Projects

CPS is involved in several research grants and special projects, a few of which are outlined below:

The Annie E. Casey Foundation Maryland Birth Outcomes Project

There are three phases to this research project supported by the Annie E. Casey Foundation:

1. Phase 1 demonstrated the feasibility of collecting and linking maternal and child records not available from any routine source to investigate the utilization, cost, and outcomes between mode of delivery and neonatal intensive care unit (NICU) utilization. The Phase 1 findings were published in February 2007 in the Journal of Evaluation in Clinical Practice. (PDF)
2. Phase 2 of the project collected far more clinical data pertaining to maternal co-morbidities and neonatal outcomes. The findings are being prepared for publication.
3. Phase 3 of the project is underway to test national data using the model applied in Maryland. The new analysis includes adjustments for maternal comorbidities and adverse events during hospitalization. As such, Phase 3 will not only address the cost of the delivery and NICU utilization, but also safety of care issues.

Maryland HSCRC’s Quality Initiative and Pay-for-Performance Initiative

As technical consultant to HSCRC’s quality initiative, CPS has been responsible, since 2005, for conveying the conceptual model endorsed by the Commission into an operational quality-based reimbursement program. Key components of the grant included:

• Facilitating and directing the work group
• Expanding and maintaining a system for data collection and management
• Completing an Alpha Pilot and planning and managing the Beta Pilot
• Refining the methodology for scoring and weighting measures and developing statistical models for analyzing the data and determining and comparing the level of performance on selected measures
• Communicating with the hospital industry and the public for input and buy-in to the measures, design, pilot processes, and statewide implementation
• Planning and implementing the program for statewide implementation and Year One baseline data collection for FY 2009
• Providing technical assistance to HSCRC in comparing the relevance of different performance measurement models for hospital care reimbursement.

Maryland Patient Safety Center’s (MPSC) Healthcare Information Technology (HIT)

Adjunct to the Pay-for-Performance Initiative, the HSCRC, MPSC, and Maryland hospitals have pursued the establishment of HIT which has a proven record of assistance in the improvement of safety of health care. There are two stages to this grant project:

1. Design and conduct a web-based survey to establish a baseline of the types of HIT currently in use among Maryland’s acute care hospitals. CPS conducted the first survey in 2006 with the participation of 34 Maryland hospitals.
2. Analyze the data in depth using regression analysis to identify the enablers or predictors of various HIT adoption, use, and impact on safety. The final report and recommendations were presented to the HSCRC and MPSC in 2007.

An article titled "HIT or Miss: The application of healthcare information technology to managing uncertainty in clinical decision-making" has been accepted by the Journal of Evaluation in Clinical Practice and is expected to be published in December 2010.

A follow-up survey was conducted by CPS in January 2010 with the participation of 42 Maryland hospitals. The new data have been compared to those from the 2006 survey and the report will be submitted to MPSC in June 2010.