Juliana C. Capp, M.D.
- Surgical Outcomes Research Fellow, 2023-2024
- Neurosurgery Resident
What moment or experience in your life influenced your decision to be a surgeon?
My interest in neuroscience began when a neurosurgical operation called deep brain stimulation successfully treated my grandmother's Parkinson's disease. Her transformation drove me to work on Parkinson's disease research while serving as her caregiver and motivated me to become a physician.
During a neurosurgery rotation in medical school, I had the opportunity to observe deep brain stimulation surgery. The combination of technology and teamwork in the operating room, as well as the transformation of the patient's rigidity and tremor, inspired me to pursue a career in neurosurgery.
Why did you choose Mayo Clinic to pursue your career?
Developing nations are not known for medical care. After being born in a one-room wooden shack in the Brazilian countryside, I contracted a life-threatening illness that wasn't diagnosed until a local doctor consulted a physician at Mayo Clinic in Rochester, Minnesota. I was lucky — I survived because that consultant was able to diagnose my condition over the phone and recommend a treatment plan that saved my life. Throughout my residency, I have endeavored to follow the example of that doctor by putting the needs of the patients first and living the Mayo Clinic values.
What motivated you to become a Surgical Outcomes Research Fellow in the Mayo Clinic Kern Center for the Science of Health Care Delivery?
Since starting my neurosurgery residency in 2019, my main research focus has been neurosurgery quality improvement (QI). As the resident leader of the Implementing and Sustaining a QI Culture in Neurosurgery project, I have led or advised 14 quality improvement projects leading to the successful implementation of diverse hospital initiatives such as inpatient communication guidelines, an emergency procedures cart and a major practice change.
My priority has been to continually improve my advising and mentorship so that each generation of neurosurgery quality improvement project shows better adherence to principles of the field, provides greater clinical benefit to patients and delivers a better educational experience for novice quality improvement researchers. The Surgical Outcomes Research Fellows Program will significantly impact my ability to achieve my main research goals for the final three years of my residency.
These goals are to:
- Comprehensively and quantitatively evaluate the value of each individual quality improvement project.
- Increase added health care value through improved design of future projects.
- Continue improving the process of managing departmental quality improvement projects.
- Build a sustainable model for continued neurosurgery quality improvement research at Mayo Clinic in Rochester, Minnesota.
What is your research focus in this fellowship program?
I will design novel health care delivery research projects that:
- Scientifically evaluate Mayo Clinic's surgical practices.
- Highlight the unique strengths and values that underlie effective practices.
- Use data to transform patient safety and health care value.
Learning advanced techniques to evaluate and demonstrate value in health care would enable me to comprehensively analyze the full effect of completed and future quality improvement projects. I also will be a better advisor to the next generation of neurosurgery quality improvment teams as they aim to improve hospital processes.
How will your research improve patient care or positively affect public health?
When Mayo Clinic neurosurgeons began the first generation of quality improvement projects in 2020, we formed 10 teams with diverse aims ranging from reducing surgical site infections to optimizing communication. Most teams experienced the same challenges, resulting from insufficient experience with quality improvement.
In response, our advising process was redesigned, and we started four new projects in 2021. The projects had diverse goals, including reducing deep venous thromboses and optimizing cervical collar fitting for spine fractures.
Lessons learned from these two cycles of quality improvement projects will enhance the next generation of neurosurgery quality improvement projects in 2023. Four teams of neurosurgery residents and hospital staff will select specific hospital processes to target for improvement during their projects.
Who are your mentors for this program and why did you select them?
Mohamad Bydon, M.D., generously agreed to be my primary surgical mentor. I will learn from his vast expertise and experience in surgical outcomes, quality improvement and health care delivery research. His work has had a meaningful impact on the quality of care provided to patients needing neurosurgery far beyond Mayo Clinic. His mentorship will enable me to design and execute rigorous and transformative research projects during the fellowship year and throughout my career as a neurosurgical clinician-scientist.
Mayo's neurosurgery leadership team will continue mentoring me on neurosurgery quality improvement projects. Along with Dr. Bydon, the following experts have together enabled me to successfully advise various neurosurgery quality improvement teams to produce meaningful improvements at Mayo Clinic Hospital — Rochester, Saint Marys Campus:
Even more importantly, their mentorship has empowered me to improve the quality of my mentorship and advising with each generation of quality improvement projects. And it aids me in my continued progress along the path toward becoming a neurosurgical clinician-scientist focused on health care delivery research.