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

基本信息

批准号：
10668449
负责人：
Ithan Daniel Peltan
金额：
$ 1.6万
依托单位：
IHC HEALTH SERVICES, INC.
依托单位国家：
美国
项目类别：
财政年份：
2019
资助国家：
美国
起止时间：
2019-08-01 至 2023-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10668449
关键词：
Accident and Emergency department Acute Address Admission activity Affect Ambulances Antibiotics Award Biostatistical Methods Board Certification 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 Hospitalization Hospitals Hour Human Resources Infection Infrastructure Infusion procedures Institution 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 Patient Admission Patients Pattern Persons Physicians Pneumonia Positioning Attribute Predictive Value Prehospital Emergency Care Process Protocols documentation Recommendation 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 care delivery care systems career career development clinical decision support clinical investigation cognitive task 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 success task analysis wasting

项目摘要

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.

项目概要/摘要该指导职业发展奖的支持将为医学博士、理学硕士 Ithan Peltan 提供额外的技能以及他需要的培训，以成功实现成为一名独立的医师科学家的目标，重点关注 Peltan 博士是一名经过委员会认证的肺科和重症监护医师。 Intermountain Healthcare 拥有研究成功的记录，对临床研究的奉献精神，该提案将为高质量临床研究方法奠定良好的基础。佩尔坦通过建立在他之前的基础上的结构化职业发展计划向研究独立过渡培训和经验，并利用具有丰富研究和职业发展资源的环境以及获取详细的多中心临床数据的具体学习目标包括（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； Peltan 博士将通过以下方式获得这些新技能和知识：正式课程、专业发展培训和创新的指导研究计划将增进有关脓毒症的医学知识，并确定促进高质量脓毒症治疗的策略 Peltan 医生的职业发展将由经验丰富且专业的医生指导。具有凝聚力的多学科指导团队，拥有重症监护、急诊和院前研究方面的专业知识，脓毒症、实施科学、临床试验和先进的分析方法。脓毒症每年导致超过 100 万美国患者住院或使其复杂化，死亡率为 15- 20%。早期、适当的抗生素对于脓毒症最佳治疗结果至关重要。然而，患有脓毒症的急诊室 (ED) 没有在建议的时间间隔内接受抗生素治疗考虑到实现的障碍，应遵循国际准则和政府标准的要求。使用当前的护理模式及时使用抗生素，迫切需要新的急诊脓毒症护理方法。为该 K23 奖项计划的研究旨在 (1) 验证识别可能患有脓毒症的患者的方法在 ED 到达之前，以及 (2) 了解优先考虑快速的护理系统的意外后果脓毒症的抗生素仿制品，以便 (3) 测试是否围绕多学科重新设计 ED 脓毒症护理在患者到达急诊室时或之前启动“脓毒症代码”团队可以改善高质量脓毒症的治疗重要的是，该提案解决了问题并开发了适用于护理服务的方法。其他高危危重疾病的研究结果将为R01或R01提供初步数据。同等资金支持 Code Sepsis 协议的多中心集群随机试验。

项目成果

期刊论文数量（25）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Prevalence, Characteristics, and Outcomes of Emergency Department Discharge Among Patients With Sepsis.

DOI：
10.1001/jamanetworkopen.2021.47882
发表时间：
2022-02-01
期刊：
JAMA network open
影响因子：
13.8
作者：
Peltan ID;McLean SR;Murnin E;Butler AM;Wilson EL;Samore MH;Hough CL;Dean NC;Bledsoe JR;Brown SM
通讯作者：
Brown SM

D-dimer Thresholds to Exclude Pulmonary Embolism among COVID-19 Patients in the Emergency Department: Derivation with Independent Validation.

DOI：
10.1177/10760296221117997
发表时间：
2022-01
期刊：
CLINICAL AND APPLIED THROMBOSIS-HEMOSTASIS
影响因子：
2.9
作者：
Bledsoe, Joseph R.;Knox, Daniel;Peltan, Ithan D.;Woller, Scott C.;Lloyd, James F.;Snow, Gregory L.;Horne, Benjamin D.;Connors, Jean M.;Kline, Jeffrey A.
通讯作者：
Kline, Jeffrey A.

Effect of COVID 19 pneumonia on hyperglycemia: Is it different from non COVID pneumonia?

DOI：
10.1016/j.dsx.2022.102407
发表时间：
2022-03
期刊：
Diabetes & metabolic syndrome
影响因子：
0
作者：
Knox DB;Hirshberg EL;Orme J;Peltan I;Lanspa MJ
通讯作者：
Lanspa MJ

Learning from past respiratory failure patients to triage COVID-19 patient ventilator needs: A multi-institutional study.

DOI：
10.1016/j.jbi.2021.103802
发表时间：
2021-07
期刊：
Journal of biomedical informatics
影响因子：
4.5
作者：
Carmichael H;Coquet J;Sun R;Sang S;Groat D;Asch SM;Bledsoe J;Peltan ID;Jacobs JR;Hernandez-Boussard T
通讯作者：
Hernandez-Boussard T

Disease Severity of Respiratory Syncytial Virus Compared with COVID-19 and Influenza Among Hospitalized Adults Aged ≥60 Years - IVY Network, 20 U.S. States, February 2022-May 2023.