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Research Areas


Our researchers are currently working to improve post-acute and long-term care in the following areas:

Hospital-Based Research

  • Improving communication to reduce medication errors and readmissions
  • Preventing and improving outcomes surrounding hospital-acquired conditions, including catheter-associated urinary tract infections (CAUTI), falls, pressure ulcers, delirium
  • Models of care: Acute Care of the Elderly (ACE) unit; ACE tracker
  • Antimicrobial stewardship
  • Hospital deconditioning
  • Improving rehabilitation in transition from hospital to home

Post-Acute Care 

  • Design, development and evaluation of information technologies to improve clinician support and patient health outcomes in post-acute care settings: telehealth, remote monitoring and clinical decision support systems
  • High-intensity rehabilitation with a multidisciplinary approach

Home Health Care (HHC)

  • Reducing hospital readmissions from HHC
  • Improving heart failure disease management, including nursing education, program development and patient self-care

Skilled Nursing Facilities (SNF)

  • Reducing unnecessary SNF utilization after total knee arthroplasty
  • Prognostic data of low and high performing clusters of VA contracted SNFs and CLCs
  • Qualitative analysis of decision-making for SNFs
  • High-intensity rehabilitation to improve short and long-term outcomes following hospitalization
  • Preventing and improving outcomes surrounding hospital-acquired conditions, including CAUTI, falls, pressure ulcers, delirium
  • Antimicrobial stewardship
  • Stakeholder engagement in SNF and LTC
  • Impact of insurance type on care

Long-Term Care 

  • Response to 5-star quality ratings, validity of ratings, consumer and provider view of ratings
  • Hospice care in nursing homes 
  • Medical foster home as an alternative to nursing home costs, safety, Minimum Data Set assessments
  • Advance care planning in home-based primary care and Veteran’s Administration (VA) nursing homes
  • Home-based primary care optimizing organizational structure
  • Prevention of healthcare-associated conditions including catheter-associated urinary tract infections (CAUTI), falls, pressure ulcers, delirium
  • Antimicrobial stewardship
  • Community engagement and analysis of decision-support tool

Long-Term Care at Home

  • Analyzing standardized falls assessment and physical function data at InnovAge to improve time to intervention and reduce unnecessary utilization
  • Treatment effect of provider contact to reduce community-dwelling falls