Clinical Research Oriented Workshop (CROW) Meeting: Jan 22, 2009

Present: Matt Bovee, Kairn Kelley, Rodger Kessler, Connie van Eeghen
Absent: Abby Crocker, Kim Dittus, Liz Chen, Amanda Kennedy, Charlie MacLean, Ben Littenberg, Maria Ramos, Alan Rubin

1. Start up: Trandisciplinary Research Initiative - Public Health and Health Policy update at UVM – open forum meetings for faculty/staff/students next week

2. Roundtable, with update, short term goals, long term goals

a. Connie: Update on research project: review of completed surveys
i. Issues noted for 11 surveys completed out of 19
1. 2 entries for a one entry question (#22): are “medical assistant” and “front office staff” the same? And “billing/medical records”? Don’t change – make it a “pick as many as apply” kind of response.
2. Question 25: years in the practice that are ranges (“2002 – 2003”). New rule: pick the lowest year, calculate the number of years in the practice, and add “0.5”
3. Caring and valuing something might be different – is the confounder question really a confounder? Maybe, but don’t change the survey. Make it a discussion issue in that chapter of the dissertation.
4. Anonymity – too much demographics? No need to change; request for data is a minimum to describe the population of respondents between the pre- and post-results
5. Age vagueness: middle of the range? “Fortyish” goes in as an alpha response, there will be a calculated field based on a “mid-range” rule: 45
6. Straight line response: what to do when the confounder question confounds the results?
a. Change the appearance of question: BOLD AND CAPITALIZE the “not” part of the confounder question and italicize it for future surveys.
i. I think that QI projects are not valued in our practice. Change to:
1. I think that QI projects are NOT valued in our practice.
b. Keep the one “straightline” response but create a category for “straightline” response; probably won’t make a difference in the
7. Some answers are vague in that they don’t remember QI but they have opinions about it – no changes to survey needed.
8. Providers have been there longer; front office staff shorter – are we missing some longer term front office staff? Maybe; could be turnover. Can find out based on the tenure of entire group of front office staff in this practice. Do this for all three “buckets” of staff: providers, nurses, and front office and similar roles (altogether)
9. Differences in cohort:
a. Providers: more positive, more comments
b. Nurses: less positive but positive, fewer comments
c. Front office: neutral or negative, no comments at all
10. Post survey questions: need to capture the changes made by the A3 process in the survey itself (e.g. same day lead screening and routing patient letters from providers)
a. Ask the QI team to confirm how to identify the QI process changes – not as an IRB amendment; keep in discussion of methods in dissertation chapter. This is not a change in procedure; Connie frequently talks to the team members about the QI process.
b. Put new descriptor in new post-survey to send as part of IRB amendment
c. Ask Gale Weld if I need a new amendment for every post-project survey. The pitch is not to add to her workload but to make sure “that the question captures the intention of what the survey is; materially it won’t change the nature of the survey”
ii. Rodger: finished testifying – congrats!
1. Note: AHRQ is posting many RFP/RFAs for comparative effectiveness. The timing of these announcements (which is quick) is reducing the size of the pool of applicants.
iii. Matt: accessing the resources on the BlogSpot – reviewed the “how to” but got stuck trying to access the Internet. To be continued.

3. Next Fellows Meeting(s): Jan 29, 2009 from 9:30 – 11:00 a.m., at Given Courtyard Level 4
a. Jan 29: Rodger’s survey
b. Future agenda to consider:
i. Kairn will ask for help from Peter Callas to teach us about data entry/management, possibly for Feb 5
1. Double entry in Excel so that the spreadsheets cross validate the entry
2. Moving Excel into Stata
ii. Future book club assignment: Atul Gawande’s “The Checklist Manifesto” (go to www.audible.com for downloadable copy)
iii. Skype demo: Connie & Matt? Wait until Amanda K is back. Or do twice?
iv. Future: Review of different types of journal articles (lit review, case study, original article, letter to editor…), when each is appropriate, tips on planning/writing (Abby)
v. Future: Informed consent QI: Connie to follow up with Nancy Stalnaker, Alan Rubin will follow up with Alan Wortheimer or Rob McCauly
vi. Workshop’s WIP (the history document) – discuss goals and progress, make recommendations, review and modify document, add Fellows’ orientation

4. Fellows document – nothing new this time

Recorder: Connie van Eeghen