2020-2021 Grant Recipients

Ariadne Labs Spark Grants

Beyond Birth: Optimizing the Transition from Obstetric to Primary Care

Chloe Zera, MD, MPH, Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center

The period of transition from pregnancy care to ongoing primary care represents a key opportunity to reduce short- and long-term adverse outcomes following birthing and delivery. Currently, there is little data to guide providers in improving outcomes, and there is an urgent need to explore models of care that support the changing focus of health during pregnancy and delivery to health beyond birth. This project aims to design and test a model to improve the hand-off from obstetric care to primary care for those at highest risk of morbidity in the year after birth, with the ultimate goal of developing a scalable intervention to bridge this gap. 

Harvard Medical School Dean’s Innovation Grants in Health Care Delivery

Developing a model for a joint provider-payer strategy to increase use of home-based palliative care

Anita Wagner, PharmD, MPH, DrPH, Associate Professor, Department of Population Medicine, a joint Department of Harvard Medical School and the Harvard Pilgrim Health Care Institute; Director, Harvard Pilgrim Health Care Ethics Program

Patricia Toro, MD, MPH, Associate Medical Director, Harvard Pilgrim Health Care

Research suggests that home-based palliative care offers numerous benefits, including improved quality of life and care that is less intensive, less costly, and more patient-centered. It may even prolong survival in some patients. Home-based palliative care has been shown to offer numerous benefits, including improved quality of life, potentially prolonged survival, and less intensive, less costly, more patient-centered care. However, the majority of patients who could benefit from home palliative care, including those with chronic, serious illnesses, do not receive it. The ability to identify eligible patients at a population level is a key barrier to more widespread use. This project aims to develop a scalable provider-payer collaboration to ensure rapid targeting of patients for whom home-based palliative care would be appropriate and address the barriers to adoption among payers and providers. 

Protocols for safe postpartum care at home for women delivering by cesarean section in rural Africa

Bethany Hedt-Gauthier, PhD, Associate Professor, Department of Global Health and Social Medicine, Harvard Medical School; Associate Professor, Department of Biostatistics, Harvard T.H. Chan School of Public Health

Cesarean sections (c-sections) are the most common surgery performed worldwide. Global protocols detail standards of care for the procedure and hospitalization; however, reviews suggest there is a lack of guidelines for post-discharge instructions, leading to inconsistent care messages and poor follow-up. This gap is particularly harmful for women at high risk for complications after discharge, most notably for surgical site infections, which are common in women delivering via c-section in sub-Saharan Africa. This project will begin building a foundation for development of protocols for postpartum care for women delivering via c-section. The protocols aim to improve consistency in discharge messages and quality of care and to set a reference point for future interventions, including those that incorporate use of community health workers.

Updates on 2019 Grants

Effect of Health Systems Expansion on Health Care Utilization and Outcomes

This project investigated the impact of hospital closures and consolidations on patient outcomes, costs, and physicians. Using a master dataset, the team evaluated trends in consultation of surgical practices, assessed differences in outcomes for surgeons operating at a single location versus multiple locations, and analyzed the effects of rural hospital mergers on hospital financial performance and patient outcomes. The team plans to produce peer-reviewed publications, and the results of initial analyses will serve as pilot studies for future grants. 

Behavioral Drivers of Mental Health Resiliency 

This project focused on increasing behaviors, such as meditation, sleep, exposure to nature, and physical activity, to reduce stress, anxiety, and mild depression. The team completed a landscape analysis of existing evidence and sought expert impact to inform development of a survey, administered to patients by primary care physicians, on stress, stressors, and resilience behaviors. The survey has undergone initial face validity testing, and the team continues to engage with experts.

Better Partnerships: Family Engagement in Pediatric Health

This project aimed to develop a solution to improve communication and strengthen relationships between pediatric providers and families or caregivers in order to improve follow-through of treatment plans for developmental delays. The resulting tool, the Clinician-Caregiver Conversation Roadmap, supports pediatric providers and caregivers in having more collaborative conversations about a child’s developmental care. The team at Brazelton Touchpoints Center is planning to disseminate the tool for broad public use. Efforts include collaboration with national organizations, journal publications, and the development of additional implementation supports, such as training webinars and handouts.