These are projects completed by Mayo Clinic Health System Practice-Based Research Network (MCHS PBRN) members. See additional completed projects.
Diabetes CARe MAnager Assessment (Diabetes CARMA)
- Principal investigator: James R. Deming, M.D.
Diabetes affects 13 percent of our country's population and extracts an increasingly heavy toll in suffering and economic costs. Because standardization and teamwork can yield highly reliable diabetes care, this research project sought to inventory the methods of diabetes care adopted by the practices of Mayo Clinic Health System, particularly the role of a care manager, and correlate the methods to success in diabetes control.
The team found a wide variety in the definition and role of a care manager, suggesting that studies to date may lack uniform definition. The future aim will be to tailor the care manager role to the needs of each site.
Survey of a community-based health system
- Principal investigator: Rodney A. Erickson, M.D.
A Web-based survey of research experience and interests was distributed to all physicians and midlevel providers within the MCHS PBRN. Practice-based research participatory and skills-development interests were uniformly high and relatively durable across demographic and practice-related characteristics: 61 to 80 percent wished to participate in various types of practice-based studies, while 57 to 74 percent wished to develop further practice-based research skills.
As the demographics of Mayo Clinic Health System are comparable to other systems nationwide, this information will be useful in determining what resources and opportunities will be of interest to members of other practice-based research networks.
Appropriateness of medications used near the end of life
- Principal investigator: Thomas R. Loepfe, M.D.
Medication use becomes a significant concern at the end of life, with patients often continuing to receive medications for chronic conditions along with palliative care. Side effects, adverse events and cost all present challenges to clinicians. The specific aim of this research was to describe the types, classes, diagnostic indications and costs of medications unrelated to the terminal diagnosis used by hospice patients in the last months of life.
The study found a high use and cost of such medications in the care of hospice patients, as well as variation between hospices. Building on this research can lead to development of practice guidelines.
How and why research is valued in community practice: Reflections of medical providers and practice managers
- Principal investigator: Maureen H. O'Brien Pott
Focus groups conducted with community providers and practice managers found that they valued research that was directly relevant to their practices. While both administrators and providers agreed that referring to an activity as research conveyed a higher level of status to that activity, providers tended to be much more specific about definitions of research than administrators, who tended to describe research in terms of general discovery and understanding.
However, there was no clear consensus on the definition of research activities. Participants felt that the depth and breadth of the patient populations they served would be a valuable resource to the research process, and that the ability and resources to conduct research created an opportunity to enhance their patients' level of care.
Group B streptococcal screening
- Principal investigator: Kathy L. MacLaughlin, M.D.
Current Centers for Disease Control and Prevention guidelines call for pregnant women to be screened at 35 to 37 weeks gestation for group B streptococcus and, if positive, treated with antibiotics in labor to reduce neonatal complications. This study looked at the process for providers, with a goal of decreasing of duplication of testing within the five weeks prior to giving birth.
Study results led to changes in the ordering system, allowing providers to more easily order group B streptococcal screening consistent with current guidelines and recommendations, as well as a more effective and efficient practice.
Multisource feedback process in a family medicine clinic
- Principal investigator: Marc D. Tumerman, M.D.
- This study evaluated practice-improvement efforts in team-based communications. A 360-degree review process for providers in a family medicine clinic resulted in benefits around team cohesiveness and physician behavior. Participants felt that the use of a multisource feedback process on provider behaviors around core values was a positive experience and one worth continuing.
Wilderness medicine training evaluation
- Principal investigator: Rodney A. Erickson, M.D.
Wilderness first-aid training includes basic first-aid skills along with moderately advanced lifesaving skills, which may require complex decision making under stress in a remote environment with few resources. There is little evidence-based literature to support the curriculum or process for training lay caregivers.
The study intended to identify injuries and illnesses that alumni of this course have encountered since taking a wilderness first-aid course — taught by the investigator — to assess the course's usefulness in addressing these problems and solicit advice for improving the course curriculum and modes of instruction delivery.