Improving Sickle cell care in Adolescents & Adults in Chicago (ISAAC)

改善青少年镰状细胞护理

基本信息

批准号：
9928658
负责人：
Victor R Gordeuk
金额：
$ 10.34万
依托单位：
UNIVERSITY OF ILLINOIS AT CHICAGO
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 2020-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9928658
关键词：
Accident and Emergency department Accountability Acute pain management Address Adherence Adolescent Adult Age Ambulatory Care Area Beds Caring Chicago Childhood Communities Community Health Community Health Aides Community Healthcare Computerized Medical Record Development Enrollment Epidemiologist Evaluation Evidence based intervention Funding Geography Goals Guidelines Health Health Sciences Health Status Health system Healthcare Healthcare Systems Home visitation Hospitals Ice Illinois Inherited Institutes Institution Intervention Life Medical Medicine Midwestern United States Modeling National Heart, Lung, and Blood Institute Organ Outcome Pain Pain management Participant Patient advocacy Patients Pediatric Hematologist Phase Physicians Population Practice Management Primary Health Care Principal Investigator Provider Public Health Research Research Personnel Resources Schools Scientist Self Management Sickle Cell Sickle Cell Anemia Specialist System Target Populations Technology Testing Time Training Transportation United States Centers for Medicare and Medicaid Services United States Health Resources and Services Administration Universities Urban Health advocacy organizations base biomedical referral center care delivery cell registry clinical research site community based participatory research community organizations design evidence base evidence based guidelines hospital bed hydroxyurea implementation research implementation science improved improved outcome innovation multi-component intervention multimodality population health programs school health smartphone Application tool ward

项目摘要

Improving Sickle cell care in Adolescents & Adults in Chicago (ISAAC): Project Summary Many Chicago adolescents and adults with sickle cell disease (SCD): (1) lack longitudinal regular ambulatory care, (2) infrequently use hydroxyurea and (3) have inadequate pain control. The overall goal of this project is to improve outcomes of adolescents and adults with SCD by systematically developing, testing, and implementing multi-level, multi-modal interventions. Implementation science will guide each activity through the Getting To Outcomes (GTO) application,2 a widely-used accountability implementation framework.3 ISAAC Collaborating Institutions and Targeted Population: The University of Illinois Hospital & Health Sciences System (UI Health) includes a 495-bed hospital and the largest pediatric and adult referral Sickle Cell Center in the Midwest. Sinai Health System (SHS) includes the 319-bed Mt. Sinai Hospital, the 160-bed Holy Cross Hospital and the Sinai Urban Health Institute (SUHI). SUHI is a regional resource for the Community Health Worker (CHW) training and implementation. These collaborating institutions serve 542 unique SCD patients age 15-44 years who live in the Chicago area, about 65% of all SCD patients of this age living in Chicago. Clinical Site Research Team and Advisory Group: The Research Team will be led by adult and pediatric hematologists, an implementation research scientist, an expert in health systems coordination and population health, and an epidemiologist with expertise in community health worker (CHW) coordination. Co-investigators include primary care and emergency department (ED) clinicians, a biostatistician, design and community based participatory research experts, and a school health specialist. The Advisory Group includes health system executives and representatives of FQHCs, community organizations, providers, patients, patient advocacy organizations, public schools, urban transportation center and Illinois Department of Public Health (IDPH). Many participants are already collaborators in sickle cell projects funded by HRSA, PCORI and IDPH. Strategy. We will collaborate in the development of the ISAAC Care Plan (regular longitudinal care; use of hydroxyurea by patients and clinicians; and evidence-based acute pain management in the ED and hospital ward (“pain passport”)). Implementation of the Plan will be facilitated by technology - an app that provides patients and providers access to the ISAAC Care Plan in the patient's electronic medical records (EMR)- and by CHWs during CHW-led home visits to support patient self-management using the ISAAC Care Plan. Specific Aims - Phase I. 1. Conduct a needs and resources assessment, identifying barriers and facilitators to the ISAAC Care Plan. 2. Refine and finalize the ISAAC Care Plan based on the needs and resources assessment. 3. Enroll at least 300 patients age 15-44 years into a Sickle Cell Registry. Specific Aims - Phase II. 4. Implement the ISAAC Care Plan developed in Aim 2 among patients enrolled in the Sickle Cell Registry. 5. Evaluate the Care Plan with and without a CHW intervention.

改善芝加哥青少年和成人的镰状细胞护理（ISAAC）：项目摘要许多芝加哥青少年和患有镰状细胞病的成年人（SCD）：（1）缺乏纵向常规卧床（2）很少使用羟基脲，（3）无法控制疼痛。这个项目的总体目标是通过系统地开发，测试和实施多层次，多模式干预措施。实施科学将通过到达结果（GTO）应用程序，2一个广泛使用的责任实施框架。3 ISAAC合作机构和目标人口：伊利诺伊大学医院与健康科学系统（UI Health）包括一家495张病床的医院以及最大的儿科和成人转诊镰状细胞中心中西部。西奈卫生系统（SHS）包括160张床的圣十字架西奈山山山山医院和西奈城市卫生研究所（SUHI）。 Suhi是社区健康的区域资源工人（CHW）培训和实施。这些协作机构为542名独特的SCD患者提供服务居住在芝加哥地区的15-44岁年龄，约有该年龄段的所有SCD患者的65％居住在芝加哥。临床现场研究团队和咨询小组：研究团队将由成人和小儿领导血液学家，实施研究科学家，卫生系统协调和人口的专家健康，以及具有社区卫生工作者（CHW）协调专业知识的流行病学家。共同投资者包括初级保健和急诊科（ED）临床医生，生物统计学家，设计和社区基于的参与研究专家和学校卫生专家。咨询小组包括健康系统主管和代表FQHC，社区组织，提供者，患者，患者倡导组织，公立学校，城市运输中心和伊利诺伊州公共卫生部（IDPH）。许多参与者已经是HRSA，PCORI和IDPH资助的镰状细胞项目的合作者。战略。我们将在ISAAC护理计划的制定中进行合作（定期纵向护理；使用患者和临床医生的羟基脲；以及急诊和医院的循证急性疼痛管理沃德（“痛苦护照”）。该计划的实施将由技术制定 - 该应用程序提供患者和提供者在患者的电子病历（EMR）和通过CHW在CHW领导的家访期间，CHW使用ISAAC护理计划来支持患者的自我管理。特定目标 - 第1阶段。1。进行需求和资源评估，确定障碍和 ISAAC护理计划的促进者。 2。根据需求和资源评估。 3。至少300名15-44岁的患者进入镰状细胞注册表。特定目的 - 第二阶段。 4。在AIM 2中实施ISAAC护理计划中的患者参加了镰状细胞注册表。 5。在有没有CHW干预的情况下评估护理计划。