Hospital Enhancement of Resuscitation Outcomes for In-Hospital Cardiac Arrest (HE

医院增强院内心脏骤停 (HE) 的复苏效果

• 批准号: 8757524
• 负责人: Paul Sheung-Yan Chan
• 金额: $ 47.99万
• 依托单位: SAINT LUKE'S HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-08-01 至 2019-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8757524
• 关键词: Address; Adopted; Adoption; American Heart Association; Baseline Surveys; Cardiology; Caring; Characteristics; Clinical; Code Blue; Communication; Continuity of Patient Care; Critical Care; Data; Databases; Discipline of Nursing; Event; Feedback; Foundations; Future; Goals; Guidelines; Heart Arrest; Hospitals; Incidence; Institution; Interview; Leadership; Medicine; Methods; National Heart, Lung, and Blood Institute; Outcome; Patient Care; Patients; Policies; Prevalence; Prevention; Process; Qualitative Research; Registries; Research; Resources; Rest; Resuscitation; Risk; Sampling; Site; Site Visit; Structure; Surveys; Survival Rate; Time; Work; clinical epidemiology; experience; high risk; improved; innovation; insight; instrument; multidisciplinary; novel; prevent; programs; public health relevance; routine practice

DESCRIPTION (provided by applicant): In-hospital cardiac arrest (IHCA) is a common event that is associated with poor patient outcomes. Yet, some hospitals have been consistently more successful in preventing and treating IHCA than others. While this is thought to be explained by the adoption of key strategies that improve care processes for IHCA, how these strategies are actually utilized in routine practice and the underlying factors contributing to their successful implementation remain largely unknown. Further, an integrative approach that examines strategies used during IHCA and those employed before and after these events has not been previously undertaken. This study will build on extensive prior work by our investigative team using the American Heart Association's Get With The Guidelines (GWTG)- Resuscitation registry and leverage our team's expertise in IHCA and qualitative research. The proposed HEROICA study will lay the foundation for future quality improvement efforts in IHCA by defining 'best practices' adopted by top-performing hospitals to address these events as well as potential barriers to their implementation. We will use a sequential mixed-methods approach to accomplish this goal, integrating quantitative and qualitative analyses. Its 3 Aims will: (1) identfy top- performing hospitals in preventing and treating IHCA within the GWTG-Resuscitation registry; (2) identify 'best practices' at the top-performing sites through semi-structured qualitative interviews; and (3) validate the practices associated with low IHCA incidence and high IHCA survival at top-performing sites. Findings from the study will be used to construct a toolkit of 'best practices' - the Code Blue Bundle. Upon successful completion of this research, we will partner closely with the American Heart Association (AHA) and the GWTG-Resuscitation registry to develop a national quality improvement program that will implement the Code Blue Bundle. Thus, the HEROICA study will increase the capacity of the NHLBI to improve outcomes for patients who suffer an IHCA by providing hospitals with practical and actionable strategies that can be implemented broadly to reduce the incidence and improve the survival of IHCA.

描述（由申请人提供）：院内心脏骤停 (IHCA) 是一种常见事件，与患者预后不良相关。然而，一些医院在预防和治疗 IHCA 方面始终比其他医院更成功。虽然这被认为是通过采用改善 IHCA 护理流程的关键策略来解释的，但这些策略如何在日常实践中实际使用以及有助于其成功实施的根本因素仍然很大程度上未知。此外，以前还没有采用综合方法来检查 IHCA 期间使用的策略以及这些事件之前和之后使用的策略。这项研究将建立在我们的调查团队之前使用美国心脏协会的 Get With TheGuidelines (GWTG) - 复苏登记系统进行的广泛工作的基础上，并利用我们团队在 IHCA 和定性研究方面的专业知识。拟议的 HEROICA 研究将定义顶级医院为解决这些事件以及实施过程中的潜在障碍而采用的“最佳实践”，从而为 IHCA 未来的质量改进工作奠定基础。我们将使用顺序混合方法来实现这一目标，整合定量和定性分析。其 3 个目标将：(1) 在 GWTG 复苏登记处确定在预防和治疗 IHCA 方面表现最好的医院； (2) 通过半结构化定性访谈确定表现最佳的站点的“最佳实践”； (3) 在表现最佳的场所验证与低 IHCA 发生率和高 IHCA 存活率相关的实践。该研究的结果将用于构建“最佳实践”工具包——Code Blue Bundle。成功完成这项研究后，我们将与美国心脏协会 (AHA) 和 GWTG 复苏登记处密切合作，制定一项国家质量改进计划，以实施 Code Blue Bundle。因此，HEROICA 研究将提高 NHLBI 改善 IHCA 患者预后的能力，为医院提供可广泛实施的实用且可操作的策略，以降低 IHCA 的发生率并提高生存率。