Characterizing the Impact of Fragmented Care in Acute Respiratory Failure

描述分散护理对急性呼吸衰竭的影响

基本信息

批准号：
10665671
负责人：
Andrew John Admon
金额：
$ 16.96万
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：
2021
资助国家：
美国
起止时间：
2021-08-15 至 2026-07-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10665671
关键词：
Acute respiratory failure Address Adult Affect Ambulatory Care Award Awareness Caring Cessation of life Characteristics Clams Clinical Clinical Data Clinical Investigator Communication Complex Critical Care Data Data Sources Development Development Plans Doctor of Philosophy Ensure Epidemiology Event Excess Mortality Exposure to Foundations Global Change Goals Health Care Research Healthcare Systems Hospitalization Hospitals Inpatients Intensive Care Units Length of Stay Link Lung Manuscripts Measures Medicine Mentors Methods Michigan Modernization National Heart, Lung, and Blood Institute National Research Service Awards Nosocomial Infections Observational Study Outcome Outpatients Patients Pharmaceutical Preparations Physicians Public Health Publications Research Research Methodology Research Personnel Respiratory Failure Safety Series Survey Methodology Surveys Techniques Testing Training United States Universities Veterans Health Administration Work care delivery care fragmentation career career development clinical effect design evidence base experience improved innovation inpatient service instrument lecturer novel prevent skills thrombotic complications

项目摘要

PROJECT SUMMARY/ABSTRACT Candidate’s Long-Term Career Goal: To become an independent investigator who uses advanced observational research methods to improve the organization and delivery of critical care. Clinical Problem to be Addressed: Acute respiratory failure leads to 2,000,000 hospitalizations and 400,000 deaths in the US each year. Outcomes vary widely across hospitals, suggesting that improvements to how care is organized and delivered may improve survival. Yet, global changes affecting inpatient care teams have encouraged fragmentation—discontinuous care spread across multiple physicians. Little is known about how fragmented care affects adults with respiratory failure and what hospitals can do to protect patients from harm. Specific Aims: Using advanced methods for causal inference applied to novel data sources, Dr. Admon will 1) compare the causal effects of fragmented care on in-hospital and post-hospital respiratory failure outcomes; 2) determine whether specific complications occur more often in fragmented care and predict poorer outcomes; and 3) test whether specific features of inpatient care are protective against harm when care is fragmented. Candidate’s Background: Dr. Andrew Admon is a Lecturer and Research Fellow in Pulmonary and Critical Care Medicine at the University of Michigan. He has advanced training in public health and health care research. He has 25 total publications, including 17 original research manuscripts, with 7 original research manuscripts as first author. Dr. Admon’s work is supported by an NHLBI NRSA F32 award. Career Development Plan: To meet his long-term career goal, Dr. Admon seeks deep, focused training in causal inference and survey methodology. Accordingly, his 5-year plan includes curated courses that build on his strong foundation in quantitative research, project-based mentoring by experts in critical care epidemiology, causal inference, and survey research, selected career development activities, and specific milestones to ensure a successful transition to independence. Dr. Admon’s primary mentor is Colin Cooke, MD, MS, MSc. His co-mentors are Andrew Ryan, PhD, Sarah Krein, PhD, RN, and Theodore J. Iwashyna, MD, PhD. Deliverables: Completing the research and training in this proposal will generate data informing strategies to mitigate fragmentation while equipping Dr. Admon with advanced skills in observational causal inference and survey methods. In subsequent work, this expertise will prepare him to maximally leverage observational data to generate timely and accurate evidence addressing other research challenges in critical care delivery.

项目摘要/摘要候选人的长期职业目标：成为使用高级的独立调查员观察性研究方法，以改善重症监护的组织和交付。要解决的临床问题：急性呼吸衰竭导致200,000医院化和400,000个医院美国每年的死亡结果都在医院中差异很大，这表明组织和交付可能会提高生存率。鼓励碎片分散的护理护理分布在多个医生中。分散的护理会影响成年人的呼吸衰竭以及医院可以采取的措施来保护患者免受伤害。具体目的：使用高级方法用于应用于新型数据源的因果推理，Admon博士Will 1）比较分散的护理对院内和医院改造失败结果的因果影响；确定特定的复杂性是否在碎片的护理中发生并预测较差的结果； 3）测试注射护理的特定特征是否是保护者。候选人的背景：安德鲁·阿德蒙（Andrew Admon）博士是肺和关键的讲师和研究员密歇根大学的护理医学。研究。手稿是第一作者。职业发展计划：为了满足他的长期职业目标，Admon博士寻求深入，重点培训因果推理和调查方法。他在定量研究方面的强大基础，由专家在批判性护理流行病学方面的基于项目的指导，因果推论和调查研究，选定的职业发展活动以及特定的里程碑确保成功过渡到独立性。他的联赛是Andrew Ryan博士，RN，RN和Theodore J. Iwashyna，医学博士。可交付：完成此建议中的研究和培训将生成数据，以告知策略减轻分散性的同时，为Admon博士提供了观察性推理的高级技能和调查方法。为了及时，准确的证据，解决重症监护提供的其他研究挑战。

项目成果

期刊论文数量（7）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Knowledge from the Noise: A Regression Discontinuity Design to Inform Optimal Transfusion Thresholds for Critically Ill Patients.

DOI：
10.1513/annalsats.202203-259ed
发表时间：
2022-07
期刊：
Annals of the American Thoracic Society
影响因子：
8.3
作者：
通讯作者：

Understanding clinician connections to inform efforts to promote high-quality inflammatory bowel disease care.

DOI：
10.1371/journal.pone.0279441
发表时间：
2022
期刊：
PLOS ONE
影响因子：
3.7
作者：
Cohen-Mekelburg, Shirley;Van, Tony;Yu, Xianshi;Costa, Deena Kelly;Manojlovich, Milisa;Saini, Sameer;Gilmartin, Heather;Admon, Andrew J.;Resnicow, Ken;Higgins, Peter D. R.;Siwo, Geoffrey;Zhu, Ji;Waljee, Akbar K.
通讯作者：
Waljee, Akbar K.

External Validation and Comparison of a General Ward Deterioration Index Between Diversely Different Health Systems.