Optimization and Implementation Trial of a User-Centered Emergency Care Planning Tool for Infants with Medical Complexity

以用户为中心的医疗复杂性婴儿紧急护理计划工具的优化和实施试验

• 批准号: 10678867
• 负责人: Christian Donald Pulcini
• 金额: $ 15.54万
• 依托单位: UNIVERSITY OF VERMONT & ST AGRIC COLLEGE
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-08-08 至 2027-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10678867
• 关键词: Academy; Accident and Emergency department; Address; Admission activity; Adoption; American; Caregivers; Child; Child Advocacy; Child Care; Childhood; Chronic; Clinical Investigator; Clinical Trials; Clinical Trials Design; Complex; Cost Effectiveness Analysis; Cost Measures; Data; Dedications; Development; Disparity; Dissemination and Implementation; Dose; Emergency Care; Emergency Department Physician; Emergency Health Services; Emergency Medicine; Emergency Situation; Emergency department visit; Ensure; Expert Opinion; Family; Future; Goals; Health; Health Services; Health Services Research; Healthcare; Infant; Infant Care; Inpatients; Intervention; Interview; Length; Life; Maternal and Child Health; Measures; Medical; Medical Technology; Mentors; Mentorship; Monitor; Outcome; Pediatrics; Pharmaceutical Preparations; Physicians; Positioning Attribute; Professional Organizations; Provider; Publishing; Quality of Care; Randomized; Randomized, Controlled Trials; Recommendation; Research; Research Training; Resources; Rural Population; Scientist; Site; Structure; Subgroup; Surveys; Time; Training; Training Programs; Vermont; Vulnerable Populations; Work; acute care; care outcomes; care providers; career development; clinical care; college; cost; design; dissemination science; ethnic minority; experience; family burden; feasibility trial; health care disparity; health care service utilization; high risk; implementation barriers; implementation process; implementation science; implementation tool; implementation trial; improved; improved outcome; infant outcome; innovation; low socioeconomic status; medical vulnerability; meetings; patient population; patient subsets; pediatric emergency; racial minority; rural area; rural setting; skills; tool; uptake; user centered design

PROJECT SUMMARY/ABSTRACT Dr. Pulcini proposes a five-year research training program to support his development into an independent physician-scientist dedicated to improving emergency care of children with medical complexity, which account for approximately 20% of all pediatric emergency department (ED) visits and 33% of all healthcare spending among children. Dr. Pulcini’s project goal is to optimize and implement a user-centered emergency care planning tool to improve outcomes for infants with medical complexity (notably those in rural areas), a particularly vulnerable subset of this patient population. Under the first aim of the proposal, Dr. Pulcini will optimize an existing emergency care planning tool that, despite advocacy for children with medical complexity by two professional societies, has been poorly implemented to date. Dr. Pulcini will optimize the emergency care planning tool for infants with medical complexity through iterative semi-structured and targeted interviews and surveys of tool users: providers, local interdisciplinary collaborators, and families. Under the second aim, Dr. Pulcini will design and conduct a randomized feasibility trial of the user-centered emergency care planning tool’s implementation, measuring resultant emergency health care outcomes. As part of the trial implementation process, Dr. Pulcini will monitor barriers to implementation, as well as measure key emergency health service research measures with plans for cost-effectiveness analysis for a full-scale future randomized controlled trial to be submitted as an R01. Dr. Pulcini’s training program is focused on dissemination and implementation (D&I) science, supplemented with training in clinical trials and health services measure development. The training in D&I science builds upon Dr. Pulcini’s previous training in pediatric emergency medicine and maternal and child health. Dr. Pulcini’s research will be supported by an accomplished group of mentors with expertise in D&I science, clinical trials, pediatric emergency medicine and health services research. His mentors are dedicated to ensuring his career development into an independent clinical investigator through successful conduct of the proposed project and training plan. By providing Dr. Pulcini with the skills and mentored experience necessary to complete this proposal, he will be well positioned to succeed as an independent scientist and significantly improve the emergency care of children with medical complexity.

项目摘要/摘要 Pulcini博士提出了一项为期五年的研究培训计划，以支持其发展为独立的 身体科学家致力于改善医学复杂性儿童的紧急护理，这是 大约20％ 在儿童中。 Pulcini博士的项目目标是优化和实施以用户为中心的急诊 计划工具以改善医疗复杂性的婴儿（尤其是在粗糙地区的婴儿）的预后，一个 该患者人群特别脆弱的子集。在提案的第一个目的下，普尔西尼博士将 优化现有的紧急护理计划工具，该工具是针对医疗复杂性儿童的目的地倡导 迄今为止，由两个专业社会实施的实施率很高。 Pulcini博士将优化紧急情况 通过迭代半结构化和针对性访谈的医疗复杂性婴儿的护理计划工具 和工具用户的调查：提供者，本地跨学科合作者和家庭。在第二个目标下， Pulcini博士将对以用户为中心的紧急护理计划设计和进行随机可行性试验 工具的实施，衡量由此产生的紧急医疗保健结果。作为审判的一部分 实施过程，Pulcini博士将监控实施障碍，以及测量关键紧急情况 卫生服务研究措施通过计划成本效益分析的计划，用于全面的未来随机分析 对照试验将作为R01提交。 Pulcini博士的培训计划侧重于传播和实施（D＆I）科学，补充了 随着临床试验和卫生服务的培训，衡量的发展。 D＆I科学的培训基于 Pulcini博士先前在小儿急诊医学以及母婴健康方面进行的培训。 Pulcini博士 研究将得到一群成熟的导师，具有D＆I科学专业知识，临床试验， 小儿急诊医学和卫生服务研究。他的导师致力于确保他的职业生涯 通过成功进行拟议项目和 培训计划。通过为Pulcini博士提供技能和修补经验来完成这项技能 提议，他将有能力成为独立科学家，并显着改善 患有医疗复杂性儿童的急诊护理。

项目成果

A Holistic Approach to Childhood Firearm Injuries.

儿童枪伤的整体治疗方法。

• DOI: 10.1542/peds.2023-063322
• 发表时间: 2024
• 期刊: Pediatrics
• 影响因子: 8
• 作者: Pulcini,ChristianD;Hoffmann,JenniferA;Alpern,ElizabethR;Chaudhary,Sofia;Ehrlich,PeterF;Fein,JoelA;Fleegler,EricW;Goyal,MonikaK;Hall,Matt;Jeffries,KristynN;Myers,Rachel;Sheehan,KarenM;Zamani,Mark;Zima,BonnieT;Hargarten
• 通讯作者: Hargarten