From left: Jessica Dudley, Melissa Spinks, Karl Laskowski, Anthony Massaro, Erika Pabo and Allen Kachalia

Thanks to six innovative teams of clinicians and their care redesign projects, BWH is improving the quality of patient care and enhancing efficiency, while achieving a cost savings of $1.2 million in total medical expense.

The projects were funded by the Brigham and Women’s Physicians Organization (BWPO) Care Redesign and Incubator Startup Program (BCRISP).

“What we were trying to do with this program was engage our clinicians to come up with great ideas,” said Karl Laskowski, MD, assistant medical director of the BWPO. “We don’t have all the answers, but people on the frontlines do. We wanted to put a structure in place where we could succeed in helping these projects prove their value.”

Established in 2013, BCRISP encouraged teams of frontline clinicians to submit proposals for projects that improve quality of care and reduce health care costs. Structured like an incubator or early venture capital fund, BCRISP supported clinicians in developing their game-changing ideas.

“This type of work is a critical part of providing good care and striving to improve the value that we provide for our patients,” said Sarah Abbett, MD, BWPO senior clinical project manager, who guided the BCRISP teams in their projects.

From 42 initial proposals, 14 were selected to receive $5,000 in seed funding, as well as support for further project development and early implementation. Six of those projects were then selected to receive additional funding of up to $50,000, as well as ongoing analytic and strategic support. The six projects were piloted, and most have been implemented. Some will continue on.

Several BCRISP projects were highlighted at a recent Quality Rounds:

“Coordinating Follow-Up After Emergency Department (ED) Visits for Patients with Diabetes”: This project reduced, by 50 percent, the number of diabetes patients revisiting the ED within two months of their initial visit, through better follow-up and outreach to patients and an IT tool.

“Integrating a Community Health Worker Into a Medical Home”: This project introduced a community health worker into Brigham and Women’s Advanced Primary Care Associates at South Huntington, to work closely with some of its highest-risk patients. After the first five months, the number of ED visits by these patients decreased by five percent; hospitalizations decreased by 16 percent and 30-day readmissions went down by 39 percent.

“Integrated Patient-Centered Care in Chronic Critical Illness”: This project looked at the current model of care in chronic critical illness, specifically for BWH’s Medical Intensive Care Unit patients who are discharged to Spaulding Hospital for Continuing Medical Care Cambridge (SHC). The team sought to decrease 30-day readmissions to BWH of patients discharged from BWH to SHC. The group created a continuity team, made up of BWH intensive care physicians, BWH and SHC social workers and SHC physicians, which focused on enhanced communication among both teams, including short interval check-ins by video and in-person and pre-transfer evaluation. The team reduced the 30-day readmission rate by 37.5 percent.

The BWPO is soliciting ideas for BCRISP 2.0, with hopes to engage the entire BWH community in care redesign innovation. Contact
sabbett@partners.org to learn more.