Research in the lab focuses on equitable access to surgical subspecialty care, violent injury prevention and survivorship, and the impact of social vulnerability on altering the response to surgery and injury with respect to morbidity and mortality.
Emergent Surgery That Could Have Been Elective
The overall goal of this NIH-funded research is to understand why having health care coverage (or eligibility for health care coverage) is not sufficient to allow equal access to elective surgical care. This proposal will leverage our ability to link data from multiple sources in novel ways, our diverse, robust general surgery population in a Medicaid expansion state. With this data we can model and understand what influences the persistent disparity in the ability to access elective surgical care despite increased coverage, and predict which factors contribute the most to the disparities and thus hold potential for the greatest impact using Mixed Methods and Markov modeling.
Research/Evaluation and Expansion of a Hospital-based Violence Intervention Program
This Department of Justice-funded research assesses the implementation of our hospital-based violence intervention program, At-Risk Intervention and Mentoring. Outcome measures include connection to post-discharge services, school enrollment, hospital recidivism, justice system recidivism, employment, resource utilization, and mortality over time. For comprehensive data analysis, data linkages are performed using data from EHR, AIM and research staff assessments, including needed services and remaining gaps, and Denver law enforcement criminal justice open records using mixed methods. In addition to primary outcome measures will perform a cost effectiveness analysis to quantify how much AIM interventions save over the health, social, and criminal justice costs of individuals not participating in the program. We also evaluate the expansion of the program from one site to 3 sites over the last few years (Denver Health, University Hospital, Children’s Hospital).
Partnership with A Community Organization to Deliver Mental Health Services After Trauma
We were awarded a federal grant from the Substance Abuse and Mental Health Services Administration (SAMHSA) to partner with the Therapist of Color Collaborative in our metro area to deliver culturally-competent mental health services. The overall goal of our project is to study implementation outcomes for the mental health component of our hospital-based violence intervention program (HVIP), utilizing the RE-AIM (reach, effectiveness, adoption, implementation, maintenance) framework. This includes understanding the feasibility and acceptability of administering multiple mental health assessments from the patient perspective, determinations of which assessments yield the most valuable information from a programmatic standpoint, and optimal implementation of mental health care navigation within our hospital-based violence intervention program that directly addresses firearm injury and prevention of further injury.
Evaluation of a Multi-Site Pilot of a Trauma Informed Care Curriculum
We were a pilot site for the new Trauma Informed Care Curriculum introduced by the American College of Surgeons Committee on Trauma, and have led the data collection and analysis, including ethnographic study of the implementation across different types of staff members within the hospital setting.
Implementation of a Community-led Clinic to Address Violent Injury and Survivorship
The Colorado Health Foundation has awarded our community partner funds for the design and implementation of a holistic clinic within the community that addresses the barriers and facilitators to exiting a cycle of violence. In the process, our Outreach Workers from our hospital-based violence intervention program have been trained in qualitative research data collection and analysis, and will be instrumental in directing this research.