Introduction

Purpose

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, efficiency and patient-centeredness of care provided by 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.


Description of the Funding Opportunity

The SC CTSI and the DHS intend to award one or more pilot grants of up to $75,000 for up to one year to support the design and implementation of interventions within DHS that will achieve the goals of quality, efficiency, and patient centered care. Priority will be given to projects that develop, implement or evaluate interventions that are designated by DHS as high priority. 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 DHS within the project period and generate results that enable project teams to attempt to secure extramural funding for larger scale implementation or further application of the strategies tested in the project.  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 impact on patients (e.g., access, experience, health outcomes, reducing health disparities) and impact on efficiency (e.g., improving efficiency of outpatient care, reducing use of unnecessary diagnostic testing).

Examples of patient impact include improved patient experience, effective communication, health outcomes, patient reported outcomes, patient reported value, care accessibility. Examples of outpatient care impact include but are not limited to: use of group visits; selective and targeted use of synchronous telehealth, especially for distant clinics/patients; optimized clinic staffing, space, and patient volume/complexity; specialty to primary care transitions after consultation; specialty chronic disease management. Examples of reducing testing include but are not limited to: applications with low specificity or low predictive value, for example: certain radiology tests (e.g., for back pain, headaches, total body scans, abdominal pain); certain lab tests (e.g., for rare or unusual conditions); sleep studies; echocardiograms. 

The program is designed to support projects that:

  • Test a solution for a bona fide problem within healthcare;
  • Test solution(s) that is/are aligned with the DHS’s specific infrastructure, business approach and operations;
  • Involve broad participation across DHS sites and disciplines; and
  • Are focused on effectiveness (i.e., whether the intervention works in real-life), as opposed to efficacy (e.g., randomized trials in a controlled setting). 

This program does NOT support projects that:

  • Seek to only measure or understand a problem or solution;
  • Are proposed as a theoretically good idea;
  • Involve a single discipline or single hospital or clinic;
  • Focus on efficacy (whether the intervention works under controlled conditions). 

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. Applicants should describe how the proposed research contributes to DHS delivery system goals, and its potential for/relevance to large-scale implementation within DHS and dissemination of findings more broadly.

Questions about the appropriateness of projects can be directed to Dr. Amy Towfighi, Director of SC CTSI Healthcare Delivery Science, through this form. She is available to advise applicants as they assemble research teams and identify enabling resources (e.g., access to EHR) that will be needed for their proposed projects.


Application

Eligibility

Awards will be made to research teams consisting of investigators from USC working closely with investigators and staff members from DHS to design and conduct proposed projects. Multisite collaboration is strongly encouraged. All USC faculty members in any series (tenured/non-tenured) including adjunct and professional research series may apply.


Educational Offering

The SC CTSI is pleased to offer to applicants a new online, self-paced course, Introduction to Healthcare Delivery Science. The multidisciplinary course is a series of seven modules (about eight hours total) featuring experts in the fields of dissemination and implementation science, systems engineering, behavioral economics, team science, informatics and community engagement. Researchers who are interested in applying to this funding opportunity are strongly encouraged to complete all introductory lectures and incorporate Healthcare Delivery Science principles into their projects before submitting a Letter of Intent. Please fill out the SC CTSI Healthcare Delivery Science Course intake form for access to the course.


Letter of Intent (LOI)

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, efficiency and patient centeredness of care within DHS, including patient-level and system-level outcomes, as relevant [100 words max]

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


Submission

Letters of Intent (LOI) must be submitted by 5pm PST on January 25th, 2021 through this website. Questions about the submission process can be addressed to Research Development (rd@sc-ctsi.org).


Review

LOIs will be reviewed by representatives of the SC CTSI and the DHS for potential to improve quality, efficiency and patient centeredness of care within the LAC DHS delivery system. Projects that adhere to the criteria outlined above will be most strongly considered to proceed with a full proposal.


Next Steps

LOIs will be chosen for further consideration within one week of LOI submission. Instructions for preparing a full proposal will be provided at that time.


Summary of Timeline

  • Receipt Deadline for Letters of Intent: January 25th, 2021
  • Receipt Deadline for Full Proposals: March 29th, 2021
  • Notification of Awardees: May 2021
  • Award Start Date: July 2021


Timeline

Receipt Deadline for Letters of Intent

Receipt Deadline for Full Proposals

Notification of Awardess

Award Start Date:

NIH Funding Acknowledgment: Important - All publications resulting from the utilization of SC CTSI resources are required to credit the SC CTSI grant by including the NIH funding acknowledgment and must comply with the NIH Public Access Policy.