ISP Cohort 12 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 |
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Nelly Bellamy, MD Evan Raff, MD |
Adult Inpatient | Our intent is to improve the accuracy of language needs assessment and documentation in the electronic medical record (EMR) for adult inpatients at the University of North Carolina Medical Center (UNCMC). | |
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Jessica Curcio
|
Surgery | Surgical outcomes and recovery are worse for minorities, particularly Black and Hispanic populations, as compared to white patients. ERAS has the potential to reduce health disparities by standardizing high value, evidence-based care across the board thus minimizing unwarranted care variation based on race/ethnicity or other non-clinical factors. | Curcio application |
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Zachary S. Feuer, MD |
Urology | Since launching our Rapid Access Clinic in February 2024, we have seen 400 men with an elevated PSA, 25% of whom have been 70 years of age or older. Among these patients, more than half are referred with a PSA <6.5. For men with a PSA <6.5, 40% ultimately undergo no additional testing, suggesting an unnecessary visit which is often associated with anxiety and costs incurred by the patient. Amongst men that do proceed to further diagnostic testing, 60% undergo MRI and 35% have proceeded to prostate biopsy. However, only a small fraction (<10%) were diagnosed with prostate cancer that ultimately required treatment for prostate cancer. This highlights the inefficiency and potential harm associated with the current schema. | Feuer application |
| Alyssa Flippo, Audiology Supervisor | Audiology | Many patients live in areas with limited access to audiology services, often requiring them to travel several hours to attend appointments at UNC Hospitals. This situation frequently necessitates patients or their companions to take time off work and sometimes even spend the night in a hotel for a 1-2 hour appointment. | Flippo application |
| Aaron Fried, MD | Adult Inpatient | Many aspects of patient care require daily attention but are often overlooked due to the demanding nature of inpatient care. This includes essential tasks such as DVT prophylaxis, Foley catheter removal, central line removal, telemetry reduction, removing 1:1 observation when indicated, bowel prophylaxis, de-escalation of narcotic pain regimens, weaning supplemental oxygen use, antimicrobial stewardship etc. | Fried application |
| Susan C. Gilchrist, MD, MS | Cardiology, Endocrinology | Our goal is to address the excess risk and disease complexity of the CKM population by forming an interdisciplinary clinic to help patients achieve intensive risk factor modification targets. |
Gilchrist application |
| Lindsey Gouker, MD | Anesthesia | Penicillin (PCN) de-labeling is not broadly accessible to patients presenting to UNC Pre-Procedure Services (PPS) Clinic. | Gouker application |
| Kristi Hildebrand, CPNP | Pediatric Neurosurgery | Our pediatric neurosurgery team has noticed a significant disparity in preop and postop care recommendations for prevention of surgical site infection (SSI). We are particularly concerned regarding the number of patients impacted who are racial minorities and/or speak a language other than English. | Hildebrand application |
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Emily Hollis, MD Ashley Weiner, MD |
Radiation Oncology | The problem we seek to address is the lack of a formalized structure for the peer review huddle and associated handoff between the many teams participating in this huddle (physicians, dosimetrists, and physicists). | Hollis application |
| Joshua Hudson, MD | Emergency Department | There is currently an overutilization of diagnostic testing in this patient population that increases treatment time in the ED/delays hospital admission, increases cost to the patient/our health system, and exposes the patient to unnecessary diagnostic testing. The two tests that are being overutilized without any benefit to the patient include CT angiogram GI bleed protocol (CTA-GIB) and fecal occult blood test (FOBT). | Hudson application |
| Elisabeth Leong, DO, MSCR | Pediatrics | The pediatric cardiac catheterization lab at UNC experiences frequent no-shows and late arrivals for scheduled procedures, occurring at least once per week. These disruptions impact patient care, procedural efficiency, and resource utilization. | Leong application |
| Molly Marsh, MMSc, MS, PA-C, RD, CNSC; BICU APP | Burn Intensive Care Unit | Currently, the BICU continues to have inconsistent adherence to the preoperative TF hold policy. There are likely many reasons for inconsistent adherence. | Marsh application |
| Arvind Narayanan, MD | Surgery | We are looking to improve the reliability of our clinical processes surrounding joint replacement surgery at Hillsborough hospital. This will improve provider wellness, improve patient outcomes, and increase our efficiency (enabling increased surgical volumes). | Narayanan application |
| Erin Parrish Reade MD, MPH, FAAP | Pediatrics | In FY24 there were 14 non mucosal barrier infection (MBI) CLABSIs at UNC Children’s across 2 ICUs and 3 regular inpatient care units. This represented a nearly 50% decrease from FY23. This decrease was attributed to an effort throughout the Children’s Hospital which focused on unit-based rounding and bundle adherence. However, there is still more work to be done to move toward zero CLABSIs. CLABSI remains a serious threat to children admitted to the hospital. | Reade application |
| Anand Shah, MD | Cardiology | Hospital readmission rates in cardiology services – Med C and Med D – from June 2023 to July 2024 were 14.6%. We are aiming to improve this number by increasing utilization of SGLT2i in eligible heart failure patients. | Shah application |
| R. Gina Silverstein, MD | Anesthesia | Interpreter services need to be both available and consistently used during preoperative preparation and the transition to the PACU. | Silverstein application |
| Erika Yazawa, MD | Neonatal Intensive Care Unit | Our key outcome measure is the number of UE events in all intubated patients in the neonatal intensive care unit, excluding patients with tracheostomies. Through this project, we aim to decrease the rate of unplanned extubation events to less than 0.4 per 100 ventilator days by January 2026. Our global aim being to improve patient safety by reducing the incidence of unplanned extubation events in the NICU. | Yazawa application |