There’s an RFA: Can I Apply?

CRICO’s grant team seeks proposals containing designs that further impact organization-wide risk related to patient safety issues. We encourage both young investigators and senior researchers to apply for funding and we support CRICO-member partnerships among potential investigators during our annual RFA period.

Rules for Grant Awards

• Applications must meet one of the designated focus areas.
• The total budget and project period may not exceed 24-months per award.
• The total budget cannot exceed $200,000 per award including all indirect costs. (max 15%)
• Indirect costs may not exceed 15% of Direct Costs per Award. Note: Indirect costs may be issued to subcontractors at a rate of 15%, but do not qualify as an additional Direct Cost for the applicant/prime institution administering the grant.
• Principal Investigators must dedicate a minimum of 5% annualized effort.
• Salaries cannot exceed the National Institutes of Health (NIH) salary cap in effect at the time of the grant’s commencement.
• CRICO grant funds do not support the purchase or maintenance of capital equipment, as defined by the NIH.

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Grant Application Submission Guidelines

• Only CRICO members may apply. CRICO is the largest medical professional liability carrier in Massachusetts, distinguished by the varied size and structure of our member organizations. Coverage is limited to employees of, and physicians sponsored by, a member institution, each of whom must meet CRICO’s eligibility criteria.
• All research must be conducted at CRICO-member health care organizations with written support from the head of the department approving the Principal Investigator’s proposed project and request for funding.
• Applicants must indicate any co-funding obtained if the proposed project requires greater than $200,000 to meet the aims of the project.
• Applicants must provide all active Other Support for Key Personnel.
• Grant proposals are accepted only during the official application time frame. Our online application portal will not allow applicants to complete and submit applications after the deadline of 9/15/21 at 5:00 p.m.

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Project Scope

The RFA is offered to CRICO-insured members at all levels of experience. Partnerships across CRICO-insured organizations are encouraged. Submissions that contain designs to further impact enterprise risk and emerging patient safety issues are also encouraged.

Funding priority will be given to proposals that are original, evidence-based and directly aimed at improving patient safety and reducing malpractice risk in one of our designated priority areas. This includes proposals that:

• Examine specific domains of malpractice risk and patient harm while assessing the factors at various levels that contribute to such risks.
• Investigate strategic interventions at individual, systems, and organizational levels to help reduce and eliminate specific patient harm and malpractice risk.
• Disseminate proven solutions to reduce malpractice risk. It is anticipated that knowledge gained from these projects will positively affect care delivery and promote risk reduction.

Focus Areas

CRICO is interested in funding projects that examine patient safety risks, investigate strategic interventions for those risks, and/or disseminate proven solutions in the following areas:

1. Patient Assessment: We are interested in proposals that address “clinical situations which present vulnerabilities to frontline clinicians and predispose them to diagnostic errors” (Reyes, 2016). Issues to be addressed include:
   
   • Factors (system or individual) that contribute to a provider’s failure or inability to identify, address, or synthesize relevant clinical information—e.g., symptoms, history, physical findings, diagnostic tests, imaging results—leading to missed or delayed diagnosis. This category also includes failures or delays in ordering or interpreting diagnostic studies.
   • Factors related to narrow diagnostic focus (includes reliance on previous assessment or diagnosis, atypical presentations, and inadequate patient assessment).
   • Failure to rescue, defined as a clinician’s or provider’s delay in or lack of appropriate and timely response to a patient’s deteriorating clinical condition.
   • Factors (system or individual) that contribute to a provider’s failure or inability to provide equitable patient care. The Institute of Medicine (IOM) defines health equity as “providing care that does not vary in quality because of personal characteristics such as gender, ethnicity, geographic location, and socioeconomic status.”
   
   We are interested in applications that explore risks in Patient Assessment for the following clinical domains: Emergency Medicine, Radiology, General and Internal Medicine, Medicine Subspecialties, and Advanced Practice Clinicians (i.e., Physician Assistants and Nurse Practitioners).
   
   
   
2. Management and Performance of Medical Treatment/Procedural Safety: (procedures performed outside the operating room): We are interested in proposals that address the management and performance of medical treatment (procedures performed outside the operating room) by Emergency Medicine, General and Internal Medicine, Interventional Radiology, Radiology, and Nursing. Issues to be addressed include:
   
   
   • Ways to reduce the risk of improper technical performance of specific procedures or treatments, e.g., cardiac catheterization, endoscopy, and interventional radiology.
   • Risks associated with improper management of a patient’s medical treatment course before, during, or after a procedure, e.g., delays, failure or mismanagement of acute and/or chronic conditions, improper medication management, improper monitoring.
   • Risks associated with a failure or inability to provide equitable patient care. The Institute of Medicine (IOM) defines health equity as “providing care that does not vary in quality because of personal characteristics such as gender, ethnicity, geographic location, and socioeconomic status.”
   • Risks associated with medical documentation, including insufficient or incomplete documentation, use of medical scribes, use of templates, use of voice recognition.
3. Emergency Medicine: We are interested in proposals that address risks and challenges associated with patient throughput, capacity management (patient surge), clinical processes for the management of complex patients, and the clinical responsibilities and associated risks of Advanced Practice Clinicians (i.e. Physician Assistants and Nurse Practitioners). Priority will be given to proposals that establish collaborations between/among academic medical centers and community hospitals.
4. OB/GYN: We are interested in proposals that include the design, evaluation or dissemination of interventions aimed at addressing risks associated with the recognition and management of fetal distress, and the clinical responsibilities and associated risks of Advanced Practice Clinicians (i.e. Physician Assistants and Nurse Practitioners). Priority will be given to proposals that establish collaborations between/among academic medical centers and community hospitals.
5. Surgery:We are interested in proposals that address risks associated with, and potential interventions for, the technical performance of general, orthopedic, neuro, and plastic surgery. We are also interested in proposals that address risks associated with and the clinical responsibilities and associated risks of Advanced Practice Clinicians (i.e. Physician Assistants and Nurse Practitioners). Priority will be given to proposals that establish collaborations between/among academic medical centers and community hospitals.
6. Emerging Health Care Delivery Models: We are interested in proposals that examine and evaluate the application of innovative health care delivery models including the impact of telehealth and virtual visits.
7. Data Analytics:We are interested in proposals that investigate new and innovative ways to leverage internal malpractice data with external data sources such as administrative data, billing data, EHR data, clinical data repositories, and other referential data sets to identify leading indicators of safety and malpractice risk.
8. Employment Practices Liability: We are interested in proposals that investigate new and innovative ways to identify risk mitigation opportunities for Employment Practices Liability (EPL), which includes, but is not limited to, claims of discrimination, retaliation, and wrongful termination. Issues to be addressed may include ways to reduce EPL risk such as programs to:
   • Implement processes to effectively receive, track, and respond to employee reports of EPL-related issues
   • Develop, and communicate with stakeholders, meaningful reports regarding allegations of employee misconduct and/or effective response to such allegations
   • Educate supervisors on employment matters (e.g. laws they must comply with, performance reviews, disability accommodation, support provided by the organization)
9. Documentation: We are interested in proposals that address risks associated with documentation, including insufficient or incomplete documentation, use of medical scribes, use of templates, use of voice recognition, impact of the 21st Century Cures Act’s prohibition of information blocking, and failure or inability to provide equitable patient care.

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CRICO’s Review Process

1. CRICO reviews the Letters of Intent to determine alignment with our mission and targeted areas of funding interest.
2. Next, CRICO will invite those Principal Investigators with project intentions deemed the most congruent with CRICO’s objectives to submit a full length, detailed proposal.
3. The initially submitted Letter of Intent, proposed budget and other Required Appendix materials then become part of the Principal Investigator’s full application to be submitted for funding consideration.
4. Upon full review, final applications will be selected and the PIs notified by email of their award.

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Application Materials

• 2022 RFA Announcement (PDF includes Application Submission Process; Letter of Intent Instructions; and Budget Guidelines)
  
  
• CRICO Budget Spreadsheet (XLS)

The 2022 RFA Announcement and CRICO Budget Spreadsheet may also be found within CRICO’s online grants management system (see link at top of page Ready to Apply? Log-in Now)

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Questions?

If you have any questions regarding this announcement, please contact Jeff Timperi, Grants Manager, at [email protected] or 617.450.6887, or Fred Essieh, Grants Administrator, at [email protected] or 617.450.5527. The grants team can also be reached by email at [email protected].

Reference

Reyes, H. Diagnostic Pitfalls: A New Approach to Understand and Prevent Diagnostic Error.

Society to Improve Diagnosis in Medicine 9th International Conference. Hollywood, CA. 2016.

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