Theodore "Jack" Iwashyna, MD, PhD is a Professor of Internal Medicine in the Division of Pulmonary and Critical Care Medicine at the University of Michigan, where his clinical practice is as a medical intensivist. He is also part of the Survey Research Center at the Institute for Social Research and the Center for Clinical Management Research at the Ann Arbor VA HSR&D Center of Excellence.
Dr. Iwashyna’s research seeks to understand the context of critical illness, both how critical illness influences a patient’s life course, and how the organizational environment influences the effectiveness of the care that a patient receives. His clinical work in the University of Michigan’s and Veteran’s Administration Hospital medical intensive care units emphasize medical critical care, including severe sepsis, ARDS and high complexity patients. A major focus of Iwashyna’s current work is to define the experience of survivorship after critical illness, particularly severe sepsis. Evidence increasingly suggests that severe sepsis is not only life-threatening, but also life-altering. How does severe sepsis reshape the lives of patients? What can be done to lessen the adverse consequences among those who survive? In collaboration with the Health and Retirement Study and others, he is working to measure long-term functional, cognitive and health care outcomes after severe sepsis. Further, he is establishing the mechanisms by which these long-term changes occur, with an eye to interventions, particularly hospital-based, that can improve the lives of survivors. At the same time, the organization of care is at the heart of critical care as specialty, rather than a focus on specific organ dysfunction. A continuing focus of Iwashyna’s work is on the organization of critical care services. Hospitals vary substantially in the quality of the critical care they provide. He is interested in two related problems. First, how can we better evaluate the quality of care that hospitals provide, using techniques that are fair and patient-centered. Second, can we integrate such information with already existing informal inter hospital transfer networks, to use existing resources more effectively. Methodologically, the group combines the traditional tools of health services research (including analysis of administrative databases and multi-level modeling) with emerging techniques in network analysis and longitudinal data analysis. It has funding from the NIH, the VA Office of HSR&D, and foundation sources.