Michael Cary, PhD, RN, assistant professor for Duke University School of Nursing (DUSON), is the first nurse from the School to be selected to participate in the Duke Clinical and Translational Sciences Award (CTSA) Research Career Development Award Program to fund his study titled “Chronic Conditions Associated with Hospital Readmission Among Hip Fracture Patients Discharged from Inpatient Rehabilitation.” The award provides 75 percent protected effort for three years as well as $20,000 for research expenses per year and $2,500 for travel to professional meetings per year.

Cary’s research focuses on improving health care outcomes among older adults who are at risk for functional decline -- deterioration in mobility and in the performance of daily activities -- due to an injury or worsening disease. He has a particular interest in the use of post-acute rehabilitation services delivered in institutional settings such as inpatient rehabilitation facilities (IRFs) and skilled nursing facilities. This study focuses specifically on hip fracture patients in these settings.  

Eighteen percent of hip fracture patients discharged from IRFs are readmitted to an acute care hospital within 30 days. New research also suggests that multiple chronic conditions in hip fracture patients may have synergistic effects, meaning they have a greater additive impact on health outcomes than would be expected based on their individual impacts.

In his research study, Cary will use large clinical and administrative datasets to better understand the impact of multiple chronic conditions on hospital readmission among hip fracture patients treated in IRFs. He will also develop new informatics and data analysis skills to develop a readmission risk prediction tool to be used at the point of care to guide clinical observations.

“By leveraging electronic health data in real time to build decision support tools capable of predicting future outcomes for individual patients with hip fracture -- including their likelihood of recovery, risk for complications and hospital readmission -- health care providers can intervene early to prevent adverse outcomes or to refer patients for more intensive rehabilitation services,” said Cary. “Together, these efforts involve an interdisciplinary, translational collaboration designed to move from research discovery to clinical application.”

Cathleen Colon-Emeric, MD, MHS, associate professor at Duke University School of Medicine and associate director of the Durham VA Geriatric Research Education and Clinical Center, is the primary mentor on the study. Together, Cary and Colon-Emeric have assembled an interdisciplinary team that stretches across Duke. Members of the mentoring team include: Sayan Mukherjee, PhD, professor in the Duke University Department of Statistical Science; Elizabeth Merwin, PhD, RN, FAAN, Ann Henshaw Gardiner Professor of Nursing and executive vice-dean of DUSON; Wei Pan, PhD, associate professor at DUSON; and Lesley Curtis, PhD, professor in the Duke University School of Medicine and director for the Center for Pragmatic Health Services Research within the Duke Clinical Research Institute.