Research Overview

Quality Improvement / Health Services Research Project

UCSF Public Psychiatry Fellowship at ZSFG

Overview

Each fellow will conduct a Quality Improvement / Health Services Research Project.  The topic should be of interest to both the fellow and the clinic site medical director: a true public-academic partnership.  This project needs to be feasible given the available resources (fellow’s time, research assistant time, other resources).  We will help you do this.  Your project could be developed in any of the following ways:

  • Projects could be selected from areas of active interest to the health care system or specific clinics (research “menu”) 
  • Projects could arise out of a better understanding of the clinics’ needs (logic and congruence models)
  • Projects could build upon work from prior fellows
  • Projects could arise out of shared interest with your site supervisor

 

Supervision

Each fellow will receive weekly research supervision with Dr. Melanie Thomas.  We will use Wednesday afternoons for research supervision time with a mix of individual and group supervision. You will receive co-mentorship from Drs. Dilley and Mangurian during group supervision time.  Dr. Thomas is available for PRN consultation throughout the year.  Please take advantage of this resource. 

Protection of Human Subjects

The line between research and quality improvement is something we will be discussing at length.  When you conduct a typical research study, you need to obtain IRB (Institutional Review Board) approval.  Here at UCSF, the IRB is called the Committee on Human Research (CHR).  The CHR has a Quality Improvement Unit (QIU).  The purpose of the QIU is to provide information to faculty and staff on regulatory compliance and Good Clinical Practice (GCP) Guidelines related to human research participants, data collection and data management; to verify that safeguards protecting the rights and welfare of human research participants are met; to verify investigator adherence to the study design as approved by the CHR protocol, and applicable regulatory requirements; and rarely, to investigate complaints and/or allegations of noncompliance with research regulations. 

Once we have fully developed your research idea, we will either complete a CHR application or discuss the project with QIU and receive written clarification that your project is QI and CHR approval is not necessary.

Of note, the APA does not consider quality improvement efforts to be research and therefore do not require IRB approval on their posters.

For more information on this area, feel free to watch a lecture on this issue from the UCSF CTSI Training in Clinical Research Program:

http://ticr-ucsf.mediasite.com/mediasite/Play/cf21f5a14581472fbf082251c626cb3f1d?catalog=26711d11-8cca-4d1e-880c-22621f7a1567

 

Research Assistant

One of the unique aspects of the UCSF Public Psychiatry Fellowship at ZSFG is the access to a research assistant for six hours a week.  This person will help you with all aspects of your study from study design to data collection to preparation of your poster.  In addition, you will have the opportunity to learn how to supervise someone through this experience. 

  • Fellows, Dr. Thomas, and RAs will meet regularly as a group on Wednesday afternoons.  We will work together to make a schedule of individual and group meetings. 
  • RA will be allowed to work at the clinics or at ZSFG as needed.
  • The RA will likely be one of the co-authors on the poster presentation.

 

 

Study Products

We believe that it is important for your work to be disseminated.  This is important both for the information to help guide best practices for patient care, and also to further your career development.  The following are the specific deliverable products you will create by the end of the year.  We will also encourage clinical impact of your project by actively involving clinical site directors in both your project development and the dissemination process.

 

  • American Psychiatric Association abstract submission (www.psych.org submissions open in September) + poster presentation if abstract accepted (Examples on CLE)
  • Oral presentations 
    • Staff at clinic placement
    • SFHN-BH medical directors meeting
    • ZSFG Psychiatry Grand Rounds

 

  • 1-page written Executive Summary of project, suitable for distribution to clinic staff and SFHN-BH medical directors (Examples on CLE)
  • Final fellowship feedback (15 min for each fellow, presentation + discussion)
    • This presentation is informal and requires only your reflection
    • Provide a brief discussion response of various audiences to results and clinical impact
    • Generate ideas for future fellow research projects
    • Pearls of wisdom on how to utilize an AHP intern
  • Publication (optional)
    • If you would like, Drs. Mangurian and Thomas are willing to help you publish your results, likely as a Letter to the Editor or Frontline Reports in Psychiatric Services.   These letters or column should not exceed 500 words and may have a maximum of three authors and five references (no references for column).  
    • Regarding authorship, in most cases the fellow will be the first author and Dr. Mangurian will be the senior author, and Dr. Thomas will be the middle author.

 

 

 

 

 

 

Resources

The CLE website had several documents to help you with your project, including but not limited to: 1) a menu of project ideas; 2) prior CHR proposals; 3) prior drafts of PPF publications, 4) prior APA posters; 5) computer issues (MyAccess/MyResearch/VPN, PubMed, HIPPA, REDCap); and 6) guide to working with RAs.

Time Line

The following timeline indicates general timeframe as well as deadlines/deliverables for the project:

Month

Study Aspect

Specific Deadlines/Deliverables

July

Get to know your clinic

 

August

Work on logic model

 

September

Brainstorm ideas and conduct literature review

Logic model—presentation and written

October

Finalize study idea and draft CHR if necessary

Literature review submitted

November

Create data collection forms & draft APA poster proposal

CHR application or QI signoff completed

December

Finalize data collection forms

Submit poster abstract; Data collection tool

January

Data collection

Begin data collection

February

Data collection

Complete data collection

March

Data analysis & prepare APA poster

Complete data analysis

April

Finalize APA poster

Poster submitted

May

Poster presentation at the APA

Draft Executive Summary & oral presentation slides

June

Various oral presentations

Executive summary completed