HOMERuN at SHM:
Celebration, Successes, and Collaboration
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The Hospital Medicine Reengineering Network (HOMERuN) is a national network of Hospital Medicine investigators at 12 academic medical centers (AMCs) and 50 affiliated sites.
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UPSIDE results on center stage at SHM Converge
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HOMERuN convened its first post-pandemic in-person meeting among its consortium members at SHM Converge to celebrate accomplishments and plan for future collaboration.
Organizers and Facilitators: Jeffrey Schnipper, Katie Raffel, Tiffany Lee, Andrew Auerbach
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HOMERuN: Key Accomplishments
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Executive Committee: The EC focuses on how to promote HOMERuN's mission and vision, through supporting scholarship in Hospital Medicine.
Achievements:
- Strategic partnerships with HCA and the CHARGE consortium.
- Facilitated access to HOMERuN data sets and supported surveys led by junior faculty.
- Strategic planning for remote mentoring, National Grand Rounds, and partnerships with SHM Academic Hospital Medicine and Research Committees to provide mentoring and collaborative opportunities.
- Activism with NIH and national stakeholders to promote creation of an Office of Hospital Medicine Research (modeled on EM) and initiatives to promote Hospital Medicine research.
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Jeffrey Schnipper and Mark Williams
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HOMERuN Sponsored Research Programs
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Achievements:
- 2,510 chart reviews completed (2510x45)/60=1882.50 hours! During a pandemic, no less!
- 11 UPSIDE Clinical Case Vignettes accepted as posters, preliminary results accepted as plenary at HM22.
- Podcast: Clinical Problem Solvers will present Diagnostic Error Case Studies.
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HCA-CHARGE Consortium: HCA-CHARGE Consortium focused on research related to the SARS-CoV-2 virus and COVID-19 global pandemic, using detailed data from 180 hospital electronic health records. Studies included studies of stability for discharge (Jeff Schnipper, Brigham and Women's Hospital), risk of C Diff (Matthew Pappas, Cleveland Clinic), non-invasive ventilation strategies (Lauren Westafer, Baystate Medical Center) risk stratification scores (Priya Prasad, UCSF), healthcare disparities (Jennifer Stevens, Beth Israel Deaconess Medical Center).
Achievements:
- Plenary: Analysis of Clinical Criteria to Determine Stability for Discharge among Patients Hospitalized with COVID-19 (Schnipper).
- Oral presentations: Effect of Antibiotic Classes on Risk of Clostridioides Difficile (Pappas), Risk Stratification Scores and Prediction of Clinical Outcomes Among COVID-19 Patients (Prasad).
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HOMERuN Collaborative Work Groups
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The Collaborative work groups are composed of more than 75 people across 55 hospitals lead inquiry and collaboration within areas of high shared interest by HOMERuN sites. These work groups are Discharge Planning (leads Jeffrey Schnipper, Ryan Greysen), Workforce Planning (leads: Luci Leykum, Marisha Burden, Angelia Keniston) Provider Wellness (Krishna Chokshi, Elizabeth Murphy), Medical Education (Amit Pahwa, Matthew Sakumoto), and Antiracism, Justice, and Health Equity (Archna Eniasivam).
Achievements:
- 32 collaborative calls held, each of which included real-time focus groups and qualitative research, followed by rapid turnaround knowledge dissemination through newsletters, feedback to sites, and publications.
- At last count, 6 peer reviewed publications in print, 3 Research Abstracts accepted as posters, 10 more submitted/in press, 13 newsletters published.
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Workforce Planning members: Kirsten Kangelaris, Marisha Burden, Luci Leykum, Annie Linker, Gopi Astik, and Angela Keniston
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HOMERuN Patient and Family Advisory Council (PFAC)
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The HOMERuN PFAC is composed of 11 members who represent patients, families, and caregivers from across the US. The PFAC partners with investigators to ensure the patient voice and perspective are included in the development, design, implementation, and dissemination of projects.
Achievements:
- Co-developed, conducted and co-authored an environmental scan of COVID-19 visitor policies with Patient Experience work group.
- Accepted as an innovation poster: Developing and Operationalizing a Research-focused Patient and Family Advisory Council (PFAC) for a Hospital Medicine Research Network.
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Published a perspective in JHM on how to earn trust of patients and caregivers.
- Provided feedback on: the UPSIDE Study, Sachin Shah's study evaluating decision-making tools for atrial fibrillation, Valerie Press's study on how to reduce COPD revisits to the hospital, Sunil Kripalani's project developing a health equity dashboard, James Harrison’s study exploring the hospital to SNF care transition, and more.
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Opportunities and Future Directions
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Research Opportunities
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Clinical Care/Systems Redesign Research on transitions of care, intervention trials with specialists as Co-PIs, clinical trials.
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Defining academic hospital medicine groups, via surveys of how hospitalists work in different divisions, e.g., how they hire, how their systems are structured, number of shifts, etc.
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Enhancing Diagnostic Accuracy using Epic to identify, prioritizing patients at high risk for diagnostic error, and investigating models that may reduce diagnostic error.
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Accelerate Patient-Centered Improvement by deepening role of our HOMERuN PFAC into project development and execution.
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Promoting Collaboration
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Continue to support cross-site teamwork: Maintain workgroups and create new ones — weekly meetings seem effective.
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Develop partnerships with community hospitalists, sites which care for underserved populations and outpatient providers to accelerate research — particularly around care transitions.
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Share Research Resources: Streamlining IRB approvals with central IRB for surveys, data use for Vizient and CHARGE data, and access to analytics.
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Plan for the future of electronic data capture leveraging new technologies to share EHR data.
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Mentoring and project development support, by providing support in key career activities such as how to get funding for quasi-quality improvement and research hybrid type projects.
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Key Takeaway: Our cross-site collaboration is powerful. Its fusion of questioning minds, diverse perspectives, shared data, and experienced researchers creates a foundation for improvement.
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Our next meeting will be on May 13, 2022.
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