Preventing avoidable deaths from pneumonia by improving use of intensive care

通过改善重症监护的使用来预防可避免的肺炎死亡

基本信息

批准号：
9975017
负责人：
Thomas Sebastian Valley
金额：
$ 19.37万
依托单位：
UNIVERSITY OF MICHIGAN AT ANN ARBOR
依托单位国家：
美国
项目类别：
财政年份：
2018
资助国家：
美国
起止时间：
2018-08-07 至 2023-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9975017
关键词：
Achievement Address Admission activity Age American Appointment Automobile Driving Award Beds Blood Pressure California Caring Cessation of life Characteristics Clinical Clinical Data Cluster Analysis Cluster randomized trial Cognitive Critical Care Data Data Collection Decision Making Development Plans Emergency Medicine Ensure Feedback Foundations Funding General Ward Goals Grant Health Care Research Health Sciences Health system Hospitalists Hospitals Intensive Care Intensive Care Units Intervention Interview K-Series Research Career Programs Knowledge Life Lung Manuscripts Marketing Master&apos s Degree Medicine Mentors Michigan Modeling Motivation National Heart, Lung, and Blood Institute Organizational Policy Outcome Oxygen Paper Patients Pattern Physicians Pneumonia Psychology Publishing Randomized Research Research Peer Review Research Personnel Resources Risk Savings Science Scientist Surveys Testing Universities Utah Variant Veterans Work Writing base career career development clinical decision-making improved lecturer population health predictive modeling prevent professor secondary analysis stressor tool

项目摘要

PROJECT SUMMARY/ABSTRACT Candidate’s Long-Term Career Goal: To become an independent investigator and decision scientist seeking to improve clinical decision-making in the intensive care unit (ICU). Clinical Problem to be Addressed: Each year, 10,000 Americans die from pneumonia, yet might not if they had received care in the ICU. This proposal’s overall hypothesis is that there are definable characteristics of patients who could benefit from ICU care but do not receive it, that those characteristics are often not incorporated into cognitive models of physician decision-making around ICU care, and that even when those models are accurate, hospital factors prevent physicians from providing potentially life-saving ICU care. Candidate’s Background and Achievements: Dr. Thomas Valley is a Lecturer in Pulmonary and Critical Care Medicine at the University of Michigan. He has earned a Master’s degree in healthcare research. To date, he has published 15 papers, including 9 original peer-reviewed research manuscripts, of which he was first author on 5, including 1 in JAMA. He has won 2 pilot grants and an NHLBI Loan Repayment award. His department’s strong commitment to him includes an appointment as Assistant Professor on June 1, 2018, regardless of the outcome of this proposal, with a start-up package including $250,000 of discretionary research funds. Career Development Plan: In order to achieve his goals, Dr. Valley proposes to develop new expertise in decision science through formal coursework and mentored research. His primary mentor is Theodore Iwashyna at Michigan, who has mentored 5 clinician-scientists on K awards, of whom 2 have already won R01 or equivalent awards. He is co-mentored by Angela Fagerlin, Chair of Population Health Sciences and a decision scientist at Utah, and Colin Cooke, an expert in ICU organization and policy at Michigan. Aims: Using both secondary analysis of existing data and primary data collection, he will 1) develop and validate a prediction model to identify patients with pneumonia who should be admitted to the ICU, but often are not; 2) empirically identify key decision-making models of physicians about ICU admission; and 3) characterize barriers and facilitators at the organizational-level to improving ICU admission practices. Deliverables from Aims: The proposed Aims will lead to 4 new papers and prepare Dr. Valley to write 1 R21 and 1 R01 proposal. The R21 will develop and pilot a tool to identify patients with pneumonia who should receive ICU care. The R01 will test this tool in a cluster randomized trial to improve ICU use for pneumonia.

项目摘要/摘要候选人的长期职业目标：成为一名独立的研究者和决策科学家寻求改善重症监护病房（ICU）的临床决策。临床问题要解决：每年有10,000名美国人死于肺炎，但如果他们没有在ICU接受了护理。该提议的总体假设是可以从ICU护理中受益但没有收到的患者，这些特征通常不是纳入ICU护理的身体决策的认知模型，即使模型是准确的，医院因素阻止医生提供潜在的挽救生命的ICU护理。候选人的背景和成就：Thomas Valley博士是肺和重症监护的讲师密歇根大学的医学。他已经获得了医疗保健研究硕士学位。迄今为止，他已经发表了15篇论文，其中包括9篇原始同行评审的研究手稿，他是第一作者 5，包括贾马1。他赢得了2个飞行员赠款和NHLBI贷款还款奖。他的部门对他的坚定承诺包括2018年6月1日任命为助理教授该提案的结果，其中包括25万美元的可酌情研究基金。职业发展计划：为了实现他的目标，Valley博士的提议旨在发展新的专业知识通过正式课程和指导研究的决策科学。他的主要导师是西奥多密歇根州的Iwashyna，他在K奖中获得了5名临床科学家的指导，其中2个已经赢得了R01 或同等奖项。他由人口健康科学主席安吉拉·法格林（Angela Fagerlin）和犹他州的决策科学家和密歇根州ICU组织和政策专家Colin Cooke。目的：使用现有数据和主要数据收集的次要分析，他将开发和验证一个预测模型，以识别应入院的肺炎患者，但通常是不是; 2）从经验上确定医生关于ICU入院的关键决策模型； 3）特征组织级别的障碍和促进者改善ICU入学惯例。 AIMS的可交付成果：拟议的Aims将导致4篇新论文，并准备谷博士撰写1 R21 和1个R01提案。 R21将开发并试行一种工具来识别肺炎患者接受ICU护理。 R01将在群集随机试验中测试该工具，以改善ICU对肺炎的使用。