Developing Key Performance Indicators for Improving Health Outcomes

Client
The Alliance for Positive Change
Faculty
Bob Criscuolo
Team
Junior Burgos, Jean Youn Lee, Rachel Nelson, Lela Sabashvili, Adi Yeheskiel
The Alliance for Positive Change (Alliance) is a multiservice organization that focuses on helping New Yorkers who live with HIV and other chronic health conditions. The Alliance connects clients to housing assistance, medical care, and peer support to help them achieve a healthy and stable lifestyle. To improve health outcomes for their target populations, the Alliance engaged a Capstone team in developing a list of key performance indicators (KPIs) that measure program effectiveness and client engagement. The team interviewed directors and vice presidents of the Alliance’s Peer Program and Care Management Program to understand fully the organization’s strategy and operational priorities. The team then conducted a literature review, environmental scan, and an organizational assessment to derive pertinent KPIs. The team used their findings to recommend operational protocols that will ensure data collection, flow, and integration to aid in the development of additional or alternative KPIs.
Capstone Year

Developing a Risk Extraction and Information Control Method and Visualizing Industry Risk Data

Client
Grant Thornton
Faculty
Regina Gurvich
Team
Malik Dent, Supreet Kalsi, Bethlehem Kebret, Alex Lengle, Amanda Mohabir, Hetal Patel, Ethan Roaldi, Yingxuan Wang
Grant Thornton is the American member firm of Grant Thornton International, one of the world’s leading audit, tax, and advisory services firms. The firm’s Business Risk Advisory Services department developed a new risk assessment approach that aligns risk management with business strategy. Grant Thornton enlisted a Capstone team to create methods of identifying, prioritizing, visualizing, and managing key risks in the healthcare industry. Based on the Committee of Sponsoring Organizations, or COSO, framework, the team analyzed and classified publicly-filed risk factors from the financial statements of 10 healthcare organizations. The team developed four risk categories: strategic, compliance, reporting (financial), and operational. The team then visualized their data to analyze risk trends. The visualization depicted the following: risk changes, risk distributed by industry, overall risk severity, and individual companies’ risk relative to their competitors’. The team delivered a user-friendly visualization tool that highlights overall trends and patterns.
Focus Areas
Capstone Year

Health Needs Assessment of Older Adults with Mental Illness

Client
Institute for Community Living
Faculty
Rona Affoumado
Team
Kelly Feldman, Wagma Habibi, Tingyan Huang, Alexandra Smith, Aditi Wajpe
The Institute for Community Living (ICL) is a nonprofit human services agency that provides support services to individuals who are affected by or at risk of developing mental illness in New York City. In efforts to better support its aging clients, ICL engaged a Capstone team to assess the health needs of its clients aged 55 years and older living in supported housing programs in Bedford Stuyvesant and Crown Heights. The team performed a literature review on healthy aging practices and a thorough neighborhood scan to identify existing community support services. The team analyzed a list of clinical, high-risk clients and client survey data identifying potential barriers to healthy aging. The team also interviewed case managers and facilitated a client focus group to understand their needs and identify gaps in current care delivery. The team’s final report outlines the findings of their research and provides ICL with recommendations for better addressing the needs of clients.
Focus Areas
Capstone Year

Evaluating the Impact of the Critical Time Intervention Model

Client
CAMBA
Faculty
Rona Affoumado
Team
Michelle Charles, Danielle Ladd, Therese Russo, Kaitlin Zielaznicki
CAMBA is a nonprofit agency that connects 45,000 people annually to opportunities and support services that enhance their quality of life. Through its Brooklyn-based Health Home program, CAMBA provides care management services to high-need, high-cost Medicaid users with complex, chronic conditions. CAMBA engaged a Capstone Team to evaluate its Critical Time Intervention pilot, a short-term, focused Health Homes intervention that enables their highest risk clients to receive the care they need and integrate back into the community following inpatient psychiatric hospitalization. The team analyzed acute care utilization and Medicaid expenditure patterns using available program and billing data to determine indicators of success. The team delivered a final report that included a comprehensive literature review, interviews with care coordinators, a client-facing survey tool, and recommendations aimed at improving the Health Home Program.
Focus Areas
Capstone Year

A Comprehensive Financial Strategy to Ensure Continued Clinic Operations

Client
HeartShare St. Vincent's Services
Faculty
Susan Abramowitz
Team
Juan Ospina, Alexandra Paans, Rogers Pali, Arti Trehan
HeartShare St. Vincent’s Services (HSVS) is a nonprofit organization that empowers over 6,000 youth, individuals, and families to overcome challenges of family crises, addiction, mental illness, and poverty. The Integrated Health Services division of HSVS provides mental health, chemical dependency, and clinical services to children, adolescents, and adults. However, the clinics are losing about $1 million annually and are in danger of closing. HSVS enlisted a Capstone team to assess its profitability problem and propose strategies for becoming financially viable. The team completed a literature review and market assessment, followed by a thorough financial analysis identifying opportunities for maintaining or improving current channels of revenue and potential areas for reducing costs. The team also conducted interviews with patients to identify opportunities for increasing patient satisfaction and market position, and interviews with staff to identify opportunities to increase operational efficiency. The team’s research culminated in recommendations that will alleviate HSVS’s financial instability and enhance its sustainability.
Focus Areas
Capstone Year

CENTERS OF EXCELLENCE IN BREAST CANCER CARE

Client
EmblemHealth
Faculty
Goldman/ Gurwitz
Team
Christian Blake Adams, Elnaz Michelle Fakhimi, Lorraine Hutzler, Paige Jaclyn Mintz, Suparna Roy, Anjandeep Sandhu

EmblemHealth, one of the largest nonprofit health plans in the United States, formed through the merger of Group Health Incorporated and the Health Insurance Plan of Greater New York in 2006. Headquartered in Manhattan, EmblemHealth's goal is to provide quality insurance plans for New Yorkers. EmblemHealth has an extensive network of providers, allowing members to access the tri-state area's top medical professionals. EmblemHealth seeks to improve services to its members by informing them of which providers offer the best care based on patient experiences, costs, and procedure volumes. EmblemHealth engaged a Capstone team in developing criteria to classify healthcare facilities in the New York Metropolitan region as Centers of Excellence for Cancer Care and identify which cancer type could be the basis for analysis. To this end, the team analyzed metrics based on industry standards and provided recommendations leading to said classification and identification.

Capstone Year

THE STATE OF ORAL HEALTH AND PROMOTING THE IMPORTANCE OF RINSING

Client
Johnson & Johnson
Faculty
Goldman/ Gurwitz
Team
Ellina Babar, Jermaine Blakley, Daniella Michelle Eras, Amrita Vijay Herkal, Shivani Bharat Parikh

Johnson & Johnson is one of the world's oldest and most trusted providers of oral care products. Over the last decade, Johnson & Johnson has faced significant challenges in increasing public awareness of the oral health benefits of mouthwash. As a result, Johnson & Johnson collaborates with many oral health and dental organizations to modify and promote oral health recommendations, which include rinsing as a primary method for maintaining good oral health. The Capstone team reviewed and analyzed the domestic and international oral health policy landscape and identified correlations between oral health policies and a population's state of oral health. By examining the impact of poor oral health on populations and their economies, the team strengthened the foundation for Johnson & Johnson to advocate for the therapeutic claims and economic benefits of mouthwash use. Based on this analysis, the team crafted a comprehensive document that highlights the correlations between oral health practices and improved oral health and recommends strategies for Johnson & Johnson to effectively promote of the importance of rinsing in social, corporate, and political environments.

Focus Areas
Capstone Year

IMPROVING THE GRANT PROCUREMENT PROCESS

Client
New York City Office of Emergency Preparedness and Response
Faculty
Goldman/ Gurwitz
Team
Ayaz Syed Alam, Melisa Cheung, Pallavi Bhupal Khade, Ritu Kundu, Alyssa Ann Napoli

The Office of Emergency Preparedness and Response (OEPR) promotes New York City Department of Mental Health and Hygiene initiatives such as preventing, preparing for, responding to, and recovering from health emergencies that can potentially impact the health of New Yorkers. Federal grants fund the OEPR program, which is intended to design, develop, and implement emergency preparedness plans across a wide range of stakeholders. OEPR engaged a Capstone team in identifying and addressing departmental grant management processes that can be improved and optimized. The team offered insight into which processes are key problem areas for stakeholders within OEPR and should be a priority for improvement. The research culminated in the creation of a framework that OEPR can standardize and implement for future process improvement needs within the department.

Capstone Year

EXAMINING AND CREATING NURSE RESILIENCY

Client
NewYork-Presbyterian Hospital
Faculty
Donnellan/ Kiely
Team
Consuelo Castaneda, Jodie Curren, Feruza Esanova, Cosme Taipe,

Nurses face a multitude of challenges in today's high-acuity, high-stress healthcare environment, including burnout, compassion fatigue, and bullying. An enhanced capacity for resiliency is essential for nurses to be able to maintain empathy and purpose in their work. NewYork-Presbyterian Hospital (NYP), one of the nation's largest and most renowned academic medical centers, employs over 6,400 nurses at its six main campuses. NYP is interested in better understanding the barriers to and interventions that build nurse resiliency. NYP enlisted a Capstone team to examine current evidence related to nurse resiliency. The team conducted a literature review and investigated resiliency at similar institutions. The team also explored the lived experience of nurses related to resiliency at two NYP campuses through the utilization of focus groups, a survey, and the analysis of exit interview comments. The team's research culminated in a set of actionable recommendations aimed at building and sustaining nurse resiliency at NYP.

Focus Areas
Capstone Year

RESEARCHING AND IMPROVING THE EFFECTIVENESS OF THE NEW NURSE RESIDENCY PROGRAM

Client
NewYork-Presbyterian Hospital
Faculty
Donnellan/ Kiely
Team
Ugochi Chukwuocha, Katherine O'Hara, Peter Stoffan, Diane Willemin

The NewYork-Presbyterian Healthcare System (NYP) strives to identify, define, and improve upon the current practices and measures of success while focusing on evidence-based strategies to improve new graduate nurse retention. The NYP New Nurse Residency Program aims to bridge the educational and professional gap between student nurse to successful and competent professional nurse. To measure the effectiveness of the NYP New Nurse Residency Program, the Capstone team gathered data through interviews with key stakeholders, extensive surveying and focus group participation, and observation of current practices and processes. The team also conducted a comprehensive literature review, which resulted in valuable insight into emerging best practices in the field, including other top-ranked academic medical centers. The research culminated in a set of recommendations for NYP that includes the identification of metrics to measure the effectiveness of existing and future programs within the institution and an operational framework aimed at improving processes in the New Nurse Residency Program.

Capstone Year

GENTRIFICATION AND HEALTH: FRAMEWORK AND COMMUNITY TOOLS

Client
New York City Department of Health and Mental Hygiene, Center for Health Equity
Faculty
Gurvich/ Affoumado
Team
Anais Borja, Savanna Essig-Fox , Calley Reed Heffer, Shardee Aquillia Vaughn, Whitney E. Adair

The Center for Health Equity (CHE) is a division of the New York City Department of Health and Mental Hygiene (DOHMH) whose mission is “to strengthen and amplify the DOHMH's work to eliminate health inequities, which are rooted in historical and contemporary injustices and discrimination, including racism.” CHE seeks to promote accountability, community power, and diversity and inclusion by focusing on racial justice, identifying key neighborhoods for investment, creating partnerships to advance social justice, and using evidence-based storytelling. CHE enlisted a Capstone team to create a framework that describes the relationship between gentrification and health, and to craft a community tool to empower residents in gentrifying communities. The team synthesized mechanisms to mitigate the negative effects of neighborhood change on health while amplifying any benefits. The final report included a comprehensive literature review, expert and stakeholder interviews, and recommendations for advancing the division's mission and contributing to evidence-based initiatives.

Capstone Year

CREATING A FRAMEWORK FOR A COALITION OF NEW YORK CITY KIDNEY DIALYSIS PROVIDERS

Client
Davita Kidney Care
Faculty
Gurvich/ Affoumado
Team
Sarah E Cunningham, Janice Nicole MacFarlane, Linda E Schillaci, Vivian Hsing-Chun Wang

DaVita Kidney Care, a division of DaVita HealthCare Partners Inc., provides dialysis services to patients with chronic kidney failure and end-stage renal disease throughout the United States and abroad. DaVita is the largest kidney dialysis provider chain in the New York City metropolitan area. DaVita engaged a Capstone team in determining if a coalition of kidney dialysis providers in New York area would be a cost-effective way to educate patients and lobby for policy reforms to improve dialysis healthcare. The Capstone team assisted DaVita in forming the coalition by developing a coalition framework and created a business plan to sustain the coalition. The team produced the framework and business plan using research from a literature review, stakeholder interviews, a survey of independent dialysis providers, and a focus group of interested organizations. The insights gained culminated in the identification of common issues and challenges that providers in the New York City area face and a business plan for a coalition that best addresses the providers' needs.

Focus Areas
Capstone Year