Principal Investigator: Rajesh N. Keswani, MD Among the busiest digestive disease centers in the country, Northwestern Medicine (NM) manages some 35,000 GI endoscopy procedures and more than 42,000 outpatient clinic visits a year. NM clinicians strive to deliver high quality, patient-centered cost-effective care with every patient encounter. Improving the quality of care relies on measuring clinical performance (i.e., “quality metrics”), implementing interventions to improve care delivery, and then re-measuring quality following the interventions. Our group utilized this approach to markedly improve the quality of colonoscopy at Northwestern thereby reducing the risk of colon cancer death after colonoscopy in the patients we serve, and subsequently published this innovative work in a leading journal (American Journal of Gastroenterology, 2015). Although the NM digestive health group has considerable quality improvement expertise, each initiative requires an analyst who has the computer and statistical skills to collect patient and procedure data from the electronic health record and interpret that data in a continuous fashion. The lack of a dedicated analyst has been a persistent bottleneck to replicating this approach to quality improvement research. Funding of the programmer analyst position will now allow the group to support multiple novel quality improvement projects and improve the efficiency of current research...
Principal Investigator: Ronak Vashi Patel, MD Imagine a piece of food becomes stuck in your throat while eating dinner. Unfortunately, for many patients with Eosinophilic Esophagitis (EoE), this is a symptom that occurs all too often. Dysphagia, or difficulty swallowing, is a gastroenterology “red flag” that often alerts physicians to initiate a work up to determine the cause. Typically, the first step calls for an upper endoscopy to visually assess inflammation and narrowing (strictures) that can be treated. Prior data suggests that visual evaluation is not perfect. Missed strictures can lead to additional testing and delay diagnosis. Other tools have become available to assist in measuring the esophageal diameter such as the Functional Lumen Imaging Probe (FLIP), a novel technology. Dr. Patel’s research project aims to determine how accurately physicians measure esophageal diameter as compared to FLIP in patients with EoE. Better understanding the accuracy of endoscopic assessment by both visual estimation and FLIP assessment will offer insight into which tools should be used in diagnostic and therapeutic treatment of esophageal...
Principal Investigator: Eric S. Hungness, MD Muscular weakness at the junction of the diaphragm and esophagus (hiatal hernia) is a common problem that may result in heartburn, difficulty swallowing, or anemia. Current surgical repair techniques have an unacceptably high hernia recurrence rate. A novel surgical material was developed at Northwestern University and has demonstrated promising results in animal and human studies. This project will investigate the efficacy of an innovative mesh suture in hiatal hernia repair, as compared to the current gold standard material. The principle outcome of interest will be measured by a non-invasive x-ray examination 6 months following surgery. The hope is that patients undergoing repair with the novel material will have...
Principal Investigator: Nikhilesh Mazumder, MD, MPH Severe damage to the liver can profoundly affect a variety of body systems. Patients with cirrhosis suffer from excess fluid in the legs, abdomen, and chest. Medications can reduce fluid buildup but dosing is not an exact science. Inaccurate dosing can harm the kidneys, cause confusion, and even land patients in the hospital. To avoid these complications, clinicians rely on a multitude of blood and imaging tests that often require expensive equipment, drawing blood, or specially trained staff. Dr. Mazumder’s team seeks to simplify the process by testing the benefit of a decades-old technique called the Valsalva maneuver in combination with a finger photoplethysmography device (similar to a noninvasive bedside pulse oximeter). Patients hold their breath for 10 seconds, and the device measures changes in blood flow to the finger. Safely and successfully tested in individuals with heart problems to predict levels of fluid overload, the...