(provided by the applicant): The goal of this predoctoral training grant from the Heller School for Social Policy and Management is to train talented students to become health services researchers committed to conducting investigations that will improve the U.S. health care delivery system's ability to deliver high quality services. We have the interdisciplinary faculty and student interest to train 12 doctoral students;four a year for three years. We are comfortably training action oriented, productive researchers in sound methodological approaches. Over the past decade over two-thirds of our trainees received a Ph. D. About 25% of our students are minorities. The importance of health care organizations as mediators between policy changes or clinical knowledge and patient outcomes was emphasized in the lOM's 2001 seminal report: Crossing the Quality Chasm: A New Health System for the 21st Century. Health care organizations have the complexities of many other nonhealth care organizations. However, the multiple objectives of health care organizations, the competing economic, political and cultural subsystems of organizations that must accommodate the desired autonomy of physicians, and the always changing composition of the health care work team means that theories of organizational behavior must be adapted for studying health care organizations. This is an area of health services research that has very limited capacity because of the need for inter-disciplinary training and the need to combine social sciences with management expertise. Because the Heller School has a multidisclinary doctoral program in social policy and an MBA program in the management of human services organizations, we decided in our 2002 competitive renewal to focus on health care organizations. We have been successful in redesigning our curriculum and reorienting our graduate students. In particular, we have developed a new course in organizational theory, have a seminar series on how organizational theories could be applicable to explore health care quality, and all the AHRQ trainees are using organizational frameworks in their dissertations. In this continuation, we propose a new course that will apply organizational frameworks and methods to improve health care and extensive research experiences in one of our CMS projects, most likely Value Based Purchasing for hospitals, for the trainees in which they will learn to appropriately use large claim data sets and AHRQ quality indicators for CMS'hospital payment system.
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