iCare: Research Replication and the Binghamton Standard

It is no secret that we are doing great research at Binghamton University and within the College of Community and Public Affairs. We are looking at local impacts on hydraulic fracturing, race based educational disparities, and, of course, all of the amazing work that we are doing with the Broome County Promise Zone. One of the issues to consider when conducting research is its replicability: can another research team employ your protocols and yield similar results?

I conducted a social work study in partnership with UHS Wilson Hospital (that is currently in press) with my interdisciplinary colleagues from UHS and BU: Shawn Berkowitz, MD, Kris Marks, MSW, Paul Gould, PhD and Gary James, PhD regarding the prevention of re-hospitalization within thirty days. As the Affordable Care Act focuses on the quality of care patients receive, there are some cases in which hospital readmissions within thirty days are seen as a failure of the institution and therefore hospitals will not receive payment for these subsequent hospital stays. This puts hospitals under enormous pressure to limit the thirty day readmission rate. Through a randomized control trial, we were able to provide a social work student to patients at discharge who were at moderate to high risk for re-hospitalization and fifty years of age or older and asked them if they wanted to participate in a social work intervention. Our eighty nine participants divided almost equally between the experimental and control group. The experimental group received the social work intervention, including support to the patient in understanding their treatment plans and providing them with help negotiating after care, for thirty days prior to discharge. The results were that there were only eight readmissions within the thirty day window, all of whom came from the control group (http://usat.ly/1wezd5w).

I was approached by University of South Carolina, who secured a $20,000. planning grant and asked me to be a consultant in the development of a larger grant proposal related to our work in Binghamton. This planning grant is being used in the attempt to secure a 1.5 million dollar grant to develop and implement an interdisciplinary team of professionals to replicate and expand the intervention we implemented in Binghamton on a larger scale, over a longer period of time and with a larger range of interprofessional colleagues. In March, I traveled to Columbia, SC to meet with the research team, led by Teri Browne, MSW, PhD regarding the structure of their intervention and considerations. The University of South Carolina team is developing an interprofessional intervention that consists of social workers, nurses, public health administrators, physical therapists, pharmacists, and communication disorder specialists under their initiative of iCare, which stands for Interprofessional Collaborative for Avoiding Readmissions through Education. Represented in their list of participants are professors, program directors, doctoral students, deans, and community partners who are all working toward a common goal: the reduction of hospital readmissions within thirty days of discharge. Though certainly there is an economic value to this research, as this has the potential to save hospitals a lot of money, as well as creating employment and educational opportunities, there is also an increase in agency and quality of life of the patient.

As the Dean of the College of Community and Public Affairs, it was refreshing and fun to put on my researcher hat for 1 ½ days as I collaborated with this interdisciplinary team of professionals from USC. I was also able to use my administrator hat and assist the team with developing a plan that speaks to the needs and goals of the institution. How is this project that they are undertaking going to showcase their university and the work that they are doing there? In what ways are they able to measure impact in their instruction in addition to their community engaged efforts including workforce development? It is exciting to have your work replicated on a larger, more dimensional scale and to be a part of it. The 22-person collaborative research team at iCare, of which I am proudly a part, has the capacity to improve health outcomes for people in Columbia, South Carolina, and to test a model that began in Binghamton and which can be replicated nationwide. From Johnson City, NY to Columbia, South Carolina, and beyond!

Dean Laura Bronstein

College of Community and Public Affairs at Binghamton University

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