A Better Way of Doing Medicine

Tyler Hartman, MD, a neonatologist at Children's Hospital at Dartmouth, tells a tale of two babies. Both born weeks early, Owen was on a ventilator to help him breathe as he fought a brutal infection, and Libby was being fed through a nasogastric (NG) tube but was otherwise stable and healthy. So why was Owen at home, and Libby in the Intensive Care Nursery? Doctors, nurses, and other health professionals see discrepancies and weaknesses like these in healthcare delivery, and they envision solutions. But there’s little opportunity for them to be proactive when they spend their busy days reacting. Time outside of a system is essential to making changes within it.

Launched by a gift to the Geisel School of Medicine at Dartmouth from Susan and Richard Levy, PhD, D’60, the Susan & Richard Levy Health Care Delivery Incubator is a joint initiative between

Dartmouth College and Dartmouth Hitchcock Medical Center and based at The Dartmouth Institute for Health Policy & Clinical Practice. The Incubator supports projects focused on improving patient outcomes, prioritizing patientand family-centered care, reducing spending, and promoting scholarly work. Importantly, it gives project leaders like Hartman protected time in which to further their ideas.

Hope Grows at Home was among the first cohort of Incubator funded projects. Led by Hartman, who’s also an assistant professor at Geisel, and nurse practitioner, Kathryn Richards, MSN, APRN, the project redesigned care for stable preterm infants by transitioning their feeding from the hospital to the home with extensive support and monitoring. “This was an opportunity to do something locally that’s focused on improving care and cost reduction. If you can nail those

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The project generated innovations with far-reaching impact: collaborating with engineers from Thayer, Hartman and Richards designed a new NG tube that’s easier to place and are now working on patenting their invention; physicians throughout Dartmouth Health are considering ways the continuous monitoring system may allow them to safely send their patients home sooner; enhanced feeding strategies developed for the program have been implemented in DHMC’s Intensive Care Nursery; and Hartman and Richards have developed a collaborative nationally with centers running similar programs to share data. 