Prehospital Activation of ED Teams to Improve Sepsis Care

院前激活急诊团队以改善脓毒症护理

• 批准号: 10455112
• 负责人: Ithan Daniel Peltan
• 金额: $ 19.24万
• 依托单位: IHC HEALTH SERVICES, INC.
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-08-01 至 2024-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10455112
• 关键词: Accident and Emergency department; Acute; Address; Affect; Ambulances; Antibiotics; Award; Biostatistical Methods; Bypass; Caring; Clinical Data; Clinical Research; Clinical Trials; Clinical Trials Design; Cluster randomized trial; Code; Cognitive; Conduct Clinical Trials; Critical Care; Critical Illness; Cues; Data; Dedications; Development; Development Plans; Discipline; Early treatment; Effectiveness; Emergency Care; Emergency Department patient; Emergency Situation; Environment; Epidemiologic Methods; Evaluation; Face; Foundations; Functional disorder; Funding; Future; Goals; Government; Guidelines; Healthcare; Healthcare Systems; Hour; Human Resources; Infection; Infrastructure; Infusion procedures; International; Interview; K-Series Research Career Programs; Knowledge; Learning; Length of Stay; Link; Logistic Regressions; Logistics; Lung; Medical; Mentored Patient-Oriented Research Career Development Award; Mentors; Mentorship; Methodology; Methods; Modeling; Myocardial Infarction; Notification; Organ; Organ failure; Outcome; Pathway interactions; Patients; Pattern; Persons; Physicians; Pneumonia; Positioning Attribute; Predictive Value; Process; Protocols documentation; Research; Research Methodology; Research Personnel; Research Training; Resource Development; Resources; Risk Assessment; Scientist; Sepsis; Severity of illness; Speed; Statistical Methods; Stroke; Structure; Syndrome; System; Testing; Time; Time trend; Training; Trauma; Triage; United States; Variant; advanced analytics; analytical method; base; care delivery; care systems; career; career development; clinical decision support; clinical investigation; cognitive task; cohesion; cohort; cost; design; experience; high risk; implementation science; improved; infection risk; innovation; mortality; multidisciplinary; novel; novel strategies; overtreatment; post implementation; predictive modeling; programs; prospective; randomized trial; rapid diagnosis; research and development; response; septic patients; skills; skills training; success; task analysis; wasting

PROJECT SUMMARY/ABSTRACT Support from this Mentored Career Development Award will provide Ithan Peltan, MD, MSc the additional skills and training he needs to succeed in his goal of becoming an independent physician-scientist focused on improving early sepsis care. Dr. Peltan is a board-certified pulmonary and critical care physician at Intermountain Healthcare with a track record of research success, proven dedication to clinical investigation, and an excellent foundation in methods for high-quality clinical research. This proposal will complete Dr. Peltan’s transition to research independence via a structured career development plan that builds on his prior training and experience and leverages an environment with rich research and career development resources as well as access to granular multicenter clinical data. Specific learning objectives include (1) advanced epidemiologic and biostatistical methods; (2) implementation science and associated methodologies; and (3) the design and conduct of clinical trials. Dr. Peltan will acquire these new skills and knowledge by means of formal coursework, professional development training, and an innovative program of mentored research that will advance medical knowledge about sepsis and identify strategies to facilitate delivery of high-quality sepsis care in the emergency department. Dr. Peltan’s career development will be guided by an experienced and cohesive multidisciplinary mentorship team with expertise in critical care, emergency and prehospital research, sepsis, implementation science, clinical trials, and advanced analytic methods. Sepsis causes or complicates hospital stays for over 1 million U.S. patients every year, with mortality of 15- 20%. Early, appropriate antibiotics are critical to optimal sepsis outcomes. Many patients who present to the emergency department (ED) with sepsis, however, do not receive antibiotics within the intervals recommended by international guidelines and required under government standards. Given the barriers to accomplishing timely antibiotics using current care models, new approaches to ED sepsis care are urgently needed. The research planned for this K23 award aims to (1) validate methods to identify patients likely to have sepsis at or before ED arrival and (2) understand the unintended consequences of care systems that prioritize rapid antibiotic imitation for sepsis in order to (3) test whether redesigning ED sepsis care around multidisciplinary “Code Sepsis” teams activated on or before patient’s ED arrival could improve delivery of high-quality sepsis care. Importantly, this proposal addresses questions and develops methods applicable to care delivery for other high-risk critical illnesses. Findings from this research will provide the preliminary data for R01 or equivalent funding to support a multicenter cluster-randomized trial of the Code Sepsis protocol.

项目摘要/摘要 这个指导的职业发展奖的支持将为医学博士Ithan Peltan提供其他技能 他需要训练他成为成为一个专注于独立的身体科学家的目标 改善败血症早期护理。 Peltan博士是董事会认证的肺和重症监护 Intermountain Healthcare具有研究成功的记录，对临床研究的奉献精神， 以及高质量临床研究方法的良好基础。该建议将完成博士。 佩尔坦通过一项结构化的职业发展计划过​​渡到研究独立性，该计划以他的先前为基础 培训和经验，并利用丰富的研究和职业发展资源来利用环境 以及获取颗粒多中心临床数据的访问。特定的学习对象包括（1）高级 流行病学和生物统计学方法； （2）实施科学和相关方法； （3） 临床试验的设计和行为。 Peltan博士将通过 正式的课程工作，专业发展培训和一项创新的指导研究计划 将促进有关败血症的医学知识，并确定促进高质量败血症的策略 在急诊室照顾。佩尔坦博士的职业发展将受到经验的指导和 具有重症监护，紧急和院前研究专业知识的凝聚力多学科心态团队， 败血症，实施科学，临床试验和高级分析方法。 败血症的原因或使每年超过100万美国患者住院复杂，死亡率为15-- 20％。早期，适当的抗生素对于最佳败血症至关重要。许多出现在 但是，紧急部门（ED）带有败血症，在建议的间隔内不接受抗生素 按国际准则，根据政府标准要求。考虑到完成的障碍 及时使用当前护理模型的及时抗生素，迫切需要新的ED败血症护理方法。这 该奖项颁发的研究旨在（1）验证方法来识别可能患有败血症的患者或 在ED到达之前，（2）了解快速速度优先级的护理系统的意外后果 败血症的抗生素模仿，以（3）测试是否重新设计了多学科的ED败血症护理 在患者ED到达时激活或之前激活的“代码败血症”团队可以改善高质量败血症的交付 关心。重要的是，该提案解决了问题，并开发了适用于护理交付的方法 其他高风险重症疾病。这项研究的发现将为R01或 同等资金以支持代码败血症协议的多中心群集随机试验。