Our current AHRQ T32 program has successfully recruited diverse fellows and prepared them for health services research careers. We have trained 13 researchers, resulting in 29 presentations and 30 publications. Nine have graduated, with 7 obtaining academic appointments, and two still completing their PhD training. This competitive renewal capitalizes on the opportunity to train fellows in an environment of innovation and transformation, as Boston Medical Center (BMC) transitions to its own Accountable Care Organization and becomes a Learning Health System. Over the past year, BMC, New England?s largest safety-net hospital, has become the epicenter of the Boston Accountable Care Organization (BACO). BACO is projected to be responsible for 185,000 covered lives, making it an ideal setting in which to train researchers. Our interdisciplinary predoctoral and postdoctoral fellowship aims to produce Family Medicine, General Internal Medicine, Pediatrics, and Public Health researchers who will lead efforts to improve health care delivery for underserved patients. The four objectives of our program are to: (1) Recruit and retain high-quality, diverse candidates interested in research careers focused on improving health care quality, access, and delivery for underserved patients; (2) Provide predoctoral and postdoctoral fellows with comprehensive research training; (3) Produce graduates who will conduct research on health care quality, access and delivery for low-income populations and whose research translates to systems change; and (4) Evaluate our program for continuous improvement. The program is led by Dr. Megan Bair-Merritt, an experienced researcher and mentor, and Co-Directed by an interdisciplinary team of senior scientists. We have established four pedagogical structures essential to training research fellows: (1) Intensive mentoring; (2) Boston University School of Public Health (BUSPH) courses culminating in a Master?s in Health Services Research for postdoctoral fellows and a PhD for predoctoral fellows; (3) Interdisciplinary academic seminars; and (4) Supervised conduct of at least two research projects. In this competitive renewal, we have added to each structured learning, including: pairing trainees with traditional research mentors and a hospital leadership mentor; training in quality improvement and implementation science; and the conduct of at least one research project leveraging clinical data to address a health delivery question. Predoctoral training includes the first 3 didactic years of the PhD program. Postdoctoral training is 2 years. Each year, we will train 3 predoctoral and 3 postdoctoral fellows. Fellows will become health service researchers focused on health care quality, delivery, and outcomes for low-income populations. We track graduates 1, 5, and 10 years after graduation (goal: >85% enter research careers focused on improving healthcare quality; >70% remain in health services research after 3 years; >50% lead efforts to implement new care models and have >1 funded research within 5 years).

Public Health Relevance

In 2013, Boston Medical Center, New England?s largest safety-net hospital, established an interdisciplinary predoctoral and postdoctoral AHRQ fellowship program to train Family Medicine, General Internal Medicine, Pediatrics, and Public Health researchers to improve health care delivery for underserved patients. This competitive renewal will expand our program by adding content and experiential learning relevant to the evolving issues of the current health care environment. The four objectives of our program are to: (1) Recruit and retain high-quality, diverse candidates interested in research careers focused on improving health care quality, access, and delivery for underserved patients; (2) Provide predoctoral and postdoctoral fellows with comprehensive research training; (3) Produce graduates who will conduct research on health care quality, access and delivery for low-income populations and whose research translates to systems change; and (4) Evaluate our program for continuous improvement.

Agency
National Institute of Health (NIH)
Institute
Agency for Healthcare Research and Quality (AHRQ)
Type
Institutional National Research Service Award (T32)
Project #
2T32HS022242-06
Application #
9563818
Study Section
Special Emphasis Panel (ZHS1)
Program Officer
Hsieh, Chinghui
Project Start
2013-07-03
Project End
2023-06-30
Budget Start
2018-07-01
Budget End
2019-06-30
Support Year
6
Fiscal Year
2018
Total Cost
Indirect Cost
Name
Boston Medical Center
Department
Type
DUNS #
005492160
City
Boston
State
MA
Country
United States
Zip Code
Morgan, Jake R; Barlam, Tamar F; Drainoni, Mari-Lynn (2018) A Qualitative Study of the Real-world Experiences of Infectious Diseases Fellows Regarding Antibiotic Stewardship. Open Forum Infect Dis 5:ofy102
Washington, David M; Paasche-Orlow, Michael K; Liebschutz, Jane M (2017) Promoting Progress or Propagating Problems: Strategic Plans and the Advancement of Academic Faculty Diversity in U.S. Medical Schools. J Natl Med Assoc 109:72-78
Penti, Brian; Liebschutz, Jane M; Kopcza, Brian et al. (2016) Novel peer review method for improving controlled substance prescribing in primary care. J Opioid Manag 12:269-79
Radesky, Jenny; Miller, Alison L; Rosenblum, Katherine L et al. (2015) Maternal mobile device use during a structured parent-child interaction task. Acad Pediatr 15:238-44
Burgess Jr, James F; Jones, Eric A; Khan, Maryum M et al. (2015) Capsule Commentary on Chan et al., The Effect of a Care Transition Intervention on the Patient Experience of Older, Multi-lingual Adults in the Safety Net: Results of a Randomized Controlled Trial. J Gen Intern Med 30:1849
Burgess Jr, James F; Jones, Eric A; Morgan, Jake R (2015) Capsule commentary on Tannenbaum et al., nudging physician prescription decisions by partitioning the order set: results of a vignette-based study. J Gen Intern Med 30:343