Leapfrog Group for Patient Safety
$195,345
A Learning Collaborative to Strengthen Innovative Models for Rewarding Quality
For this project, the Fund will join forces with the Robert Wood Johnson Foundation to accelerate the development and testing of incentive models to reward physicians ahd hospitals for higher-quality care. Project staff will help launch a national collaborative that will include up to seven teams of employers, health plans, state Medicaid agencies and Children's Health Insurance Programs, and other health care purchasers participating in the Rewarding Results program.

American Board of Internal Medicine Foundation
$222,200
Using Performance Data to Improve Physician Practices
As the first phase of the American Board of Internal Medicine (ABIM) Foundation's five-year, $1.5 million "Putting Quality into Practice" initiative, this project will foster doctors' use of data to improve clinical performance and guide certifying boards and accreditation organizations in the development of standards for evaluating physicians. Project staff will identify physicians in small group practices who are successfully using data on their own performance to improve quality and develop a compendium describing the actions of 50 of them. The ABIM Foundation would provide cofunding for all phases.

Atlantic Health System
$381,300
Managing Hospital Patient Safety: An Interactive System
Knowing that communication failures are the root cause of many medical errors, a team at Atlantic Health System in New Jersey will incorporate resource management techniques in an interactive, CD-ROM-based "safe practice learning center" to improve hospital patient safety. The learning center will include a simulation-based competency test and an operations control center, which hospital personnel could use to gain immediate access to information that affects patient care and safety.

Boston Medical Center
$367,087
Managing Chronic Disease with an Internet-Supported Team
Focusing on childhood asthma, a prototypical chronic disease, this randomized clinical trial will measure the impact on care of an interactive website that facilitates communication between patients and primary care practitioners and educates patients about their disease. In addition, it will attempt to demonstrate that such Internet-based technology could be used to create a "virtual" interdisciplinary team, foster teamwork, and improve clinical outcomes.

Dana Farber Cancer Institute
$100,000
Improving Ambulatory Patient Safety Rounds
Frances Cooke Macgregor Grant
This study will evaluate two promising team-based models for improving patient safety in two outpatient chemotherapy clinics. In one clinic, a nurse or other clinician acting as a patient safety champion will be added to the safety team to help identify potential problems, suggest solutions, and monitor their implementation. At another clinic that already has a safety champion, the project staff will recruit and train a patient or a patient's family member to participate as a "safety liaison." If these models prove successful, instructional materials will be disseminated to other hospitals.

Economic and Social Research Institute
$235,809
Developing Case Studies of High-Performing Hospitals
This project will develop case studies of four financially stable, integrated health systems or hospitals that have achieved a superior level of clinical performance while maintaining low costs. These "high performers" will be compared with a group of average-performing institutions. Through site visits and in-depth interviews with CEOs, clinical leaders, and other key staff at these institutions, the case studies will clarify what the high performers have achieved and how they have achieved it.

Johns Hopkins University
$223,781
Evaluating the Response to the Leapfrog Group's Standard for Intensive Care Unit Staffing
The Leapfrog Group, a large health care purchasing group, promotes standards of care for hospitals that provide services to their employees. One such standard is that hospitals must have dedicated specialist physicians known as intensivists staffing their intensive care units — a practice that reduces mortality rates but is in use in less than 10 percent of U.S. hospitals. This project will survey top management in 105 hospitals, plus their associated insurers and key purchasers, to determine the financial and nonfinancial factors that determine whether a hospital adopts the intensivist standard. Project staff will issue recommendations for implementing similar, large-scale, purchaser-based programs to reward quality.

Thomas Jefferson University
$151,268
Assessing the Potential of Value-Based Purchasing, Phase Two
In a previous phase, the investigators classified value-based purchasing (VBP) activities and identified characteristics of organizations with successful programs as well as barriers that prevent VBP's broader use. In this phase, they will: 1) perform more systematic surveys of 2,000 large and 1,000 midsize firms and employer consortia; and 2) conduct case studies of 18 successful programs. The project team will develop a guide for employers that outlines various VBP strategies.

Tufts University
$315,050
Constructing Valid Physician Performance Measures: Diabetes as a Test Case
For this project, researchers will follow principles identified by the American Diabetes Association in constructing aggregate measures of physician care and designing methods to compare doctors' scores. User guides and educational materials prepared by project staff will enable consumers and employers to choose high-quality providers and provider networks; assist accrediting boards in enforcing quality standards; and aid physicians in improving the care they provide.

University of North Carolina at Chapel Hill
$153,592
Quality Chartbook Series, Phase Two
In April 2002, the Fund released Quality of Health Care in the United States: A Chartbook, which has garnered praise for its comprehensiveness as well as its easy-to-read format. In Phase Two of this project, Sheila Leatherman and her team will develop two additional chartbooks on quality, one on care for children and one on care for the elderly.

Chicagoland Chamber of Commerce Foundation
$25,000
A Strategy to Improve Healthcare Information and Quality in a Large Metropolitan Area

Employee Benefit Research Institute
$18,471
2003 Policy Forum on Evidence-Based Medicine

Harris Interactive, Inc.
$10,000
Strategic Health Perspectives Membership

Harvard Medical School
$27,359
Promoting Physician Literacy in Health Policy

Health Research and Educational Trust
$49,050
Developing a Train the Trainer Curriculum to Disseminate 'Pathways for Medication Safety'

The National Quality Forum
$15,750
2003 Membership

University of Florida
$49,995
Transitions in Care: Emergency Department Sign-Overs

University of Massachusetts
$50,000
Talking to Patients About Medical Errors
Frances Cooke Macgregor Grant

WGBH
$45,000
The WGBH Health Desk

Harvard Medical School
$315,000
Evaluating the Impact of Health Disparities Collaboratives
In 1998, the federal Bureau of Primary Health Care launched the Health Disparities Collaboratives to address the prevalence of lower-quality care among minorities, the poor, and other medically underserved populations. This project will evaluate the collaboratives' impact on health care received by patients with diabetes, cardiovascular disease, and asthma — chronic conditions that disproportionately affect minority Americans and the poor. The federal Agency for Healthcare Research and Quality will provide cofunding for this project.

Health Research and Educational Trust
$237,729
Developing and Testing a Uniform Framework for Collection of Hospital Data by Race, Ethnicity, and Primary Language
This project will: 1) create and test a framework for collecting data on patients' race, ethnicity, and primary language in hospitals; and 2) implement the framework in five hospitals to collect clinical and administrative data. At completion of the project, each hospital will be able to assess quality of care and identify disparities in clinical diagnoses, treatment, and outcomes.

Henry Ford Health System
$88,819
Assessing the Significance of Racial and Ethnic Disparities in Health Care
For this project, David Nerenz will create analytical models to relate racial and ethnic disparities in health care to three important outcome measures: quality-adjusted life years, workplace productivity, and mortality. Findings from this work will help policymakers, health care purchasers, and clinical leaders make informed decisions about the relative importance of different types of health care disparities. The Michigan Medicaid program will provide cofunding.

Massachusetts General Hospital
$150,000
Assessing Resident Physician Preparedness to Care for Culturally Diverse Patient Populations
The project will survey resident physicians in their final year of training to determine characteristics that predict preparedness to provide care to minority patients. It also will assess cross-cultural education at the residents' graduate medical education training sites. Survey findings will inform efforts by leaders in medical education to incorporate cross-cultural education into current training. In addition, project staff will provide self-assessment tools for residency programs. The California Endowment will cofund this project.

Mount Sinai School of Medicine
$250,002
Improving the Delivery of Effective Care to Minorities, Phase Two
For the second part of this three-phase grant, project staff will continue to investigate the widespread underuse of certain medical services within minority populations and test clinical interventions to improve care. The investigative team will complete its assessment of the extent and causes of underuse, finalize designs for interventions at selected New York City hospitals to improve treatment for three of the conditions, and initiate the interventions. The Agency for Healthcare Research and Quality will provide cofunding for all phases of the project.

National Public Health and Hospital Institute
$248,846
A Consortium for Quality Improvement in Safety Net Hospitals
For this project, the National Association of Public Hospitals (NAPH) will develop a consortium of up to 12 large public hospitals to improve care for patients with diabetes. Project staff will survey 1,800 patients with diabetes to assess their health care experiences and needs, examine patient records to evaluate and compare the quality of diabetes care in different hospitals, and share information about current practices and promising interventions.

University of Arizona
$89,642
Developing an Agenda for Improving Health Care Quality for American Indians and Alaska Natives
This project will help researchers, policymakers, and health advocates develop an agenda for improving health care in American Indian and Alaska Native (AIAN) communities. The project team will convene a conference to review what is currently known about the state of AIAN health care, discuss the application of quality-of-care surveys to these populations, and develop recommendations for improving quality.

Johns Hopkins University
$14,000
Minority Health Disparities: Bridging Research and Policy

National Health Law Program, Inc.
$38,800
Tool Kit: Expanding Medical Interpreter Services to Improve Access for People with Limited English Proficiency

President and Fellows of Harvard College
$50,000
Race and Unequal Treatment: Building a Research-Based Civil Rights Agenda Around Disparities in Health Care

President and Fellows of Harvard College
$9,900
Women of Color as Leaders in Public Health and Health Policy Conference

President and Fellows of Harvard College
$920,581
Commonwealth Fund/Harvard University Fellowship in Minority Health Policy: Support for Program Direction and Fellowships, 2003—04
This fellowship program has provided young physicians with an intensive year of coursework in health policy, public health, and management as well as special program activities — ll with an emphasis on minority health issues. Since 1996, 29 fellows have successfully completed the program and received a master's degree in public health or public administration. In the coming year, the program will select an eighth group of five fellows while providing current fellows with an enriched course of study, career development, and program evaluation.

All Children's Research Institute, Inc.
$304,516
A Web-Based Support Center for Primary Care Developmental and Behavioral Screening
This project will develop a website to give primary care providers ready access to appropriate developmental and behavioral screening tools, educational materials, and interactive support. Advisors from the major child health organizations and agencies will participate in the project to ensure authoritative content, broad dissemination, and accessibility for a variety of users.

Center for Health Policy Development
$273,161
Building State Medicaid Capacity for Child Development Services
Since March 2000, the Fund has been implementing an ambitious strategy to help state Medicaid agencies promote and improve the delivery of developmental services for low-income children. Four states have added new child health services, trained pediatric clinicians in child development, changed policy affecting billing and reimbursement of developmental services, revised procedures to improve coordination of care, and prepared new educational materials for parents. In the year ahead, the National Academy for State Health Policy will launch a second consortium of four states to enhance the healthy mental development of young low-income children.

Child Trends, Inc.
$272,385
Profiling Children's Developmental Problems and Health Care Needs
To serve a broad audience of policymakers, researchers, clinicians, and journalists, this project will produce a consolidated chartbook on the current status and trends of children's development in the United States and the factors that affect it. Researchers also will review the various sources of data and provide recommendations to strengthen future data collection.

ICF Incorporated
$249,993
Healthy Steps for Young Children Program Support for Program Direction and Operations, 2002-03
Activities in the coming year will focus on devising and implementing a sustainability plan for the National Program Office of Healthy Steps. That plan will allow the Fund to continue some administrative support for the network of local funders that has evolved during the course of this program until 2005, and enable the Fund to field inquiries about Healthy Steps from clinical sites, organizations, and the media. The National Program Office also will convene the final meeting of the National Advisory Committee; organize this year's meeting of the Local Funders Network; work closely with Johns Hopkins University on the completion of evaluation analyses; and continue to provide logistical and communications support to the Healthy Steps offices, sites, and funding partners.

Johns Hopkins University Bloomberg School of Public Health
$400,000
Long-Term Follow-Up of Healthy Steps Effects, Phase Two
The first phase of the Healthy Steps' national evaluation will be completed this fall based on data collected during enrolled children's first three years of life. A second phase of evaluation will determine if early life participation in Healthy Steps influences parenting practices and health care — seeking and health promotion activities for their children at age 5. The federal Agency for Healthcare Research and Quality will supplement the Fund's support.

Kaiser Permanente Center for Health Research
$213,046
Building a State Learning Network to Improve Measurement of Child Development Services
This project will create a network of seven state Medicaid agencies dedicated to administering, reporting the results of, and sustaining the use of the Promoting Healthy Development Survey instruments. Its goal will be to improve the quality of preventive pediatric care provided to low-income young children by generating state-based models and technical assistance materials.

The Commonwealth Fund
$220,000
Authorization for Support of up to $220,000 for 1 Year for up to Four States
Since March 2000, the Fund's Assuring Better Child Health and Development initiative has been implementing an ambitious strategy to help state Medicaid agencies promote and improve the delivery of developmental services for low-income children. In the year ahead, the National Academy for State Health Policy will launch a second consortium of four states to enhance the healthy mental development of young low-income children.

The Regents of the University of California
$166,066
Identifying Effective International Approaches to Child Health Care and Developmental Services
Other nations with different medical traditions and health care systems can be valuable sources of alternative approaches to child health care in the United States. Building on an earlier international meeting that was supported by the Fund, this project will systematically identify effective approaches to preventive child health care and developmental services in 10 countries.

University of North Carolina at Chapel Hill
$262,218
Evaluation of Child Development Services Breakthrough Series Collaborative
For this project, a team at the University of North Carolina at Chapel Hill will test and refine a curriculum it developed for physicians and office staff to provide infants and toddlers with comprehensive developmental services. Project staff will establish a Breakthrough Series collaborative of 15 pediatric practices in Vermont and 25 pediatric practices in North Carolina to use the curriculum tools and materials, implement innovations in their practices, and achieve improvements in the quality of child development services they provide.

University of Vermont
$104,900
Breakthrough Series Collaborative of Pediatric Practices to Improve Child Development Services, Phase Two
For this project, a team at the University of North Carolina at Chapel Hill will test and refine a curriculum it developed for physicians and office staff to provide infants and toddlers with comprehensive developmental services. Project staff will then establish a Breakthrough Series collaborative of 15 pediatric practices in Vermont to use the curriculum tools and materials, implement innovations in their practices, and achieve improvements in the quality of child development services they provide.

AcademyHealth
$3,000
2003 Child Health Services Research Meeting

Association of Maternal and Child Health Program
$10,235
Effective Partnerships between Title V and Medicaid: Examples from Three States

Association of Maternal and Child Health Program
$40,575
Study of the Use and Potential of Title-V Funded Toll-Free Hotlines to Support Families with Young Children and Promote Children's Healthy Development

Johns Hopkins University Bloomberg School of Public Health
$24,548
Consultation and Analysis for Dr. K. McLearn's Research Entitled: Evaluating the Healthy Steps Program- Effects of A Pediatric Intervention to Promote Child Development for Low Income & Vulnerable Children & Families

Johns Hopkins University Bloomberg School of Public Health
$49,130
National Evaluation of the Healthy Steps for Young Children Program: Publication and Dissemination

National Initiative for Children's Healthcare Quality
$15,000
2nd Annual Forum for Improving Children's Health Care

National Initiative for Children's Healthcare Quality
$24,992
Incentives to Improve Quality of Care for Children — A Manuscript

University of Michigan
$50,000
American Pediatrics: A Historical Study of its Shift from an Expansive Child Health and Welfare Focus to a Subspecialty Approach, 1900—2000

Regents of the University of Minnesota
$440,989
Evaluation of Culture Change in For-Profit Nursing Homes: Business Innovation at Beverly Enterprises
The evaluation will focus on a new culture change initiative being implemented in nursing homes owned by the nation's largest for-profit chain, Beverly Enterprises. It will measure change that has occurred and identify factors that impede as well as facilitate improvements at the unit, facility, and corporate levels. Evidence that corporate business interests are furthered through quality innovations could serve as a powerful incentive for their widespread adoption — particularly among for-profit homes, which account for two-thirds of nursing facilities nationwide.

The Board of Regents of the University of Wisconsin System
$187,459
National TimeSlips Training Program
TimeSlips is a simple and inexpensive technique that allows nursing home residents with Alzheimer's disease and related dementia to express themselves without relying on failing memories and deteriorating language skills. This project will diffuse the TimeSlips method by training 480 storytelling facilitators and 24 TimeSlips trainers from around the country. The project also will permit a rigorous evaluation of the impact of the method on the relationships between nursing home residents and caregiving staff.

The Margaret Blenkner Research Institute of Benjamin Rose
$245,016
Using Performance Data to Improve Nursing Home Care in Ohio
This project will integrate the various sources of information on quality available to Ohio's nursing homes — including resident and family surveys — to provide a comprehensive picture of facility performance. In addition, the project team will help the state's facilities learn to use these data to improve their services and care, providing a model for other states.

University of Wisconsin
$322,562
Enhancing and Refining the Wellspring Model
This Picker Program Grant will seek to improve two components of the Wellspring model of improving quality in nursing homes: the staff training modules and the data collection system. It also will develop a way to assess the quality of staff's interactions with residents, an important aspect of resident care. Results from this work will enhance the efficiency and effectiveness of the Wellspring model and facilitate its replication.

Wellspring Innovative Solutions
$174,203
Refinement of the Wellspring Model and Development of a Strategic Plan for Replication and Sustainability
This Picker Program Grant will enable Wellspring Innovative Solutions, Inc., to participate in the preparation and dissemination of a model system of nursing home care. Project staff will focus their activities on: 1) testing and refining a set of staff training modules and a new data collection system; 2) developing business tools that will be used to help persuade nursing home administrators and board members to join a Wellspring alliance; and 3) developing outreach, business, and communications plans to sustain the Wellspring approach.

Elder Care Ethics Association
$39,000
The NJ SEED (Stein Ethics Education and Development) Project: A Second Look

National Citizens' Coalition for Nursing Home Reform
$29,858
Developing New Strategies to Build Public Demand for Improved Nurse Staffing in Long-Term Care

Pioneer Network
$35,000
Enhancing the Capacity of the Pioneer Network to Act as a Resource Clearinghouse

Rand Corporation
$35,203
A Validation Panel for the Minimum Data Set for Nursing Homes

University at Albany, State University of New York
$25,000
License Requirements for Nursing Home Administrators

University of North Carolina at Chapel Hill
$28,000
Bathing Without a Battle: Simple, Practical Approaches for Assisting Persons with Dementia

The Lewin Group, Inc.
$149,917
Financial Status of Academic Health Centers and Their Provision of Uncompensated Care, Phase Three
As a follow-up to two prior projects, the Lewin Group will update information on the financial health of academic health centers and their ability to train doctors and conduct research, provide sophisticated treatments, and supply uninsured patients with free care. The Lewin Group will undertake two additional studies: an analysis of the impact of health care market changes on the financial solvency of AHCs and an analysis of market factors that influence levels of uncompensated care at these institutions.

Association of Governing Boards of Universities and Colleges
$25,000
University Governing Board Responsibilites for Governance of Academic Health Centers

Alliance for Aging Research
$160,000
Paul Beeson Physician Faculty Scholars in Aging Research Program Support for Dissemination Activities, 2002—03, Phase Eight
This is the eighth and final year of support for the Paul Beeson Physician Faculty Scholars in Aging Research Program, the nation's largest nongovernmental scholarship program dedicated to university faculty development. This grant will fund the 2003 annual meeting of Beeson Scholars.