Innovative research…a commitment to quality improvement…the integration of best practices: over the years these factors have paved the way for the advancement of health care.
They’ve led to the discoveries that insulin could control diabetes, and that mammography could detect early forms of breast cancer. They’ve proven that the practices of hand washing and of cleaning local water supplies could thwart the transmission of germs to vastly improve both individual and public health.
To cite more recent examples, the combination of research, quality improvement and best practices has enabled Hewlett-Packard to apply its inkjet technology to the development of drug-coated stents. It’s prompted 3M to use its signal preemption technology to empower emergency vehicles to change traffic signals via strobe lights and road-mounted receivers.
And now, those same factors that have spawned innovation in industry, science and business worldwide, are being nurtured locally at Samaritan Health Services. With the establishment last year of its Center for Health Research & Quality,Samaritan is readying itself to play a new and major role in the continuing advancement of health care. In the process, it’s advancing its reputation for excellence in patient care and commitment to broader community health.
“The center was established to advance research and health promotion activities because these efforts help us sustain high quality patient care and ultimately improve community health,” said Jana Kay Slater, PhD, the center’s director.
Slater said the new center currently manages approximately $5 million in grants and contracts and has three major areas of focus: health research, including clinical trials; internal research to improve quality of care; and community-based health research and health promotion. Underlying these activities is the formation of an organizational infrastructure that supports physicians, nurses, allied health professionals and collaborative partners to succeed in their endeavors.
Clinical research provides new opportunities for local patients
In elaborating upon the clinical focus, Bill Origer, MD,a Samaritan physician and the center’s medical director, said that such research relies upon meticulous adherence to the clinical study and extensive documentation.
“As practicing physicians whose time is filled with the day-to-day seeing of patients, research is something most of us can’t do professionally,” Origer noted. “But still, we want to be able to contribute to these findings around the edges of our busy practices. That’s where our participation in clinical trials comes in.”
To that end, some Samaritan physicians, working through the new center, are collaborating with pharmaceutical companies to bring new and promising treatment regimens to patients in Linn, Benton and Lincoln counties. Dr. Peter Kenyon, Samaritan Regional Cancer Center’s medical director, is working to make locally available a number of cancer-related clinical trials that in the past may have been available only at large teaching hospitals. The Samaritan Sleep Disorders Center at Good Samaritan Regional Medical Center, directed by Dr. Mark Reploeg, was specifically designed to be able to conduct clinical research studies.
Other research is being designed and conducted by doctors and pharmacists locally and through collaboration with Oregon State and other universities. One such local study is evaluating the use of fish oil to reduce possible complications in heart patients.
“We’re doing these things always with an eye toward what’s best for our patients,” Origer said. “In the short term, a small percentage of patients may benefit by having access to experimental drugs they couldn’t get otherwise. In the long term, for future generations, a large percentage will benefit because of the overall increase in general medical knowledge.”
A critical component of such clinical research is meticulous oversight. Barbara Croney, the center’s administrator for sponsored programs and head of the center’s Institutional Review Board, noted that with all clinical trials, patient safety and privacy is paramount.
“We make sure that the information is pulled in a way that does not identify individual patients,” Croney said. “It’s aggregate information….overall numbers of breast cancer patients who have undergone specific therapies, for example. We de-identify the data for patients’ sake.
“Similarly, through the Institutional Review Board,we make sure that clinical trials and grant-funded research adhere to stringent protocols,” Croney continued. “We review and approve all applications involving human subjects, and we monitor any reported adverse effects. Our overall concern is always for our patients.”
Internal research to improve quality leads to better outcomes
As for its focus on quality, the Center for Health Research & Quality works with the quality directors at Samaritan-affiliated hospitals to strengthen the collection, reporting and use of data to advance best practices throughout the system. Its methods range from extracting data from patient charts to compiling responses from patient satisfaction surveys (given to patients at all five Samaritan hospitals).
Nancy Keuneke, MS, CPHQ, RN, SHS Quality Improvement Director, said assessment of quality begins with a researchable question, such as: What are the recorded side effects of a particular drug on particular patients? What’s the optimal time during which to insert a stent in a heart attack patient? How should patient information be arranged in the computerized record to best suit the needs of a medical provider?
“We’re always looking at core measures—those basic measures that tell us if we’re doing something most effectively,” Keuneke said. “And we’re looking at best practices. Based on information that’s coming in, should we change any of our practices?
“For example, we’ve studied extensively how the timeliness of care affects the overall outcomes of cardiac patients,” Keuneke continued. “We know that minutes count when it comes to getting a patient on a monitor and/or into the cath lab. We’ve taken the information we’ve gathered from our quality studies, isolated best practices, and trained paramedics and other cooperating agencies to quickly get some patients to a cath lab andothers to a local hospital—wherever best meets their particular needs. We’ve also trained cath lab and hospital personnel to be ready for such incoming patients. The result is that Samaritan’s mortality rate for heart attack patients is well under the national rate of 10 percent.”
Center infrastructure supports grants, community projects
In explaining her role in building a successful infrastructure for the SHS Center for Health Research & Quality, director Slater says she considers herself a “partnership broker.”
To that end, she’s working with local, state, federal and business partners to facilitate alliances that will strengthen health care in the region. She also works diligently to assure that Samaritan Health Services is recognized as an exemplary steward of external funding. Some of these partnerships come about because of the center’s alerting of hospital departments and others of grant opportunities and because of the center’s support for grant writing. In fact, one of the center’s major accomplishments in its first year was the development of a grant-finding service called “ScanGrants” (see
www.ScanGrants.com).
Designed and maintained by Library Technical Specialist Hope Leman, this free grant-finding service already has been promoted and used by academic institutions and health care organizations throughout North America.
One of the community projects monitored and supported by the center is a state-funded grant to help those with chronic disease. “Living Well With Chronic Conditions” is an evidence-based program helping people with diabetes, arthritis, cardiac disease and other chronic diseases lead more active, satisfying lives. Another project supported in part by the Ann and Bill Swindells Charitable Trust is exploring how to help individuals with chronic pain develop coping skills and compiling this information in a resource document for patients dealing with chronic pain.
Still other collaborations are in the works. Slater is in communication with local community partners, county and state agencies and academic institutions, including Legacy Health, Western University of Health Sciences, The Center for Healthy Aging Research at Oregon State University and Oregon Health & Science University. Croney is working with pharmaceutical companies and federally funded cooperative research groups to build opportunities for patients to participate in clinical research and at the same time access cutting edge treatments in their local community.
“In everything we do, we want to facilitate state-of-the-art care for our patients and improve the health of those we serve,” Slater said. “We’re making sure our research and quality capacities are firmly in place so we are ready to support opportunities for our patients and the community.”
To find out what clinical research studies are currently accepting patients or for more information, contact the
Center for Health Research & Quality at (541) 768-6612.