PHILADELPHIA – Penn Medicine has announced funding for five new projects through the Innovation Accelerator Program, many of which feature new tools and platforms for integrating care and improving patient outcomes.
Penn Medicine’s Innovation Accelerator Program, now in its fourth year, is run by leaders in the Penn Center for Health Care Innovation and supports promising ideas from faculty and staff across departments and roles at the University of Pennsylvania Health System in their efforts to develop, test and implement new approaches to care. This year’s program is co-sponsored by UnitedHealthcare.
Ongoing progress towards accountable, high value care over the past several years has generated record numbers of novel health care interventions. However, without interdisciplinary funding, mentorship and support, new solutions often face an uphill battle to testing, analysis and implementation.
“The Innovation Accelerator Program provides seed money to out-of-the-box ideas that use technology to improve patient care, but in a way that promotes rapid experimentation and quick learning so ongoing adjustments can be made based on new insights and discoveries,” said David A. Asch, MD, MBA, executive director of the Center for Health Care Innovation. “The goal is to provide an opportunity for all Penn Medicine staff members to be involved in improving patient care through collaboration and novel interventions, implementing changes, and quickly identifying whether the idea would be effective if taken to scale.”
The five newly funded teams were selected from a pool of 84 proposals.
Reducing readmissions in cirrhotic and post liver transplant patients
This project aims to reduce the rate of readmissions in cirrhotic and post liver transplant patients using telehealth monitoring. The team has developed a wireless mobile device monitoring system using a tablet provided to patients to detect early signs and symptoms. In a yearlong pilot of 21 patients, the system reduced readmission rates from 28 percent to 5.2 percent. In the next phase of work, the team plans to refine the intervention and expand the pilot to all patients.
Project lead: Vandana Khungar, MD, MSc, Assistant Professor of Medicine, Department of Medicine, Division of Gastroenterology and Hepatology
Improving nutrition monitoring for critically ill patients
Critically ill, brain-injured patients are especially vulnerable to malnutrition. Enteral nutrition (EN) is a liquid formulation of nutrients delivered to the GI tract through a tube. Early EN has been shown to decrease infections, shorten length of stay, promote faster cognitive recovery, and reduce mortality. However, these benefits are only realized if patients receive more than 80 percent of energy expenditure, which is not consistently observed in current practice. As a foundational starting point, this project seeks to explore how an automated calculation of caloric and protein goals and intake will impact physician awareness of nutrition needs and patient outcomes. The team will then design interventions based on such information to ensure patients receive required nutrition.
Project lead: David Do, MD, Neurology Resident
Increasing the identification and monitoring of OPAT patients to improve outcomes
Close laboratory monitoring and ambulatory follow-up care are essential for outpatient parenteral antimicrobial therapy (OPAT) patients. OPAT – which allows patients requiring antibiotics for a wide range of infections to be treated outside hospital – occurs in different settings including the home, long-term-care facilities, and infusion centers. Due to the diversity of OPAT locations and the higher acuity of this population, readmission rates and complications are high. Publications show a 35 percent readmission rate for OPAT patients. This project aims to explore ways to improve how we identify and monitor all OPAT patients – along with changes ensuring the right actions are taken on behalf of patients – to enhance provider efficiency, improve care delivery and reduce readmissions.
Project lead: Keith Hamilton, MD, Director of Antimicrobial Stewardship, department of Medicine, division of Infectious Diseases
Reducing functional decline and loss of mobility for hospitalized patients
Functional decline and loss of mobility for hospitalized patients, particularly in older patients and patients requiring intensive care, leads to increases in length of stay, fall risk, and hospital acquired conditions. This project seeks to pilot a systematic early mobility care pathway for moderate and high-risk populations. Several pilots run at Penn Presbyterian Medical Center (PPMC) have shown benefits for targeted populations.
Project leads: Jennifer Nelson, RN, MSN, CCRN, Nurse Manager; Staci Pietrafesa, MSN, RN, NE-BC; Nurse Manager
Evidence based guideline for management of hyperglycemic emergencies
This project aims to promote use of an evidence-based, guideline driven tool that will be used by all entities within the health system for management of hyperglycemic emergencies. The team has gathered an interdisciplinary group of stakeholders from multiple entities within the health system to revise the existing protocols. In the next phase of work, the team plans to create strategies to promote adoption of these best practices, as well as collect and implement ideas for revisions to enhance the end-user experience.
Project leads: Ilona Lorincz, MD, Director of Quality, Endocrinology; Nikhil Mull, MD, Co-Director of the Penn Medicine Center for Evidence-based Practice
Over the next six months, the winning teams will learn high impact innovation methods for refining and rapidly validating solutions, and work closely with mentors from the Center for Health Care Innovation to test and develop their concepts. In April, the program will culminate with a pitch event, where teams will present their progress for the opportunity to receive additional investment to take their ideas to scale.
“Solving the big problems in health care requires an interdisciplinary approach. It requires people from diverse roles, units and specialties to share their knowledge and skills and then rapidly and iteratively test new interventions. We’re excited to work with UnitedHealthcare on these projects given its national reach and extensive resources aimed at improving health care delivery. This kind of partnership and approach is one way to effect change in a meaningful, cost-effective and timely manner,” said Roy Rosin, MBA, chief innovation officer at Penn Medicine. “This year’s grant proposals were incredibly impressive and reveal compelling insights from thought leaders across the health system. We’re looking forward to seeing what these teams come up with at the Pitch Day in April, which will help decide next steps for each of the projects, whether it’s continued investment in the models that show the most promise, or refocusing on new ideas and approaches.”
Since its inception, the Innovation Accelerator Program has provided support in the form of mentoring and funding for projects achieving high value care across a broad range of health care challenges. These projects – often taking the form of new care models – have achieved national leadership in areas including preeclampsia management, miscarriage care, antibiotic stewardship and helping keep the most vulnerable patients out of the hospital, with several going on to win additional awards and grant funding while scaling beyond Penn to other health systems. Other projects have shown measurable improvement in areas ranging from dermatology access to advance directive completion, reducing surgical delays, cancellations, and complications and increasing follow-up visit attendance.
“UnitedHealthcare is grateful for the opportunity to support Penn Medicine’s Innovation Accelerator Program,” said Dan Tropeano, executive director of UnitedHealthcare of Pennsylvania. “Programs like the Innovation Accelerator have the potential to play a significant role in helping to close the gap between health care quality and cost.”
To learn more about this year’s winners and finalists and stay up to date on Innovation Accelerator news, please visit the Center for Health Care Innovation website