A health services researcher and section head of the Department of Cardiac Surgery at the University of Michigan, Donald “Donny” Likosky is dogged in both his study of variation in practice and his pursuit of innovative new ways to improve care. Working with a state-wide collaborative of 33 centers that perform cardiac surgery, Likosky engages an array of healthcare professionals throughout Michigan—from physicians to data coordinators to the technicians who operate heart/lung machines—to advance quality improvement (QI) in cardiac surgery. At the same time, he mentors faculty, medical students, and residents at The University of Michigan. In addition to all that, Likosky also works on a number of ongoing projects related to: reducing healthcare-associated infections after cardiac surgery; evaluating healthcare technology advancements; and identifying potentially modifiable aspects of care which could advance quality or reduce unnecessary expenditures.

While this may seem like a lot to tackle at once, Likosky says he draws inspiration from the work of Dartmouth Institute Founder and Director Emeritus John “Jack” Wennberg, whose pioneering research began the study of unwarranted (or geographic) variation in healthcare. He was introduced to Wennberg’s work by his father, a neurologist by training, who was working as the director of utilization for Kaiser Permanente’s Northern California region. Intrigued by the work Wennberg was doing, Likosky’s father traveled across the country to meet with Wennberg at Dartmouth, bringing his son along. Likosky later applied to the MS and PhD programs, where he says he learned the importance of asking the right questions: “Most often, as healthcare researchers, it’s not the lack of data that’s an obstacle, it’s not knowing the right questions to ask,” he says.

Likosky believes in the importance of “innovation from the inside.” He says there are many members of the clinical care team who are untapped resources for driving quality forward. If given knowledge about how to evaluate their own practice and how they intersect with the broader care team, they could really be “wonderful levers for driving quality forward,” he says. The University of Michigan’s Frankel Cardiovascular Center has taken on this challenge by “putting money on the line to help drive that innovation from the inside.” For example, the Center’s “CVC Innovation Challenge” offers up to $100,000 to support novel solutions aimed at improving the quality or financial impact of patient care. Any patient, trainee, staff or faculty member at the Center can apply for the award. Last year, the winning award was given to the Center’s ventricular assist device team to develop a Michigan Medicine certification program for patients and families.  

Likosky is also a faculty member at the University of Michigan’s Institute for Healthcare Policy and Innovation (IHPI), which brings together faculty members from across the university’s campus. His work at IHPI focuses on influencing both the state legislature and legislators in Washington, D.C. “One of the things I’ve learned from working with the state legislators is that their staffers are untapped resources (at least in Michigan) because they are the ones who filter information to those who are going to vote yes or no on policy,” he says. “So, if we can continue to build a dialogue with the staff of key decision makers, I think that would be a phenomenal next step.” 

"One of the most rewarding (and most fun) things about being a student and a researcher at The Dartmouth Institute was building my own cohort of very close friends and colleagues, working with faculty/researchers who are renowned investigators in their fields.

It’s a locus of brilliant individuals who are very passionate about what they do. I keep in touch with many of my friends from my Dartmouth Institute days. Of course, I would be remiss if I didn’t’ say that I also met my future wife (my father-in-law was my classmate) while at Dartmouth. As they say, you may no longer be in Hanover, but Hanover doesn’t leave you."