Health Services & Outcomes

Department of Surgery faculty lead a wide range of research initiatives to improve the delivery of health services and, ultimately, the outcomes for surgical patients everywhere. Much of our faculty's health services and outcomes research is conducted through our Center for Healthcare Outcomes & Policy (CHOP), led by Dr. Jennifer Waljee. The Center provides a unique opportunity for principal investigators to come together to work collaboratively on improving care for our surgical populations.

Research focuses on two key areas of health services and outcomes research: improving the quality of healthcare and evaluating healthcare policy. We also place great emphasis on mentorship and faculty development efforts, training early-career health policy and health services researchers through several CHOP training programs.

Leveraging qualitative and quantitative research cores and many other resources, our health services investigators identify research questions, develop new collaborative proposals and share findings that make surgical care safer and more effective for patients. Impacts of Department of Surgery faculty-led research initiatives include:

Reducing Opioid Use

The Michigan Opioid Prescribing Engagement Network (OPEN) is attacking the problem of opioid addiction head-on in several ways. Led by Department of Surgery faculty, Dr. Jennifer Waljee and Dr. Michael Englesbe, Michigan OPEN research has led to:

• Development of opioid prescribing guidelines for 25 common surgical procedures
• Reduction in the size of opioid prescriptions following many surgical procedures, while improving pain control for patients
• Novel take-back programs that lessen the amount of leftover opioid medications in the community
• Widespread media coverage, including by National Public Radio and The New York Times in addition to peer-reviewed articles in The New England Journal of Medicine, JAMA Surgery, the Journal of Clinical Oncology and others.

Novel Surgical Coaching Initiatives

Faculty research on the connection between surgeon technical skill and patient outcomes, directed by Dr. Justin Dimick, has led to the development, implementation and evaluation of surgical coaching programs in bariatric surgery and colorectal surgery. These programs are helping surgeons improve their technical skills in the operating room, reduce complications and, as our research has shown, improve patient outcomes.

Policy Evaluation

Department of Surgery research also results in important analyses of and subsequent changes to healthcare and reimbursement policies, including Medicare payment reform, that impact patients and their care teams. Work in this area spans a wide range of medical conditions, surgical procedures and patient populations — state- and nationwide. Our goal is to identify those policies that lead to the best outcomes and lower costs.

Many of the Department's health services and outcomes research initiatives are funded through competitive National Institutes of Health R01 and T32 grants, the Michigan Department of Health and Human Services, Blue Cross and Blue Shield of Michigan/Blue Care Network and other sources.

Our Department and its Center for Healthcare Outcomes and Policy serve as the coordinating center for several statewide quality improvement collaboratives. Our faculty lead initiatives in key areas, such as:

• Bariatric surgery through the Michigan Bariatric Surgery Collaborative (MBSC)
• Surgical quality through the Michigan Surgical Quality Collaborative (MSQC)
• Trauma through the Michigan Trauma Quality Improvement Program (MTQIP)
• Urological surgery through the Michigan Urological Surgery Improvement Collaborative (MUSIC)

These initiatives include invaluable clinical registries with data from nearly every hospital in the State of Michigan. In addition, the Michigan Value Collaborative (MVC) pairs claims data with clinical information toward the goal of developing best practices and assessing care value. Close collaboration around the shared goal of improving care and value amplifies the impact of research and translates to improvements in surgical care delivery statewide. Some of our programs are serving as national models as well.