I partner researchers with providers to design and test interventions in ways that reflect the real-world conditions in which care is delivered to older adults, particularly those residing in nursing homes. My training and background centers on improvement science and provider engagement.
As director of the Center for Long-Term Care Quality & Innovation (Q&I), I oversee a pragmatic research program that moves interventions along the continuum from design to effectiveness testing and dissemination. We also expand national capacity for the conduct of such research, through training and infrastructure grants and via funding opportunities. Our focus ranges from rehabilitation research and dementia care to SARS-CoV-2-- and may include any topic or intervention that is a priority for our provider partners and to improve care delivery.
We are always seeking research partners: people with innovative practices to test, providers wanting to implement interventions to improve care delivery and experience, and researchers with methdological expertise in the conduct of such research.
| Hawk T, White EM, Bishnoi C, Schwartz LB, Baier RR, Gifford DR. "Facility characteristics and costs associated with meeting proposed minimum staffing levels in skilled nursing facilities." Journal of the American Geriatrics Society, vol. 70, no. 4, 2022, pp. 1198-1207. |
| Baier RR, Jump RLP, Zhang T, Kabbani S, Gifford DR, Gravenstein S. "Feasibility of a Nursing Home Antibiotic Stewardship Intervention." Journal of the American Medical Directors Association, vol. 23, no. 6, 2022, pp. 1025-1030. |
| Gardner RL, Baier RR, Cooper EL, Clements EE, Belanger E. "Interventions to Reduce Hospital and Emergency Department Utilization Among People With Alcohol and Substance Use Disorders: A Scoping Review." Medical Care, vol. 60, no. 2, 2022, pp. 164-177. |
| Towsley GL, Neller S, Baier RR, Wong B. "Me & My Wishes: Concordance of End-of-Life Preferences between Residents with Dementia, Family, and Staff." Journal of Palliative Medicine, vol. 25, no. 6, 2022, pp. 880-887. |
| Olson MB, McCreedy EM, Baier RR, Shield RR, Zediker EE, Uth R, Thomas KS, Mor V, Gutman R, Rudolph JL. "Measuring implementation fidelity in a cluster-randomized pragmatic trial: development and use of a quantitative multi-component approach." Trials, vol. 23, no. 1, 2022, pp. 43. |
| McCreedy EM, Sisti A, Gutman R, Dionne L, Rudolph JL, Baier R, Thomas KS, Olson MB, Zediker EE, Uth R, Shield RR, Mor V. "Pragmatic Trial of Personalized Music for Agitation and Antipsychotic Use in Nursing Home Residents With Dementia." Journal of the American Medical Directors Association, vol. 23, no. 7, 2022, pp. 1171-1177. |
| Berry SD, Baier RR, Syme M, Gouskova N, Bishnoi C, Patel U, Leitson M, Gharpure R, Stone ND, Link-Gelles R, Gifford DR. "Strategies associated with COVID-19 vaccine coverage among nursing home staff." Journal of the American Geriatrics Society, vol. 70, no. 1, 2022, pp. 19-28. |
| Towsley GL, Wong B, Baier RR, Neller S. "An Efficacy Trial of Long-Term Care Residents With Alzheimer's Disease Using Videos to Communicate Care Preferences." Journal of the American Medical Directors Association, vol. 22, no. 7, 2021, pp. 1559-1560. |
| Riester, Melissa R., Bosco, Elliott, Bardenheier, Barbara H., Moyo, Patience, Baier, Rosa R., Eliot, Melissa, Silva, Joe B., Gravenstein, Stefan, van Aalst, Robertus, Chit, Ayman, Loiacono, Matthew M., Zullo, Andrew R. "Decomposing Racial and Ethnic Disparities in Nursing Home Influenza Vaccination." Journal of the American Medical Directors Association, vol. 22, no. 6, 2021, pp. 1271-1278.e3. |
| Snow AL, Loup J, Morgan RO, Richards K, Parmelee PA, Baier RR, McCreedy E, Frank B, Brady C, Fry L, McCullough M, Hartmann CW. "Enhancing sleep quality for nursing home residents with dementia: a pragmatic randomized controlled trial of an evidence-based frontline huddling program." BMC geriatrics, vol. 21, no. 1, 2021, pp. 281. |
| White EM, Wetle TF, Reddy A, Baier RR. "Front-line Nursing Home Staff Experiences During the COVID-19 Pandemic." Journal of the American Medical Directors Association, vol. 22, no. 1, 2021, pp. 199-203. |
| Silva JBB, Bosco E, Riester MR, McConeghy KW, Moyo P, van Aalst R, Bardenheier BH, Gravenstein S, Baier R, Loiacono MM, Chit A, Zullo AR. "Geographic variation in influenza vaccination among U.S. nursing home residents: A national study." Journal of the American Geriatrics Society, vol. 69, no. 9, 2021, pp. 2536-2547. |
| Gardner, Rebekah L., Baier, Rosa R., Cooper, Emily L., Clements, Erin E., Belanger, Emmanuelle. "Interventions to Reduce Hospital and Emergency Department Utilization Among People With Alcohol and Substance Use Disorders." Medical Care, vol. 60, no. 2, 2021, pp. 164-177. |
| McCreedy EM, Gutman R, Baier R, Rudolph JL, Thomas KS, Dvorchak F, Uth R, Ogarek J, Mor V. "Measuring the effects of a personalized music intervention on agitated behaviors among nursing home residents with dementia: design features for cluster-randomized adaptive trial." Trials, vol. 22, no. 1, 2021, pp. 681. |
| Baier RR, McCreedy E, Uth R, Gifford DR, Wetle T. "Nursing home leaders' perceptions of a research partnership." Aging Clinical and Experimental Research, vol. 33, no. 12, 2021, pp. 3371-3377. |
| Reddy A, Resnik L, Freburger J, Ciolek DE, Gifford DR, Whitten MJ, Baier RR. "Rapid Changes in the Provision of Rehabilitation Care in Post-Acute and Long-Term Care Settings During the COVID-19 Pandemic." Journal of the American Medical Directors Association, vol. 22, no. 11, 2021, pp. 2240-2244. |
| Bélanger E, McHugh J, Meyers DJ, Joyce NR, Rahman M, Schwartz M, Baier RR, Mor V. "Characteristics of Top-Performing Hospitals Caring for High-Need Medicare Beneficiaries." Population Health Management, vol. 23, no. 4, 2020, pp. 313-318. |
| Lewis C, Zwetchkenbaum SR, Baier RR, Harris D, Gardner RL. "Dental and Oral Health Care in Nursing Homes: Results from Two Multi-Stakeholder Surveys." Rhode Island medical journal (2013), vol. 103, no. 8, 2020, pp. 62-68. |
| Gitlin LN, Baier RR, Jutkowitz E, Baker ZG, Gustavson AM, Sefcik JS, Hodgson NA, Koeuth S, Gaugler JE. "Dissemination and Implementation of Evidence-Based Dementia Care Using Embedded Pragmatic Trials." Journal of the American Geriatrics Society, vol. 68 Suppl 2, 2020, pp. S28-S36. |
| Bardenheier BH, Baier RR, Silva JB, Gravenstein S, Moyo P, Bosco E, Ogarek J, van Aalst R, Chit A, Loiacono M, Zullo AR. "Persistence of Racial Inequities in Receipt of Influenza Vaccination Among Nursing Home Residents in the United States." Clinical Infectious Diseases, vol. 73, no. 11, 2020, pp. e4361-e4368. |
| Tuzzio L, Hanson LR, Reuben DB, Baier RR, Gurwitz JH, Bayliss EA, Williamson J, Fraser JR, Sherman SJ, Larson EB. "Transforming Dementia Care Through Pragmatic Clinical Trials Embedded in Learning Healthcare Systems." Journal of the American Geriatrics Society, vol. 68 Suppl 2, 2020, pp. S43-S48. |
| Keeler H, Baier RR, Kosar C, Culross B, Cramer ME. "Examining the Impact of Board-Certified Registered Nurses in Skilled Nursing Facilities Using National and State Quality and Clinical Indicators." Journal of Gerontological Nursing, vol. 45, no. 11, 2019, pp. 39-45. |
| McCreedy EM, Yang X, Baier RR, Rudolph JL, Thomas KS, Mor V. "Measuring Effects of Nondrug Interventions on Behaviors: Music & Memory Pilot Study." Journal of the American Geriatrics Society, vol. 67, no. 10, 2019, pp. 2134-2138. |
| Baier RR, Jutkowitz E, Mitchell SL, McCreedy E, Mor V. "Readiness assessment for pragmatic trials (RAPT): a model to assess the readiness of an intervention for testing in a pragmatic trial." BMC Medical Research Methodology, vol. 19, no. 1, 2019, pp. 156. |
| McKinnell JA, Singh RD, Miller LG, Kleinman K, Gussin G, He J, Saavedra R, Dutciuc TD, Estevez M, Chang J, Heim L, Yamaguchi S, Custodio H, Gohil SK, Park S, Tam S, Robinson PA, Tjoa T, Nguyen J, Evans KD, Bittencourt CE, Lee BY, Mueller LE, Bartsch SM, Jernigan JA, Slayton RB, Stone ND, Zahn M, Mor V, McConeghy K, Baier RR, Janssen L, O'Donnell K, Weinstein RA, Hayden MK, Coady MH, Bhattarai M, Peterson EM, Huang SS. "The SHIELD Orange County Project: Multidrug-resistant Organism Prevalence in 21 Nursing Homes and Long-term Acute Care Facilities in Southern California." Clinical Infectious Diseases, vol. 69, no. 9, 2019, pp. 1566-1573. |
| Baier RR, Mitchell SL, Jutkowitz E, Mor V. "Identifying and Supporting Nonpharmacological Dementia Interventions Ready for Pragmatic Trials: Results From an Expert Workshop." Journal of the American Medical Directors Association, vol. 19, no. 7, 2018, pp. 560-562. |
| Pelland KD, Baier RR, Gardner RL. "It's like texting at the dinner table": A qualitative analysis of the impact of electronic health records on patient-physician interaction in hospitals." Journal of innovation in health informatics, vol. 24, no. 2, 2017, pp. 894. |
| McConeghy KW, Baier R, McGrath KP, Baer CJ, Mor V. "Implementing a Pilot Trial of an Infection Control Program in Nursing Homes: Results of a Matched Cluster Randomized Trial." Journal of the American Medical Directors Association, vol. 18, no. 8, 2017, pp. 707-712. |
| Thomas KS, Baier R, Kosar C, Ogarek J, Trepman A, Mor V. "Individualized Music Program is Associated with Improved Outcomes for U.S. Nursing Home Residents with Dementia." The American Journal of Geriatric Psychiatry, vol. 25, no. 9, 2017, pp. 931-938. |
| Baier RR, Mor V. "Pragmatic trials may help to identify effective strategies to reduce nursing home antipsychotic medication use." Israel Journal of Health Policy Research, vol. 6, no. 1, 2017, pp. 5. |
| Morrill HJ, Mermel LA, Baier RR, Alexander-Scott N, Dosa D, Kavoosifar S, Reece R, LaPlante KL. "Antimicrobial Stewardship in Rhode Island Long-Term Care Facilities: Current Standings and Future Opportunities." Infection Control & Hospital Epidemiology, vol. 37, no. 8, 2016, pp. 979-82. |
| Baier RR, Trivedi AN. "For Hospital Readmissions, Hindsight is Not 20/20." J GEN INTERN MED, 2016. |
| Zullo, Andrew R., Dore, David D., Daiello, Lori, Baier, Rosa R., Gutman, Roee, Gifford, David R., Smith, Robert J. "National Trends in Treatment Initiation for Nursing Home Residents With Diabetes Mellitus, 2008 to 2010." Journal of the American Medical Directors Association, vol. 17, no. 7, 2016, pp. 602-608. |
| Gardner, Rebekah, Choo, Esther K., Gravenstein, Stefan, Baier, Rosa R. "Why Is This Patient Being Sent Here?”: Communication from Urgent Care to the Emergency Department." The Journal of Emergency Medicine, vol. 50, no. 3, 2016, pp. 416-421. |
| Baier, Rosa R., Wysocki, Andrea, Gravenstein, Stefan, Cooper, Emily, Mor, Vincent, Clark, Melissa. "A Qualitative Study of Choosing Home Health Care After Hospitalization: The Unintended Consequences of ‘Patient Choice’ Requirements." J GEN INTERN MED, vol. 30, no. 5, 2015, pp. 634-640. |
| Gordon SH, Baier RR, Gardner RL. "Primary Care Physicians' Use of Electronic Health Records in Rhode Island: 2009-2014." Rhode Island medical journal (2013), vol. 98, no. 10, 2015, pp. 29-32. |
| Pelland K, Mota T, Baier RR. "The Nuts and Bolts of Long-term Care In Rhode Island: Demographics, Services and Costs." Rhode Island medical journal (2013), vol. 98, no. 3, 2015, pp. 15-9. |
| Baier, Rosa R, Cooper, Emily, Wysocki, Andrea, Gravenstein, Stefan, Clark, Melissa. "Using Qualitative Methods to Create a Home Health Web Application User Interface for Patients with Low Computer Proficiency." eGEMs (Generating Evidence & Methods to improve patient outcomes), vol. 3, no. 2, 2015. |
| Epstein-Lubow G, Baier RR, Butterfield K, Gardner R, Babalola E, Coleman EA, Gravenstein S. "Caregiver presence and patient completion of a transitional care intervention." The American Journal of Managed Care, vol. 20, no. 10, 2014, pp. e349-444. |
| Pop-Vicas A, Baier R. "Healthcare workers' hands and Clostridium difficile spores: making progress?." Infection Control & Hospital Epidemiology, vol. 35, no. 1, 2014, pp. 16-7. |
| Cooper E, Baier R, Morphis B, Viner-Brown S, Gardner R. "HIT implementation by Rhode Island physicians, advanced practice registered nurses and physician assistants, 2014." Rhode Island medical journal (2013), vol. 97, no. 10, 2014, pp. 57-9. |
| Shamji H, Baier RR, Gravenstein S, Gardner RL. "Improving the quality of care and communication during patient transitions: best practices for urgent care centers." The Joint Commission Journal on Quality and Patient Safety, vol. 40, no. 7, 2014, pp. 319-24. |
| Gardner R, Li Q, Baier RR, Butterfield K, Coleman EA, Gravenstein S. "Is implementation of the care transitions intervention associated with cost avoidance after hospital discharge?." J GEN INTERN MED, vol. 29, no. 6, 2014, pp. 878-84. |
| Wylie MC, Baier RR, Gardner RL. "Perceptions of electronic health record implementation: a statewide survey of physicians in Rhode Island." The American Journal of Medicine, vol. 127, no. 10, 2014, pp. 1010.e21-7. |
| Jiang Y, Baier R, Morphis B, Mermel L, Viner-Brown S. "Rhode Island Clostridium difficile infection trends and laboratory ID events ranking." Rhode Island medical journal (2013), vol. 97, no. 6, 2014, pp. 60-3. |
| Jiang Y, Viner-Brown S, Baier R. "Burden of hospital-onset Clostridium difficile infection in patients discharged from Rhode Island hospitals, 2010-2011: application of present on admission indicators." Infection Control & Hospital Epidemiology, vol. 34, no. 7, 2013, pp. 700-8. |
| Limpahan LP, Baier RR, Gravenstein S, Liebmann O, Gardner RL. "Closing the loop: best practices for cross-setting communication at ED discharge." The American Journal of Emergency Medicine, vol. 31, no. 9, 2013, pp. 1297-301. |
| Baier R, Morphis B, Marsella M, Mermel LA. "Clostridium difficile surveillance: a multicenter comparison of LabID events and use of standard definitions." Infection Control & Hospital Epidemiology, vol. 34, no. 6, 2013, pp. 653-5. |
| Pelland K, Baier R, Morphis B, Viner-Brown S, Gardner R. "Health information technology (HIT) adoption and use by Rhode Island advance practice registered nurses and physician assistants, 2013." Rhode Island medical journal (2013), vol. 96, no. 12, 2013, pp. 48-9. |
| Voss R, Gravenstein S, Baier R, Butterfield K, Epstein-Lubow G, Shamji H, Gardner R. "Recruiting hospitalized patients for research: how do participants differ from eligible nonparticipants?." Journal of Hospital Medicine, vol. 8, no. 4, 2013, pp. 208-14. |
| Baier RR, Gardner RL, Coleman EA, Jencks SF, Mor V, Gravenstein S. "Shifting the dialogue from hospital readmissions to unplanned care." The American Journal of Managed Care, vol. 19, no. 6, 2013, pp. 450-3. |
| Baier RR, Keough L, McDonald J. "Transitions of care: professional expectations." Rhode Island medical journal (2013), vol. 96, no. 11, 2013, pp. 26-32. |
| Yan H, Gardner R, Baier R. "Beyond the focus group: understanding physicians' barriers to electronic medical records." The Joint Commission Journal on Quality and Patient Safety, vol. 38, no. 4, 2012, pp. 184-91. |
| Baier RR, Gardner RL, Buechner JS, Harris Y, Viner-Brown S, Gifford DS. "Creating a survey to assess physicians' adoption of health information technology." Medical Care Research and Review, vol. 69, no. 2, 2012, pp. 231-45. |
| Liu C, Baier R, Gardner R, Trivedi A. "Eligibility for financial incentives and electronic medical record use among physicians." Medicine and health, Rhode Island, vol. 95, no. 11, 2012, pp. 358-62. |
| Baier RR, Gravenstein S. "Use of electronic surveillance to drive improvement in hospital infection rates." Infection Control & Hospital Epidemiology, vol. 33, no. 2, 2012, pp. 112-3. |
| Baier R, Gardner R, Gravenstein S, Besdine R. "Partnering to improve hospital-physician office communication through implementing care transitions best practices." Medicine and health, Rhode Island, vol. 94, no. 6, 2011, pp. 178-82. |
| Baier R, Voss R, Morphis B, Viner-Brown S, Gardner R. "Rhode Island physicians' health information technology (HIT) use, 2009-2011." Medicine and health, Rhode Island, vol. 94, no. 7, 2011, pp. 215-7. |
| Voss R, Gardner R, Baier R, Butterfield K, Lehrman S, Gravenstein S. "The care transitions intervention: translating from efficacy to effectiveness." Arch Intern Med, vol. 171, no. 14, 2011, pp. 1232-7. |
| Viner-Brown S, Baier R. "Central line-associated bloodstream infections (CLABSI) in Rhode Island." Medicine and health, Rhode Island, vol. 93, no. 9, 2010, pp. 289-90. |
| Baier R, Buechner J, Gifford D, Harris Y, Gardner R. "The adoption and use of health information technology (HIT) by Rhode Island physicians, 2009." Medicine and health, Rhode Island, vol. 93, no. 3, 2010, pp. 89-90. |
| Baier R, Butterfield K, Patry G, Harris Y, Gravenstein S. "Identifying star performers: the relationship between ambitious targets and nursing home quality improvement." Journal of the American Geriatrics Society, vol. 57, no. 8, 2009, pp. 1498-503. |
| Baier RR, Butterfield K, Harris Y, Gravenstein S. "Aiming for star performance: the relationship between setting targets and improved nursing home quality of care." Journal of the American Medical Directors Association, vol. 9, no. 8, 2008, pp. 594-8. |
| Buechner JS, Baier RR, Gifford DR. "The Rhode Island survey of physician EMR adoption." Medicine and health, Rhode Island, vol. 91, no. 2, 2008, pp. 64. |
| Baier RR, Kissam S, Gifford DR. "Data's role in quality improvement." Provider (Washington, D.C.), vol. 31, no. 1, 2005, pp. 43-5. |
| Baier RR, Gifford DR, Mor V. "Reporting nursing home quality in Rhode Island." Medicine and health, Rhode Island, vol. 88, no. 6, 2005, pp. 186-7, 191. |
| Baier RR, Gifford DR, Patry G, Banks SM, Rochon T, DeSilva D, Teno JM. "Ameliorating pain in nursing homes: a collaborative quality-improvement project." Journal of the American Geriatrics Society, vol. 52, no. 12, 2004, pp. 1988-95. |
| Baier RR, Patry G, Gifford DR. "The business case for quality." Provider (Washington, D.C.), vol. 30, no. 12, 2004, pp. 41-2. |
| Baier RR, Gifford DR, Lyder CH, Schall MW, Funston-Dillon DL, Lewis JM, Ordin DL. "Quality improvement for pressure ulcer care in the nursing home setting: the Northeast Pressure Ulcer Project." Journal of the American Medical Directors Association, vol. 4, no. 6, 2003, pp. 291-301. |
My career as a public health practitioner and scholar focuses on catalyzing and conducting rigorous research to measure and improve quality.
From 2002 through 2014, I worked at a non-profit quality improvement agency, implementing Medicare quality initiatives, and as a Rhode Island Department of Health contractor, directing the state's quality reporting program. In 2015, I launched the School of Public's research program to establish the evidence base for promising interventions to improve care and outcomes for older adults.
As director of the Center for Long-Term Care Quality & Innovation (Q&I), I use my experience with stakeholder engagement and quality improvement to create effective research partnerships and to ensure that interventions are designed and tested in ways that reflect the real-world conditions in which providers operate and older adults live.
Collectively, my current and prior experience inform my understanding of how to engage provider partners and how to design and adapt interventions that are feasible and acceptable.
Q&I's pragmatic research program focuses on moving interventions along the continuum from design to effectiveness testing and dissemination. We also expand national capacity for the conduct of such research, through training and infrastructure grants and via funding opportunities. To support the conduct of pragmatic research, I co-created the Readiness Assessment for Pragmatic Trials (RAPT) model to help research teams assess their interventions strengths and weaknesses when deciding if and how to proceed with pragmatic testing. Its nine domains include concepts that relate to stakeholder engagement and reflect the need to employ quality improvement methods to iteratively refine an intervention prior to proceeding with a trial.
I have mixed-methods experience and am PI or Co-I on numerous nursing home interventional studies and pragmatic trials. This includes leadership roles and serving as Core PI on several large NIH-funded efforts that provide funding and training opportunities to expand pragmatic research capacity: the Impact Collaboratory (U54AG063546, MPIs: Mor and Mitchell), LeaRRn Rehabilitation Research Network (P2CHD101895, PI: Resnik) and a Program Project Grant (P01AG027296, PI: Trivedi). I am also PI of a CDC-funded master contract, under which we are currectly contracted to examine nursing home COVID-19 vaccine immunogencity (PI: White).
Because we focus on the topics of highest priority to providers, Q&I's research portfolio shifted rapidly to focus on SARS-CoV-2, with studies and papers ranging from infection control practices and risk factors for infection and outbreak to real-world vaccine effectiveness, safety, and uptake. My grants include a Connecticut-funded project to create a nursing home infection control shift coaching intervention, ICAN, that is publicly-available for staff to use. In my personal time, I also volunteer with a national group of people with organ transplants and other immunocompromise who are navigating the ongoing COVID-19 pandemic; my role involves sharing science and guidance. All of this requires me to be well-versed in the emerging SARS-CoV-2 literature; best practices for quarantine, isolation, and testing; and treatments.
Please see my CV for a current list of research studies.
Please see my CV for a current list of publications.
| Name | Title |
|---|---|
| Besdine, Richard | Professor of Medicine, Professor of Health Services, Policy and Practice |
| Braun, Joseph | Professor of Epidemiology, Director of Children's Environmental Health |
| Epstein-Lubow, Gary | Associate Professor of Psychiatry and Human Behavior, Associate Professor of Medical Science, Associate Professor of Health Services, Policy and Practice |
| Gadbois, Emily | Assistant Professor of Health Services, Policy and Practice |
| Gardner, Rebekah | Associate Professor of Medicine |
| Gifford, David | Clinical Associate Professor of Health Services, Policy and Practice, Clinical Associate Professor of Medicine |
| Gravenstein, Stefan | David S. Greer Professor of Geriatric Medicine, Director, Division of Geriatrics and Palliative Care, Professor of Health Services, Policy and Practice |
| Harrison, Jill | Associate Professor of the Practice of Health Services, Policy and Practice |
| Jutkowitz, Eric | Associate Professor of Health Services, Policy and Practice |
| McCreedy, Ellen | Assistant Professor of Health Services, Policy and Practice |
| Mor, Vincent | Florence Pirce Grant University Professor of Health Services, Policy and Practice, Professor of Health Services, Policy and Practice |
| Rudolph, James | Professor of Medicine, Professor of Health Services, Policy and Practice |
| Wetle, Terrie | Professor of Health Services, Policy and Practice, Professor Emerita of Health Services, Policy and Practice |
| White, Elizabeth | Assistant Professor of Health Services, Policy & Practice |
Brown University School of Public Health (2015-present)
| Professor of Practice. Brown University School of Public Health, 2022- |
| Associate Professor of Practice. Brown University School of Public Health, 2015-2022 |
| Teaching Associate. Brown University School of Public Health, 2009-2015 |
