Secondary Prevention and CABG: A Society-Led CQI RCT

二级预防和 CABG：社会主导的 CQI 随机对照试验

• 批准号: 6802231
• 负责人: T B FERGUSON
• 金额: $ 47.43万
• 依托单位: SOCIETY OF THORACIC SURGEONS
• 依托单位国家: 美国
• 财政年份: 1999
• 资助国家: 美国
• 起止时间: 1999-09-01 至 2006-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6802231
• 关键词: Internet; cardiovascular disorder education; cardiovascular disorder prevention; clinical research; computer assisted instruction; coronary bypass; educational resource design /development; health care quality; heart surgery; human data; therapy compliance

DESCRIPTION (provided by applicant): The overall purpose of this three-part Competitive Renewal Proposal is to determine whether established measures for secondary prevention of cardiovascular disease can be incorporated into the clinical practice of coronary artery bypass graft surgery (CABG). This proposal will build upon the operational infrastructure for CQI in CABG developed by the Society of Thoracic Surgeons, its National Cardiac Database and its partnership with the Duke Clinical Research Institute, during the first award interval. The Specific Aims of this first award have essentially been achieved, and this Medical Specialty Society-based CQI platform has been documented to positively influence CQI in CABG on a national level. Using a RCT design, we will first determine whether our initial CQI efforts in surgery are sustainable and translate into durable changes in national care practices, second, assess whether this surgical CQ1 platform can be extended to address secondary prevention, in order to impact on the long-term hazard phase of CABG, and third develop and disseminate a Web-based information tool for promoting long-term patient compliance with secondary prevention. The Specific Aims of this renewal are: 1. To determine whether ongoing QI intervention and performance feedback is necessary to sustain site improvements in targeted care processes, 2. To evaluate whether surgical CQI activities at sites can be extended to secondary prevention, 3. Conduct a demonstration project that uses an innovative web-based patient education tool for promoting long-term patient compliance following CABG and provide pilot data. In sum, this Competitive Renewal intends to take a unique, successful professional society-led CQI platform to the next level, and by doing so continue to set a standard for other areas of medicine.

描述（由申请人提供）：本竞争更新提案由三部分组成，其总体目的是确定心血管疾病二级预防的既定措施是否可以纳入冠状动脉搭桥手术（CABG）的临床实践中。该提案将建立在胸外科医生协会、其国家心脏数据库及其与杜克临床研究所的合作伙伴关系的第一个奖励期内开发的 CABG 中 CQI 运营基础设施的基础上。第一个奖项的具体目标基本上已经实现，并且这个基于医学专业协会的 CQI 平台已被记录在国家层面对 CABG 的 CQI 产生积极影响。使用 RCT 设计，我们将首先确定我们最初在外科手术中的 CQI 努力是否可持续，并转化为国家护理实践的持久变化，其次，评估该外科 CQ1 平台是否可以扩展以解决二级预防问题，从而影响CABG 的长期危险阶段，第三，开发和传播基于网络的信息工具，以促进患者长期遵守二级预防。此次更新的具体目标是： 1. 确定是否需要持续的 QI 干预和绩效反馈来维持有针对性的护理流程中的现场改进， 2. 评估现场的外科 CQI 活动是否可以扩展到二级预防， 3. 开展一个示范项目，使用基于网络的创新患者教育工具来促进 CABG 后患者的长期依从性，并提供试点数据。 总之，本次竞争更新旨在将一个独特、成功的专业协会主导的 CQI 平台提升到一个新的水平，并以此继续为其他医学领域树立标准。