Teams: A project team is a fun, collegial way to engage with peers in learning about and participating in clinical inquiry. The Language of Data Program is strongly oriented around a team-based approach to learning and practicing statistical “speaking skills.” To learn more about current Project Teams select from the links below. To inquire about participating on a team contact the Team Lead identified on the page, or contact us at: languageofdata@gmail.com
Project Page Title: BIG DASH
Project By-line: Blood pressure Improvement and Glucose control using Duke Dashboard and Pillbox (BIG-DASH)
Therapies known to prevent disabling diabetes complications, such as medications to improve blood glucose and blood pressure control, are not being adequately implemented for patients with diabetes at a national level. At Duke University, over 25% of patients with diabetes and uncontrolled blood pressure were found to be either not prescribed or not taking optimally dosed antihypertensive medication regimens.
Primary Aim: The purpose of this study is to improve implementation of guideline-directed medical therapy for hypertension in the Duke Endocrine clinics and to achieve improved blood pressure control in patients with diabetes.
Project Page Title: CONNECT-HF
Project By-line: Care OptimizatioN through patieNt and hospital Engagement Clinical Trial for heart failure
Hospitalization for acute HF identifies patients at increased risk of re-hospitalization and death following discharge. This increased risk justifies novel interventions to improve post-discharge outcomes. At the same time, the delivery of evidence-based HF care varies significantly across hospitals, as do HF patient outcomes.3–5 Improving the quality of care for patients with HF is an essential goal, but there are limited data available to understand best practices for hospital-based QI initiatives.
Primary Aim: There are 2 co-primary endpoints, 1) time to first HF rehospitalization or death within 12-months after discharge; 2) improvement in an opportunity-based composite score for adherence to quality metrics for HF.
Project Page Title: ECHO
Project By-line: Evaluation of Code Blue LeadersHip class on Outcomes
A gap in knowledge and confidence to engage in leadership role responsibilities during in-hospital cardiopulmonary arrest was found among Duke house staff and charge nurses. Code Blue Leadership classes were developed to focus on communication and leadership skills. Classes were to taught to internal medicine residents and CCU charge nurses that are part of the Code Blue Team.
Primary Aim: The purpose of this study is to evaluate the feasibility, design, usability and content validity included in the Duke Code Blue Leadership class. In addition, we will evaluate the degree to which the classes improve participants’ knowledge and confidence to engage in designated role responsibilities during simulated Code Blue scenarios.
Project Page Title: INTERCONNECT
Project By-line: INTERdisCiplinary rOunding iN iNpatiEnt Care seTtings
Multidisciplinary rounding, or the purposeful rounding of a group of clinicians from different clinical disciplines, focused on organizing and optimizing communication and care delivery across provider groups to improve overall patient safety, health, and satisfaction. Interdisciplinary rounding enables the team to make collaborative decisions regarding patient care as a unified whole. The goal of the interdisciplinary team and rounds is to create comprehensive and coordinated treatment plans that focus on each patient’s needs and goals of care. This is particularly important in elderly patients who often have multiple discharge needs.
Primary Aim: To evaluate the efficacy of a multidisciplinary team rounding protocol on pre-discharge measures of safety and quality (length of stay, patient-reported hospital satisfaction (HCAHPS), and readmission rate and mortality at 90 days), and post-discharge measures of safety and quality (follow-up phone call contact at 48 hours, follow-up appointment attendance, cardiac rehab attendance, and medication adherence) in patients with ACS over the age of 80.
Project Page Title: Language of Data Study
Project By-line: Language of Data Study
The adoption of critical appraisal skills required for Evidence-Base-Practice (EBP) has been slow and in many clinical settings unsuccessful. EBP requires that nurses examine the existing data and published research regarding a specific practice element and based on the weight of evidence adjust practice and care delivery processes to incorporate the evidence-based approach. However, a major barrier to EBP in real-world clinical settings is poor critical appraisal skills, or the inability of staff nurses to comprehensively read and interpret research findings.
Primary Aim: To improve the critical appraisal skills for statistical symbol recognition and interpretation.
Project Page Title: Plan A
Project By-line: Improving Early Extubation for Eligible Patients Following Cardiothoracic Surgery
Prolonged mechanical ventilation is associated with increased hospital and intensive care unit (ICU) lengths of stay, higher health care costs, and increased morbidity resulting from atelectasis, intrapulmonary shunting, and pneumonia. In contrast, early extubation of postoperative heart surgery patients has been associated with shorter ICU and overall hospital stays and decreased resource use. Early extubation, defined by the Society for Thoracic Surgeons (STS) as > 6 hours) has been shown to be safe and effective even in elderly patients, with no increased risk of reintubation. Despite this knowledge, our CTICU did not use an established protocol for promoting early extubation in postoperative heart surgery patients.
Primary Aim: To assess the effectiveness of implementing a standardized, evidence-based protocol for decreasing postoperative mechanical ventilation time to < 6 hours.
Project Page Title: Healthy Communities-Severe Hypertension Outreach (SHO)
Project By-line: Improving Severe Hypertension Outreach in FQHC
Hypertension is a widespread chronic condition and a preeminent risk factor for heart disease, stroke, and other diseases that result in premature death. In N.C. heart disease and stroke are the number one cause of death. Blood pressure control can reduce the risk of heart disease that may subsequently result in heart attack and premature death, particularly among minority groups and vulnerable populations. Achieving hypertension control can decrease costs associated with preventable emergency room visits, inpatient hospital stays and complications. Of all adults with hypertension, 84% are aware of their condition and 76% are taking medication. Of those taking medication, only 53% have a blood pressure that is controlled.
Primary Aim: To improve the rate of blood pressure control at Lincoln Community Health Center (FQHC).
Project Page Title: SUSTAIN
Project By-line: Improving Systems of Follow-Up Care for Patients with STEMI
STEMI guidelines include post-discharge systems of care as IA-IB recommendations, yet little is known about the optimal approach to link current discharge practices to post-discharge systems of care in STEMI patients in the U.S. As preliminary work in the STEMI Accelerator 2 program, we conducted a survey of post-discharge practices for STEMI care among 58 hospitals across 12 regions in the U.S. The survey assessed hospital adoption of guideline recommendations for post-discharge care and identified gaps in care coordination, systems for care transition, and quality metrics associated with post-discharge care. These findings were used to develop the SUSTAIN intervention, a pragmatic, multicenter, prospective study designed to evaluate the impact of standardized deployment of local and regional systems for post-discharge care for STEMI patients at one year.
Primary Aim: To improve P2Y12 inhibitor adherence for patients with STEMI for up to 12 months, and to improve adoption of guidelines for evidence-based processes in care transition.
Project Page Title: UNTAP
Project By-line: UNdersTAnding the Patient Experience of Pain and Discomfort During Cardiac Catheterization
Patient centeredness is an essential component of high-quality care, yet little is reported in the literature regarding the patient experience during procedures performed in the cardiac catheterization lab. In phase I of this project, we conducted a retrospective, exploratory analysis of adult cardiac catheterization outpatients receiving procedural sedation (benzodiazepine and/or opioids)
Primary Aim:
Project Page Title: CHanGing BathS
Project By-line: CHlorhexidineGluconate Bathing Intervention to DecreaseSystem-wide Central Line Associated Blood Stream Infections
A long-standing question in health care is how to implement evidence into practice in an efficient, equitable, timely and patient-centered way. One major quality gap for many hospitals is CLABSIs. Daily bathing of patients at high risk for infection with Chlorhexidine Gluconate (CHG) cloths has been shown to significantly reduce risk of CLABSIs; however, implementation of this practice varies widely.
Primary Aim:
Project By-Line: MENToring to ImproveRetention (MENTIR Study)
Introduction: New nurse turnover within the first year is 28% nationally and 27.8% at Duke. We identified an evidence-based mentorship program designed by the Association of Medical-Surgical Nursing and implemented this program in a 32 bed unit serving cardiothoracic step down patients in August, 2018.
Primary Aim:To improved new nurse retention at 12 months as compared to historical cohort.
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