Health Systems Core

卫生系统核心

• 批准号: 10673678
• 负责人: Eric B Larson
• 金额: $ 80.41万
• 依托单位: BROWN UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-09-01 至 2025-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10673678
• 关键词: Academic Medical Centers; Address; Adopted; Adoption; Alzheimer' s Disease; Alzheimer' s disease care; Alzheimer' s disease related dementia; Caregivers; Caring; Collaborations; Communities; Complex; Data; Dementia; Dementia caregivers; Development; Diagnosis; Effectiveness of Interventions; Electronic Health Record; Emotional; Ensure; Financial Hardship; Fostering; Foundations; Funding; Health system; Healthcare; Healthcare Systems; Heterogeneity; Hospitals; Institution; Integrated Delivery Systems; Intervention; K-Series Research Career Programs; Knowledge; Learning; Medical; National Institute on Aging; Nursing Homes; Patients; Persons; Pilot Projects; Population; Pragmatic clinical trial; Protocols documentation; Provider; Readiness; Research; Research Personnel; Resources; Service delivery model; Standardization; System; Testing; United States National Institutes of Health; Work; World Health; case finding; clinical practice; collaboratory; data exchange; design; efficacious intervention; experience; feasibility testing; health care delivery; health care service organization; improved; informal caregiver; insight; knowledge base; medical complication; meetings; novel; patient home care; programs; research study; successful intervention; systems research; therapy design; virtual

PROJECT SUMMARY Most persons with dementia (PWD) receive care outside of institutions, meaning that the physical, emotional, and financial burdens of dementia are borne not only by patients, but their caregivers as well. The fragmented, complex US health care system exacerbates the challenge of delivering coordinated, whole-person care for PWD. Designing and testing effective, practicable, non-pharmacological interventions must take into account the heterogeneity of the health care landscape, the specific needs of this complex population, and the context in which care is delivered. Although multiple interventions designed to improve care for PWD and their caregivers have demonstrated efficacy, few have been adopted widely, and virtually none formally tested in functioning health care systems (HCS). Reflecting the many unanswered questions in optimizing care for PWD, our imperative is to close the gap between the development and testing of interventions and their later adoption in real-world HCS. Thus, to develop a robust national capability to support embedded pragmatic clinical trials (ePCT), we must leverage the combined expertise of researchers and front-line clinicians to design interventions that ensure replicability, scalability, and sustainability. We will apply this expertise as we address the unique intricacies of conducting ePCTs focused on meeting the needs of PWD and their caregivers. The Health Care Systems (HCS) Core of the proposed National Institute on Aging (NIA) Alzheimer's disease (AD)/AD-related dementia (AD/ADRD) HCS Collaboratory will engage experts from integrated delivery systems, academic medical centers, nursing home systems, home care companies and other community based providers to accomplish the following Specific Aims. Aim 1. Establish a collaborative, supportive research resource involving diverse HCS in order to support and facilitate research in the settings where PWD and their caregivers receive care; Aim 2. Develop, document, and disseminate setting-specific approaches to conducting ePCTs in PWD; Aim 3. Facilitate the conduct of rigorous pilot studies, Career Development Award (CDA) projects, and NIH-funded ePCTs in diverse care HCS targeting PWD and their caregivers. IMPACT: A successful HCS Core will partner with the other AD/ADRD Collaboratory Cores and Teams to facilitate rigorous, high-quality research studies focused on PWD and their caregivers, in which multiple health care delivery organizations participate. Combining deep expertise in ePCTs and first-hand knowledge of caring for the AD/ADRD population in a range of settings, the HCS Core will become an unparalleled national research resource to help promulgate successful HCS based interventions designed to meet the needs of PWD, caregivers, and health systems that serve them.

项目摘要 大多数患有痴呆症（PWD）的人在机构之外接受护理，这意味着身体，情感， 痴呆症的经济负担不仅由患者承担，而且由他们的护理人员承担。分散的， 复杂的美国卫生保健系统加剧了提供协调的全人保健的挑战 PWD。设计和测试有效，可行的非药理学干预措施必须考虑 医疗保健领域的异质性，这个复杂人群的特定需求以及背景 提供护理。尽管多种干预措施旨在改善对PWD及其的护理 看护人已经证明了功效，很少有人被广泛采用，几乎没有正式测试 功能医疗保健系统（HCS）。反映了优化护理的许多未解决的问题 PWD，我们的当务之别是要弥合干预措施的开发和测试之间的差距 在现实世界中采用。因此，建立强大的国家能力来支持嵌入式务实 临床试验（EPCT），我们必须利用研究人员和一线临床医生的综合专业知识 设计干预措施，可确保可复制性，可伸缩性和可持续性。我们将应用这种专业知识 解决了进行EPCT的独特复杂性，旨在满足PWD及其需求 照顾者。拟议的国家老化研究所（NIA）的卫生保健系统（HCS）核心 阿尔茨海默氏病（AD）/与AD相关的痴呆症（AD/ADRD）HCS合作社将吸引专家 综合交付系统，学术医疗中心，疗养院系统，家庭护理公司以及 其他基于社区的提供商可以实现以下特定目标。目标1。建立协作， 涉及各种HCS的支持性研究资源，以支持和促进在设置中的研究 PWD及其护理人员获得护理；目标2。开发，记录和传播特定于设置的设置 在PWD中进行EPCT的方法；目标3。促进严格的试点研究的行为 开发奖（CDA）项目，以及NIH资助的EPCT，用于PWD及其针对PWD的多元化护理HCS 照顾者。影响：成功的HCS核心将与其他广告/ADRD合作核心合作 促进严格的高质量研究的团队集中于PWD及其护理人员，其中 多个医疗保健提供组织参加。结合EPCT和第一手方面的深厚专业知识 了解在各种环境中关心广告/ADRD人口的知识，HCS核心将成为一个 无与伦比的国家研究资源，以帮助颁布成功的基于HCS的干预措施 满足为他们服务的PWD，护理人员和卫生系统的需求。