Dr. Hall is a general surgeon with training in health services research, quality improvement, moral philosophy, and theology. His diverse portfolio of work aims to develop reliable systems of healthcare delivery that are both technically excellent and directed toward the normative good of human flourishing, conceptualized as the well-functioning of the whole person as appropriate to each patient’s vocation. Methods include statistical modeling of large datasets, surveys, qualitative interviews, focus groups, decision support, quality improvement, and implementation science. His specific interests include the measurement and mitigation of surgical frailty, long term loss of independence after surgery, shared decision making, medical ethics, and the formation of virtues necessary for the practice of good medicine.
Education & Training
- BA, Yale College
- MDiv, Yale Divinity School
- MD, Yale School of Medicine
- MHSc, Duke University
- General Surgery Residency, UPMC
Representative Publications
Dr. Hall's publications can be reviewed through PubMed.
Research, Clinical, and/or Academic Interests
Surgical Frailty: Dr. Hall is interested in how the syndrome of frailty can be used to identify patients at greatest risk for perioperative morbidity and mortality, and leveraging that information to support and improve the perioperative decision making for these patients. He is particularly interested in how preoperative palliative care consultation can improve decision-making and outcomes through explicitly negotiated and documented surgical buy-in, time limited trials and overarching goals of surgical therapy. He is also investigating ways to prehabilitate frail patients before surgery to mitigate frailty-associated risks.
Long term Loss of Independence: Dr. Hall is working to define, measure, model, and predict trajectories of long-term loss of independence after emergency and elective surgery. The approach combines data from the VA Surgical Quality Improvement Program, Medicare, Medicaid, Minimum Dataset and other VA sources arranged on a shared chronology to define the setting and duration of healthcare utilization in the year following surgery.
Shared Decision Making: Dr. Hall is working to develop care pathways to optimize the shared decision making process for high risk, frail patients—both before surgery and at presentation to ICUs. Elicitation of patient values is critical in this context but challenging to accomplish. One promising approach that he is working to implement is Best Case Worst Case scenario planning that uses storytelling to elicit patient preferences regarding a discrete choice between possible treatment options.
Medical Decision Making and the Clinical Encounter: Dr. Hall is interested in examining the secular and religious influences that shape the moral imagination of both physicians and patients, and he is interested in the role these formative influences play in the clinical encounter and in medical decision making. This research builds on continuing work that examines the associations between religious belief and practice and various health outcomes.
Research Grants
VA ORD VA QUERI I50 HX003201-01 (10/1/20-9/30/25) “Implementing the Age-Friendly Health System in VHA: Using Evidence-based Practice to Improve Outcomes in Older Adults.” Randomized, stepped wedge implementation of 4 “Age-Friendly” interventions, including the Surgical Pause across the 5 VAMCs in VISN 4 aimed at testing the impact of preoperative frailty screening as a trigger for Best Case Worst Case goal clarification before choosing surgical or nonoperative management. Primary outcome is “healthy home days” calculated using the VA’s Residential History File. Secondary outcomes include perioperative mortality, length of stay, readmission and postoperative complications as measured by VASQIP. Role: Principal Investigator
VA ORD HSRD 01HX003215A (7/1/21-6/30/25) “PAtient-centered mUltidiSciplinary care for vEterans undergoing surgery (PAUSE): a hybrid 1 comparative effectiveness-implementation trial.” This study involves a stepped wedge randomized trial of frailty screening and interdisciplinary review at VAMCs in Palo Alto, Houston and Nashville. The primary aim is to test the effectiveness of the PAUSE trial intervention vs usual care in improving 30- and 180-day mortality, non-home discharge, rehospitalizations and home-time for patients undergoing surgical evaluation. Other aims examine how the intervention’s effect is moderated and the contextual factors that influence the implementation of the intervention in surgical services. Role: Co-Investigator
VA ORD HSR&D 1I01HX003322 (10/1/21-6/30/25) “Improving surgical decision-making by measuring and predicting long-term loss of independence after surgery.” This study leverages unique VA data resources, including the Residential History File, to (1) characterize common trajectories of postoperative loss of independence (LOI) in the 365 days after to describe clinically meaningful heterogeneity in the patters of healthcare utilization; (2) adapt the RAI to predict long-term loss of independence and explore alternative models for LOI prediction; and (3) explore key stakeholders’ perspectives on how LOI risk prognosis might better align shared decisions about surgical treatment with patients’ values and goals. Role: Principal Investigator
VA ORD HSR&D I01HX003095 (7/1/21-12/31/25) “Understanding the Effect of Rurality and Social Risk Factors on Barriers to Care and Surgical Outcomes.” This study aims to identify social risk factors and levels of care fragmentation that affect surgical outcomes to inform VA quality metric policy and institutional resource allocation. In particular we aim to examine the impact of race, ethnicity, socioeconomic status and rurality on surgical outcomes, care fragmentation and resource allocation. Approach entails linking VASQIP data to other data sources, including geocoded addresses to which we can attribute census data regarding socioeconomic status. Role: Co-Investigator
VA CSR&D I01CX002150 (10/1/21-9/30/25) “Metformin Benefits Lower Extremities with Intermittent Claudication (MOBILE_IC).” This clinical trial is testing the ability of metformin therapy to improve walking performance in nondiabetic patients suffering from intermittent claudication in a quadruple blinded, placebo controlled clinical trial. Participants will be recruited at the VA Pittsburgh Healthcare System. Role: Co-Investigator
NIH NCATS 1U01TR002393 (08/1/18-07/31/22) “Harnessing the Power of CTSA-CDRN Data Networks: Using Social Determinants of Health, Frailty and Functional Status to Identify At Risk Surgery Patients and Improve Risk Adjustment.” This project uses the identified versions of the ACS NSQIP registry at San Antonio, UPMC, UNC, and Baylor to expand the list of variables through the electronic records of each institution, including natural language processing of free text notes. The data are then deidentified and merged at the coordinating site to explore social determinants of surgical outcomes, including geocoded addresses, rurality, census data and the Area Deprivation Index. Role: Co-Investigator