Health services researcher wins first National Institutes of Health grant in academic history
Karl Minges, Ph.D., MPH, is passionate about improving the health of vulnerable populations, and a nearly $ 450,000 award from the National Institutes of Health – the University’s first – will allow him to advance his important work.
May 6, 2021
As a public health researcher, Karl Minges, Ph.D., MPH, is concerned about what he considers to be one of the most puzzling phenomena in healthcare: older patients entering and leaving the hospital by bicycle. It works to help public health professionals better understand – and prevent – this “revolving door,” as it is sometimes called, which is extremely costly for patients, their families and healthcare facilities.
While completing his PhD, Dr Minges worked with many leading clinicians and academics at Yale who focus on health services research, which seeks to identify ways to improve the overall quality of care that patients get into health systems, improve health outcomes and tackle variation in health care outcomes. His own research has aligned with that and he hopes that by exploring concrete ways to break the cycle of unnecessary readmission, healthcare can be improved.
“To be the University’s first NIH Fellow is a special honor,” said Dr. Minges, assistant professor and chair of the University’s Department of Health Administration and Policy. “Knowing the incredible faculty of the University, I expect to be the first of many future NIH Fellows.”
“My project will help strengthen the research environment at the University, while exposing undergraduate and graduate students to research that will stimulate their interest in research careers in biomedical or behavioral sciences.”Karl Minges, Ph.D., MPH
“This work holds great promise for patients and health systems”
The proposal, titled “Exploring the Outstanding Low Readmission Performance of Skilled Nursing Facilities for the Elderly,” scored better than 98 percent of the competing proposals in Minges’s study section. His work has received an R15 Research Improvement Award, intended to support research projects at institutions that have not previously been the primary recipients of NIH support.
“NIH grants are the most competitive government funding mechanism in the world,” said Glenn McGee, Ph.D., vice-president and professor of health administration and policy. “I tell new professors that they should only start applying for NIH grants if they accept the word ‘no’ because, on average, an investigator will apply more than a dozen times before seeing a dollar. R15 rewards are also extremely desirable. ”
Dr. Minges’s research will focus on skilled nursing homes (SNFs) – institutions that offer more skilled medical expertise and services than nursing homes – for which readmission statistics are generally high. Out of one in four patients aged 65 and over who are transferred to an SNF following a short hospital stay, a quarter of them are readmitted to the hospital within 30 days at a significant financial cost. and with an impact on the quality of life.
Although SNFs face financial penalties for higher than expected hospital readmissions, Dr Minges says there is a dearth of information on the various factors related to readmission and the reasons for this. which some SNFs are more successful than others in preventing readmissions.
“Dr. Minges is well positioned to lead this work, which will improve care in skilled nursing settings, ”said Sarwat Chaudhry, MD, associate professor of medicine at the Yale School of Medicine and Dr. Minges co-investigator on the study. . “Building on his previous experience in positive deviance research, Dr. Minges will partner with qualified nursing facilities to develop interventions aimed at reducing readmission to hospital after 30 days. This work holds great promise for patients and health systems. ”
‘Support student research opportunities’
Dr Minges will use the nearly $ 450,000 scholarship, which will be awarded over three years, to explore the many factors associated with readmission, and he hopes this information will lead to creative and practical interventions to reduce the risk of readmission.
“I am very happy to be the first researcher to apply the methodology of ‘positive deviance’ (an inductive analytical technique using in-depth qualitative methods) to qualified nursing facilities,” said Dr Minges. “Any NIH award has the potential to improve the research environment of a given institution. At the University of New Haven, this award will institute a significant structural change as the University has never before received an NIH award.
Passionate about involving students in research, Dr Minges looks forward to the opportunities that the award will create for students at the University. It will support two dozen undergraduate and graduate students, enabling them to participate in research, visit sites, conduct analysis and attend and present at leading conferences.
“Dr. The NIH Minges Prize is recognition of the caliber and impact his research promises to have for the healthcare industry, ”said Summer Johnson McGee, Ph.D., Dean of the School of Science. health. “Learning how healthcare organizations can prevent unnecessary and costly hospital readmissions for the elderly could be one of the magic bullets in tilting the healthcare cost curve in the United States.
“I know his work will make a major contribution to this critical area of research,” continued Dean McGee. “Dr. Minges’s work is also important because his NIH grant will support student research opportunities and give our students valuable learning experiences in conducting vital health services research.
Dr Minges also expects the award to foster interdepartmental research collaborations in departments such as health administration and policy, allied health and entrepreneurship and innovation, and will include other junior faculty members. He hopes this will also encourage the development of research tools and the continued growth of the programs.
“The NIH is the nation’s medical research agency facilitating discoveries that improve health and save lives,” said Ronald Harichandran, Ph.D., dean of the University’s Tagliatela College of Engineering and vice-provost for the research. . Minges has opened the door, and we will have other health sciences, biomedical engineering and biology faculties following in his footsteps. ”
“ This study is at the right time ”
During the first two years of the study, Dr. Minges and his fellow researchers will conduct qualitative interviews with high and low performing SNFs, visiting more than a dozen across the country. They will generate hypotheses on the SNF strategies most likely to explain the lower readmission rates.
In the third year, Dr. Minges and his team will work with experts and stakeholders to develop interventions that could be tested to address the most promising strategies for reducing readmission rates. With the help of Brian Marks, JD, Ph.D., of the University’s Pompea College of Business, the research team will use a design thinking methodology, which is best described as an innovation-centered approach to human.
“I am honored to participate,” said Dr. Marks, Senior Lecturer and Executive Director of the University’s Entrepreneurship and Innovation Program. “It will be exciting to conduct ‘design sprints’ during wrap-up sessions and other dissemination aspects using a framework for conceptual thinking as well as notions of behavioral and institutional economics in order to identify and recommend organizational strategies, tactics and processes to reduce readmission. rate in skilled nursing facilities. This grant is also a great opportunity for our students to participate in this interdisciplinary educational opportunity by applying critical thinking to real world problems.
Although readmission rates were already a serious issue before the global coronavirus pandemic, Dr Minges says COVID-19 has impacted SNFs and nursing homes in ways that healthcare professionals barely begin to understand.
“This study is timely, as the vast majority of SNF patients and staff are vaccinated,” he said. “This makes this project more feasible in a post-pandemic world. While COVID is not the primary focus of the study, it’s something I’m looking to explore in the context of the study. ”
The reported research is supported by the National Institute on Aging of the National Institutes of Health under the award number R15AG067456. The content is the sole responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.