DHS-USC Safety Net Innovation Award

The Southern California Clinical and Translational Science Institute and the Los Angeles County Department of Health Services (LAC DHS) are partnering to develop and test interventions to enhance quality, patient‐centeredness and outcomes of care provided at the LAC DHS. These partners are committed to fostering the professional development of clinician-investigators and translational scientists as they strive to close the knowledge-to-practice gap in our regional healthcare delivery systems. This solicitation requests letters of intent that describe ideas for such projects. More detailed applications for funding will be solicited from a subset of the submitted intent letters.

The SC CTSI and the DHS intend to issue one or more grants of up to $125,000 each for up to 24 months to support the design and implementation of interventions within DHS that will achieve the goals of quality, improved health, and patient-centered care. Priority will be given to projects that develop, implement or evaluate interventions that are designated by DHS personnel and/or patient groups as high priority (https://sites.usc.edu/hdscenter/our-priorities/). We encourage submissions from researchers whose projects build on established partnerships and engagement from stakeholders across DHS. The DHS will provide operational support for the selected projects, as well as mentorship by DHS operational leaders. The partners intend to support scientific endeavors that provide value to patients receiving care from DHS within the project period and generate results that support larger scale implementation or further application of the strategies tested in the project. Proof of concept studies that support applications for secure extramural funding are encouraged but not required. Acceptable funding mechanisms that applicant teams can indicate that they would pursue include, but are not limited to, NIH R01, R21, R03; PCORI, AHRQ, CDC, and CMS Center for Innovation.

This RFA focuses on implementation, which refers to the systematic uptake of proven clinical treatments, practices, organizational, and management interventions into routine practice with the intent of improving health. The expected impact of this program on the DHS system includes a positive impact on patients such as access, experience, health outcomes, and reduction in health disparities.

The proposed study design should suit the specific problem and align with DHS priorities and guidelines for the RFA. Viable approaches/methods to consider include behavioral economics, design thinking, systems engineering, improvement science, and implementation science. We encourage team science in which people come together from different disciplines. We also encourage disruptive innovation, by which we mean introducing new, innovative ideas for approaches to care delivery that fundamentally transform aspects of how care is delivered and that are well suited to the population that DHS serves.

This funding mechanism intends to support teams composed of a principal investigator who is an employed faculty member at USC, plus co-investigators at DHS and, where relevant, USC. Multisite collaboration (e.g., with other universities and health systems) is strongly encouraged.

1. Identify DHS Collaborator/Mentor: Identify a DHS operational leader who will: (1) help identify a project that is high priority for DHS; (2) make introductions to system-wide stakeholders; and (3) ensure that the design is aligned with DHS infrastructure and operations. Possible mentors include:
   • Hal Yee, MD, PhD (Chief Medical Officer [CMO] and Chief Deputy Director, Clinical Affairs, LAC-DHS)
   • Paul Giboney, MD (Associate CMO, LAC-DHS)
   • Brad Spellberg, MD (CMO, LA General Medical Center)
   • Anish Mahajan, MD (CMO, Harbor-UCLA Medical Center)
   • Phillip Gruber, MD (Chief Medical Information Officer, LA General Medical Center)
   • Evan Raff, MD (Director, Specialty Care, LAC-DHS)
   • Lauren Daskivich, MD (Director, Eye Health, LAC-DHS)
   • Erin Saleeby, MD (Director, Women’s Health, LAC-DHS)
   • Amy Towfighi, MS (Director, Neurological Services, LAC-DHS)
   • Anshu Abhat, MD (Director, Care Transitions, LAC-DHS)
   • Chase Coffey, MD (Associate CMO, LA General Medical Center)
2. Identify Methodology Collaborator/Mentor: Identify a mentor in the field of Healthcare Delivery Science who will mentor you in the project design and statistical analysis plan. Possible mentors include:
   1. Dissemination & Implementation Science
      • Barbara Turner, MD MSED MACP (Clinical Professor of Medicine, USC)
      • Albert Farias, PhD MPH (Assistant Professor of Clinical Preventive Medicine, USC)
      • Jennifer Tsui, PhD (Associate Professor of Population and Public Health Sciences, USC)
      • Brian Mittman, PhD (Research Scientist, Health Services Research and Implementation Science, Kaiser Permanente Southern California – specializes in complex interventions and dissemination)
   2. Systems Engineering
      • Shinyi Wu, PhD MS (Associate Professor of Social Work and Industrial & Systems Engineering, USC)
   3. Behavioral Economics
      • Jason Doctor, PhD (Professor and Chair of Health Policy and Management, USC)
3. Complete the online Introduction to Healthcare Delivery Science course (https://sc-ctsi.org/training-education/healthcare-delivery-science-education): Applicants should complete all introductory lectures (including quizzes) and incorporate Healthcare Delivery Science principles into their projects before submitting a Letter of Intent. Contact hds@usc.edu for free access to the course.
4. Obtain a biostatistical consultation if needed. Consultations on study design and analysis plans are available through the SC CTSI: https://sc-ctsi.org/resources/study-design   

Applicants should submit a brief LOI that describes:

1. The challenge in DHS health care that they propose to address [100 words max]
2. The evidence-based intervention or approach that they propose to implement and test in DHS [100 words max]
3. The expertise proposed for the project, including the names and expertise of the PI, the DHS mentor, and other collaborators [100 words max]
4. The DHS primary and specialty care working groups to be engaged in the project, and a listing of study sites (the project should be implemented across DHS) [no limit]
5. How the project will align with DHS infrastructure and operations [100 words max]
6. The expected impact of the intervention on quality of care, patient centeredness of care, and health outcomes across DHS [100 words max]

LOIs that do not adequately address all of the above points will not be invited to submit a full application.

EXTENDED DEADLINE! Letters of Intent (LOI) must be submitted by 5pm PST on February 12, 2024 through this website: https://sc-ctsi.infoready4.com/#competitionDetail/1922341.

Questions about the submission process can be addressed to hds@usc.edu.

Letters of Intent will be reviewed by representatives of the SC CTSI, DHS health system, and DHS patient and family advisory groups to determine the extent to which the proposal:

• Tests a solution for a high-priority, bona fide problem within healthcare;
• Tests solution(s) that is/are aligned with the DHS’s specific infrastructure, business approach and operations, i.e., is sustainable;
• Involves broad participation across sites (i.e. LA General Medical Center, Harbor-UCLA Medical Center, Olive View Medical Center, Rancho Los Amigos Rehabilitation Center, and the DHS Ambulatory Care Network) and disciplines;
• Is focused on effectiveness (i.e., whether an efficacious intervention works in real‐life settings), as opposed to efficacy
• Is designed to improve patient access to care, quality of care and health outcomes

This program does NOT support projects that seek to only measure or understand a problem or solution, are proposed as theoretically good ideas, involve a single discipline or single hospital or clinic, or focus on efficacy (whether the intervention works under controlled conditions).

LOIs will be chosen for further consideration within two weeks of LOI submission. Detailed instructions for preparing a full proposal will be provided at that time.

• EXTENDED DEADLINE for Letters of Intent: February 12, 2024
• Invitation to Submit Full Proposal: March 1, 2024
• Receipt Deadline for Full Proposals: April 1, 2024
• Notification of Awardees: April 19, 2024
• Award Start Date: May 1, 2024