ISP Cohort 13 Applications Summary Page
Score each of the six factors, as well as overall impact. The overall impact score is not an average of the scores of the six factors. Your impression of overall impact takes the factors into account but reflects your gestalt of the project’s impact.
Comment on strengths and weaknesses. Specific details are more helpful than general comments.
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| Scholar(s) | Department | Description | Applications |
|
Nelly Bellamy, MD |
Adult Inpatient | SAFE reporting is consistently underutilized by physicians. In a review of all inpatient safe reports 2/2025 to 8/2025, nurses completed 43%. Attending physicians completed 4.5% and resident physicians completed even fewer. Similar trends have been seen in the UNC Department of Surgery and other academic institutions.1 The SAFE system can be confusing and cumbersome without formal training. Further, physicians are often frustrated by the lack of closure and perceived lack of action after submitting a SAFE report. Though SAFE reports are reviewed within the units, service lines, and departments, the current loop-closure process does not provide adequate information about the review back to the reporting physician, so reporting efforts may feel wasted. | |
| Marc Bjurlin, DO, MSC | Oncology | The problem I am looking to solve is the systematic failure to leverage mandatory, high-frequency clinical encounters specifically during intravesical treatments and surveillance cystoscopies, to provide consistent, protocol-driven smoking cessation support. | Bjurlin application |
| William Churchwell, PA-C | Hematology/Omcology | Some of our patients are admitted for scheduled chemotherapy. There has been an ongoing issue with getting their chemotherapy started in a timely manner on the day of admission. This leads to patients feeling like “nothing is being done” and often view the day as a waste. They feel the need to come early is unwarranted. We have had multiple patients report these and other similar experiences to UNC patient relations through the years. | Churchwell application |
| Michelle Clements, MSN | Labor and Delivery | Given the high frequency of inductions and the number of clinicians involved, a standardized, evidence-based IOL algorithm presents an important opportunity to align practice, support consistent clinical decision-making, and reduce unwarranted variation in care. | Clements application |
| Jessica Curcio, ND, M-PAS | Surgery | Transitions of Care for Patients with Limb-Threatening Ischemia Through a Multidisciplinary Standardized Pathway wound/podiatry care and medical optimization. As part of the discharge planning there can be delayed access to essential outpatient resources including wound care, vascular follow-up, home health, primary and specialty care. | Curcio application |
| Kelly Devine, Patient Services Manager | Radiology | Interventional Radiology lacks a standardized communication pathway across multidisciplinary teams and consult services, resulting in gaps in role clarity and procedural coordination. | Devine application |
| Matt Foglia, MD, PhD | Pediatric Cardiology | The overarching aim of this project is to reduce the frequency and severity of cardiac arrest events in the UNC Pediatric Cardiac Intensive Care Unit through the development of a multidisciplinary cardiac arrest prevention bundle grounded in evidence-based pediatric cardiac critical care practices. | Foglia application |
| John Hipps, MD | Pediatric Hematology/Oncology | Our pediatric oncology clinic will implement routine collection of patient-reported outcomes using the Symptom Screening in Pediatrics Tool (SSPedi), developed by Dr. Lillian Sung at The Hospital for Sick Children (SickKids), integrated into Epic via patient-facing questionnaires and clinician-facing reporting tools. This is a tool that has been built into the most recent UNC Epic update but has yet to be used in our clinical workflow. Embedding SSPedi within Epic will enable standardized symptom screening prior to or during clinic visits, provide structured data directly within the patient chart, and support real-time clinical decision-making. | Hipps application |
| Hannah Hrobuchak, MD | Pediatrics | The current pre-operative timeline is incomplete and irregular, thus presenting an opportunity for standardization and quality improvement. Through the Plan Do Study Act model, our goal is to create a clinical pathway for patients undergoing hip osteotomy or posterior spinal fusion. | Hrobuchak application |
| Lindsey Krawchuk, MD | Neurology |
The UNC Teleneurology program will improve access to neurologic care, but the addition of standardized pathways8 can further limit barriers to care and complications4. Our project will directly address this critical gap by providing an evidence-based, best-practice clinical pathway that will
standardize the assessment and management of seizures by non-neurology providers. It will likely report to the local UNC Quality and Operations Council, and feedback and guidance on this proposal was received from our local quality leadership.
|
Krawchuk application |
| Marie-Pier Lirette, MBChB, MSc | Pediatrics | Despite the recognized value of return visits as a safety-surveillance tool, the department currently lacks a formal, systematic process to routinely identify, review, and learn from pediatric ED return visits. As a result, potentially preventable harm, missed diagnostic opportunities, system failures, and inequities in care may go unrecognized, and actionable learning is not consistently fed back to clinicians or leadership. Implementing a structured return-visit review program is essential to distinguish unavoidable from preventable returns, proactively identify safety risks, and drive targeted, equitable quality improvement in pediatric emergency care. | Lirette application |
| Nicholas Piazza, MD | Hospital Medicine | Despite this progress, pressure injury rates remain above national benchmarks, and PSI-03 continues to be the only Patient Safety Indicator on which UNC underperforms. These findings indicate that while improvement is underway, preventable harm persists and additional, coordinated strategies are needed. | Piazza application |
| Christy Rowe, RRT-NPS | Pediatrics | Given the significant expectations and scope of responsibility assigned to pediatric respiratory therapists, several system-level gaps have been identified that require targeted intervention. These gaps hinder the consistent delivery of high-quality, standardized care for pediatric patients admitted with asthma or reactive airway disease. Specifically, identified gaps include variability in PAS (Pediatric Asthma Score) scoring and scoring frequency, bronchodilator orders entered in EPIC as nursing orders rather than respiratory therapy orders, and the absence of a standardized asthma education curriculum | Rowe applications |
| Abhishek Sripad, MD | Obstetrics and Gynecology | In 2025, over 5,580 new patients referred to UNC Urogynecology and Reconstructive Pelvic Surgery waited an average of 73 days between their scheduling date and first appointment date. This falls markedly short of the UNC Health goal of 10 days. Our office Press-Ganey scores reflect a critical consequence of this problem: diminished patient satisfaction and experience. In 2025, only 75% of patients rated their access to care ‘very good’, lagging 90% of patients who rated their care provider ‘very good’. Our clinic ranked nationally at the 30th and 83rd percentiles in these categories, respectively. This discrepancy between access to care and the quality of care tangibly adds to generally known consequences of longer scheduling wait times including higher cancellation rates, no-shows, and patients seeking alternative care options. Another downstream inefficiency stemming from lengthy wait times is suboptimal clinical productivity. Our group treats surgical and non-surgical conditions. Delays in the care pathways for those who undergo surgery reduces the procedural revenue productivity compared to more efficient paths to surgery. | Sripad application |
| Colette Tilly, MD | Allergy | The inappropriate ordering of serum-specific immunoglobulin E (IgE) tests for food allergens and galactose-α-1,3-galactose (alpha-gal) IgE testing represents a significant challenge in allergy diagnostics. These tests are frequently requested without a compatible clinical history, contrary to evidence-based guidelines, which recommend their use only in patients with a high pretest probability of IgE-mediated allergy. When ordered indiscriminately, these tests can lead to patients being incorrectly labeled as allergic, resulting in unnecessary dietary restrictions, nutritional deficiencies, psychological distress, and increased healthcare utilization, including specialist referrals, additional testing, and prescriptions for epinephrine autoinjectors or nasal sprays. | Tilly application |