New York City Sickle Cell Implementation Science Consortium

纽约市镰状细胞实施科学联盟

基本信息

批准号：
10197193
负责人：
Lynne D. Richardson
金额：
$ 75.33万
依托单位：
ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
依托单位国家：
美国
项目类别：
财政年份：
2016
资助国家：
美国
起止时间：
2016-08-05 至 2023-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10197193
关键词：
Accident and Emergency department Address Adolescent Adult Ambulatory Care Area Award Back Biological Caregivers Caring Centers for Disease Control and Prevention (U.S.)Cities Clinical Clinical Informatics Cluster randomized trial Collaborations Communities Community Actions Community Networks Community Participation Complement Comprehensive Health Care Data Coordinating Center Data Reporting Development Emergency Care Emergency Department Physician Emergency Medicine Enrollment Evaluation Funding Goals Guidelines Health Health Services Accessibility Health system Hematologist Hematology Hospitals Individual Interdisciplinary Study Intervention Knowledge Laboratories Learning Location Logistics Measures Modeling Multi-Institutional Clinical Trial National Heart, Lung, and Blood Institute Needs Assessment Neighborhood Health Center New York New York City Outcome Pain Pain management Patient-Focused Outcomes Patients Penetration Phase PhenX Toolkit Population Positioning Attribute Primary Health Care Process Provider Quality of life Randomized Registries Reporting Research Research Infrastructure Resources Sickle Cell Sickle Cell Anemia Site Specialist Specimen Standardization Testing United States National Institutes of Health acute care base community partnership data registry density design disease registry effectiveness testing implementation design implementation science implementation strategy implementation study implementation trial improved informatics tool multimodality programs randomized trial research study telehealth virtual healthcare

项目摘要

The goal of the New York City Sickle Cell Implementation Science Consortium (NYCSIS) is to leverage a `learning laboratory' of six hospitals and eleven ambulatory practices within the Mount Sinai Health System (MSHS) to improve penetration of best practices for adults and adolescents with Sickle Cell Disease (SCD). New York City has one of the largest SCD populations in the US, and MSHS provides SCD care to over 700 adults and adolescents. The NYCSIS team and its community partners have identified three critical knowledge-to-action gaps: 1) improving pain management in adult emergency departments (ED), 2) reconnecting individuals who as adults use only the ED back into longitudinal care and 3) delivering comprehensive care in low-density (i.e. smaller numbers of people with SCD) settings with limited access to expert SCD hematologists. Our setting and research infrastructure position us well to address these three issues as MSHS has a robust multi-site emergency medicine research infrastructure (with access to hundreds of adults with SCD who do not utilize primary care) as well as low-density hospitals and community health centers where the full complement of experts (e.g. hematologists and other specialists) are not available. We propose four aims. Aim 1: Conduct a whole-community needs assessment to a) identify additional areas of need, and b) for the three interventions already developed, to understand barriers and facilitators to scaling and implementing them at each care locations; Aim 2: Design implementation research studies that address the identified issues of importance; Aim 3: Participate in the development of the SCD registry in collaboration with the Data Coordinating Center and NHLBI; and Aim 4: Conduct implementation studies that test multi-modal, multi-sector interventions to a) improve emergency care of SCD pain, b) reconnect unaffiliated adults into comprehensive care and c) deliver comprehensive care in low SCD density settings. The NYCSIS team has the resources and community network to rigorously collect and integrate registry data with other U01 sites, and to execute implementation studies that address the needs of urban SCD populations, particularly in low-density care settings with limited access to SCD experts.

纽约市镰状细胞实施科学联盟（NYCSIS）的目标是利用六家医院的“学习实验室”和十一项门诊实践西奈山卫生系统（MSHS），以改善成人最佳实践的渗透率患有镰状细胞病（SCD）的青少年。纽约市是最大的SCD之一美国和MSHS的人口为700多名成人和青少年提供SCD护理。这 NYCSIS团队及其社区合作伙伴已经确定了三个关键的知识对行动差距：1）改善成人急诊科的疼痛管理（ED），2）重新连接成年人仅使用ED返回纵向护理和3）交付的个人使用低密度（即SCD的人数较少）设置的综合护理有限的SCD血液学家的机会有限。我们的环境和研究基础设施将我们定位很高兴解决这三个问题，因为MSHS具有强大的多站点急诊医学研究基础设施（有数百名不利用主要的SCD的成年人护理）以及低密度医院和社区卫生中心没有专家（例如血液学家和其他专家）的专家。我们提出了四个目标。目标1：进行全社区需求评估以a）确定其他需求领域， b）对于已经制定的三种干预措施，以了解障碍和促进者在每个护理位置进行扩展和实施；目标2：设计实施研究解决确定重要问题的研究；目标3：参与发展 SCD注册表与数据协调中心和NHLBI合作；和目标4：进行实施研究，以测试多模式的多部门干预措施 SCD疼痛的急诊护理，b）重新将非附属成年人重新连接为综合护理和c）在低SCD密度设置中提供综合护理。 NYCSIS团队有资源和社区网络严格收集和集成注册表数据与其他U01站点，并执行解决城市SCD人群需求的实施研究，特别是在低密度护理环境中，访问SCD专家的情况有限。