MD, Primary Care

Award: $232,750 (September 2010)

Challenge: Patients with multiple chronic conditions require an integrated, cross-disciplinary approach to insure they are getting the highest quality, most appropriate care.

Innovation: A team at Group Health's Everett Medical Center will test a team-based approach to identify, track and manage patients with multiple chronic conditions.

The pilot will define and provide identification and referral criteria for patients that require complex case management.

Potential benefits:

  • Improved outcomes and integrated care for patients with multiple chronic conditions
  • Improved coordination and collaboration across providers that care for patients with multiple chronic conditions

BACK TO: The Partnership for Innovation

A New Approach to Complex Adult Spinal Surgery

Project Lead: Rajiv Sethi, MD, Neurosurgery

Award: $87,083 (September 2010)

Challenge: The Group Health neurosurgery team uses a dual-surgeon approach to perform complex spinal surgery. The team uses both an orthopedic surgeon and neurosurgeon together during surgery to reduce complications and improve outcome for patients. Surgeons believe this model has the potential to change the way these surgeries are performed nationwide.

Innovation: The neurosurgery team will measure the effectiveness of its approach (currently in use as a best practice at Group Health) that uses both an orthopedic surgeon and neurosurgeon to perform complex adult spinal surgeries.

The team will construct a database that will track patient outcomes over two years. It will track complications, readmissions and repeat surgeries.

Potential benefits:

  • Increased patient safety
  • Fewer surgical complications within 30 days of surgery
  • Lower hospital readmission rates

Reducing Radiation Exposure from Medical Imaging

Project Lead: Mark Steffen, Radiology

Award: $181,000 (September 2010)

Challenge: Increasing usage of medical imaging, such as computed tomography (CT) scans, is exposing patients and care providers to growing amounts of radiation and the associated cancer risk.

Innovation: The radiology team will create audit reports for individual CT technologists at the Tacoma and Capitol Hill Medical Centers to show how much radiation they are exposed to in performing CT exams. The report will also show cancer risk associated with those exposures.

A training program will accompany the reports to raise awareness about radiation exposure and share methods for reducing radiation exposure for technicians and patients.

Potential benefits:

  • Reduce variation in radiation exposure among CT technologists
  • Reduce radiation exposure for patients and radiology staff

Nurse-Supported, Web-Based Education Program for Depression

Project Lead: Brad Steinfeld, PhD, Behavioral Health Services

Award: $31,265 (September 2010)

Challenge: The majority of patients with depression are managed in primary care through treatment with only anti-depressant medication. Optimal care involves integrating psychotherapy into treatment programs for patients taking anti-depressants.

Innovation: The behavioral health team will test a program that provides web-based psychotherapy for patients taking anti-depressants. Patients taking part in the program will also be supported by a coach or care manager who will encourage the patients to stay with the program through phone and e-mail communication.

Potential benefits:

  • Patient-centered care that integrates primary care and mental health treatment
  • Cost-effective, web-based resource reduces the need for in-person psychotherapy
  • Easy, convenient way for patients to get care

Treating Opioid Addiction in the Primary Care Clinic

Project Lead: Sara Thompson, MD, Primary Care

Award: $21,226 (September 2010)

Challenge: Opioid dependence is increasing in the United States. These drugs are primarily prescribed and non-prescribed pharmaceuticals.

Increasingly, health care providers are encountering opioid addicted patients in clinics but have limited ways to treat these patients.

Innovation: Suboxone is a drug that has been effective in treating patients with opioid dependence.

The primary care team will train all providers in the Family Medicine Residency Clinic to prescribe suboxone. They will identify chronic patients who are opioid users as well as patients already receiving suboxone and offer them the service.

Potential benefits:

  • Medical treatment for addiction integrated into the medical home
  • Increased access to potentially life-saving treatment
  • Fewer patients sent outside Group Health for addiction treatment

Outpatient Orthopedic Ultrasound

Project Lead: Sean Adelman, MD, Orthopedics

Award: $54,013 (September 2010)

Challenge: High-end imaging tools such as CT and magnetic resonance imaging (MRI) are invaluable for diagnosing musculoskeletal disorders. But use of these tools — and their cost impact on the health care system — has increased dramatically in the last decade.

Many musculoskeletal problems such as rotator cuff, tendon and joint disorders are diagnosable with lower-cost ultrasound technology.

Innovation: The Capitol Hill orthopedics team will pilot a project to use diagnostic ultrasound in an outpatient setting. The team will use portable ultrasound machines for diagnostic evaluation for certain patients in place of MRI.

Results from diagnostic ultrasound can be reviewed at the time of the office visit, eliminating delays incurred when using outside radiology services.

Potential benefits:

  • Fewer patient appointments needed for diagnosis and treatment
  • Reduced cost through fewer high-end imaging procedures
  • Reduced time from diagnosis to treatment