Today is Wednesday, Dec. 13, 2017

Department of

Internal Medicine - Muhammad Zafar Lab

Research Overview

My research passion is in health delivery system design to improve patient outcomes. I have advanced training in Improvement science methods and its application in healthcare. After completing my clinical fellowship in Pulmonary and Critical Care Medicine at University of Cincinnati I pursued a 2-year “Quality Scholars program in Healthcare System Transformation” from James Anderson Center at Cincinnati Children’s Hospital Medical Center and a Masters in Clinical and Translational Research at University of Cincinnati. My scholarly training was supported by IMSTAR program sponsored by Department of Medicine. I am Quality Improvement Lead for Division of Pulmonary and Critical Care Medicine and some of my active projects are mentioned below.

Improving COPD Acute Decompensation Readmissions (I-CARE)

Reducing COPD readmissions is of high priority due to their devastating effects on patient outcomes, disease progression and health care costs. At University of Cincinnati Medical Center we sought to reduce COPD 30-day all-cause readmissions in an innovative way. Through deep analysis we identified care-delivery failures and unmet patient needs at discharge transition and developed a COPD care bundle to mitigate failures and fulfill patient needs. I led this multidisciplinary team project and by using implementation science methods we redesigned the care delivery to achieve 90% reliable adherence to the COPD care bundle. We have reduced the COPD readmissions by 35% and have sustained our outcomes.

Excellence in COPD care in Emergency Department (ExCEED)

Reducing readmission rates through I-CARE project affects a vulnerable subset of patients who require hospitalization. In improving outcomes for all patients a huge opportunity lies within ED encounter which has been largely under investigated. We aim to improve care and outcomes for COPD patients as soon as they arrive in the ED. The multiple projects within this portfolio use decision analytics, clinical research and implementation science methods to discover and implement better ways of COPD care in the ED by balancing best possible patient outcomes and health resource utilization. I lead this team of investigators, clinical leaders and front-line staff that includes providers, nurses, pharmacists, care-coordinators and respiratory therapists. In the first phase of the project we have redesigned the care in the ED observation units to reliably deliver a 5-element COPD care bundle within the short time-frame of 24 hours, to reduce ED revisit rate and provide patients with tools to succeed. Other projects include developing a triage methodology in ED for COPD exacerbation patients and standardize different aspects of care and decision-making in order to best optimize patient outcomes (admission rates, adverse events, readmissions and revisits) and cost (health care resource utilization, length of stay).

Optimizing Role of LAM centers in Care delivery

Lymphangioleiomyomatosis (LAM) is a rare, progressive lung disease affecting young females. Within last two decades many advances have been made in better understanding of disease pathology, natural history as well as discovery of effective therapies. In 2016 the first set of guidelines in management of LAM were published. Being a rare disease, there are numerous challenges that may limit the delivery of effective therapies to patients in an effective, timely and safe manner. LAM centers are a handful of global sites that harbor expertise in LAM care. We are in pursuit of defining the optimal role for LAM clinics in early identification of patients, adoption of evidence based medicine and best-practices to improve patient outcomes. Our approach is to have a deep understanding of aspects of LAM clinic function that are deemed essential by providers as well as patients and prioritize their needs to be able to utilize resources towards highest-yield features.