Improving Prehospital Pediatric Emergency Readiness with Telemedicine

通过远程医疗提高院前儿科急救准备

基本信息

批准号：
10675569
负责人：
Tehnaz Parakh Boyle
金额：
$ 16.63万
依托单位：
BOSTON MEDICAL CENTER
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-09-01 至 2025-08-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10675569
关键词：
Acute Adoption Adult Adverse event Ambulances Applied Skills Assessment tool Award Basic Science Blinded Board Certification Boston Caring Child Child Care Childhood Childhood Injury Clinical Clinical Trials Design Communities Critical Illness Data Development Plans Early Intervention Education Educational Intervention Educational workshop Effectiveness Emergency Care Emergency Department Physician Emergency Situation Emergency medical service Emergency research Equipment Ethics Event Evidence based intervention Focus Groups Funding Future Goals Grant Heart Diseases Hospitals Human Human Subject Research Improve Access Individual Infant Informed Consent Infrastructure Internships Intervention Intervention Trial Interview Knowledge Life Massachusetts Measurable Measures Mentors Methods Modeling Outcome Paramedical Personnel Participant Patient-Focused Outcomes Patients Pediatric Hospitals Pediatrics Performance Pharmaceutical Preparations Phase Physicians Positioning Attribute Pre-hospital setting Pre-hospitalization care Predisposition Prehospital Emergency Care Procedures Process Protocols documentation Provider Quality of Care Questionnaires Radio Randomized Randomized, Controlled Trials Readiness Regulation Reporting Research Research Ethics Research Personnel Research Priority Research Training Respiratory Failure Respiratory distress Resuscitation Rural Rural Community Safety Sample Size Scientist Specialist Stroke Structure Surveys System Technology Telemedicine Testing Time Training Training Programs Treatment Efficacy Universities Videoconferencing Work Workload acceptability and feasibility acute care arm care systems career career development child services clinical effect clinical practice community partnership design efficacy trial emergency service responder experience field study handheld mobile device hospital care human subject improved improved outcome innovation medical specialties meetings models and simulation multidisciplinary novel open label patient oriented research patient safety pediatric emergency pilot test practice setting pre-clinical primary outcome professor programs recruit remote assessment research study respiratory risk minimization secondary outcome service providers severe injury simulation skills success teleconsultation telehealth theories tool treatment arm treatment as usual underserved community usability

项目摘要

PROJECT SUMMARY Dr. Boyle proposes a 5-year mentored research training program to become an independent clinician investigator leading prehospital pediatric emergency care research. She has a strong background in basic science research and is a board-certified Pediatric Emergency Physician and Assistant Professor of Pediatrics at Boston University. Her current research focuses on testing system-level interventions to improve patient- oriented outcomes of critically ill and injured children. This proposal focuses on teleconsultation as an innovative intervention to improve prehospital treatment of children with acute respiratory emergencies and to facilitate transitions of care to acute care hospitals. Dr. Boyle’s career development plan includes systematic education and mentoring in intervention optimization; the use of simulation as a research tool for early phase intervention testing; clinical trial design and analysis; and training in the ethics of prehospital emergency care research, including emergency exceptions to informed consent and protection of children as human subjects. She has assembled a multidisciplinary expert team to support her on this project, led by primary mentor, James Feldman, MD, MPH, FACEP and co-mentor, Carlos Camargo, MD, DrPH, FACEP. Her training plan includes a combination of formal coursework and workshops, scientific seminars and meetings, and a focused research ethics internship. These will be paired with mentored research studies where she will test the central hypothesis that pediatric teleconsultation (intervention) by Emergency Medical Service (EMS) providers will result in measurably safer care for children with life-threatening respiratory illness as compared to usual care. Dr. Boyle has partnered with local Massachusetts EMS systems and an affiliated pediatric specialty transport system to refine and pilot test the intervention in simulated and real pediatric respiratory emergencies. The specific aims of this career development proposal are to: (1) Identify predictors of stakeholder acceptance of prehospital teleconsultation for children with a mixed methods study; (2) Estimate intervention acceptability, feasibility, and effect size for prehospital team resuscitation performance in simulated pediatric respiratory emergencies using a pilot randomized controlled trial; and (3) Field test acceptability and feasibility of using a mobile video-conferencing platform for remote assessment of children transported by ambulance for respiratory distress. This proposal serves the dual purpose of supporting Dr. Boyle’s transition to independence as a clinician investigator in patient-oriented research, as well as generating important pilot data to estimate clinical effect, provide sample size justification, and establish the acceptability and feasibility of using a teleconsultation platform optimized for prehospital providers to guide future definitive trials of efficacy. If funded, this research will determine whether teleconsultation, a promising intervention to increase access to high quality care in rural and underserved settings, can improve prehospital emergency care for children.

项目概要 Boyle 博士提出为期 5 年的指导研究培训计划，以成为一名独立临床医生领导院前儿科急救研究的研究员她拥有深厚的基础背景。科学研究，是经过委员会认证的儿科急诊医师和儿科助理教授她目前的研究重点是测试系统级干预措施以改善患者的健康状况。该提案的重点是远程会诊作为一种方法。创新干预措施，改善急性呼吸道急症儿童的院前治疗，并促进护理向急症护理医院的过渡。博伊尔博士的职业发展计划包括系统性的。干预优化中的教育和指导；使用模拟作为早期阶段的研究工具干预测试；临床试验设计和分析；以及院前急救伦理培训研究，包括知情同意的紧急例外情况和保护儿童作为人类受试者。她组建了一个多学科专家团队来支持她的这个项目，由主要导师领导， James Feldman（医学博士、公共卫生硕士、FACEP）和共同导师 Carlos Camargo（医学博士、公共卫生博士、FACEP）她的培训计划。包括正式课程和讲习班、科学研讨会和会议的结合，以及有针对性的研究伦理实习将与指导性研究相结合，她将在其中测试中心。假设紧急医疗服务 (EMS) 提供者将进行儿科远程会诊（干预）与常规护理相比，对患有危及生命的呼吸道疾病的儿童的护理更加安全。 Boyle 博士与马萨诸塞州当地的 EMS 系统和附属儿科专业运输机构合作系统来完善和试点测试模拟和真实儿科呼吸紧急情况的干预措施。该职业发展提案的具体目标是： (1) 确定利益相关者接受度的预测因素 (2) 估计干预的可接受性，模拟儿科呼吸系统中院前团队复苏表现的可行性和效果大小使用试点随机对照试验来评估紧急情况；以及 (3) 现场测试使用的可接受性和可行性用于远程评估救护车运送儿童的移动视频会议平台该提案具有支持博伊尔博士过渡到呼吸窘迫的双重目的。作为临床研究者独立进行以患者为导向的研究，并生成重要的试点数据评估临床效果，提供样本量论证，并建立可接受性和可行性使用针对院前提供者优化的远程咨询平台来指导未来的疗效确定试验。这项研究获得资助，将确定远程咨询是否是一种有前景的干预措施，可以增加获得医疗服务的机会在农村和服务欠缺地区提供高质量护理可以改善儿童的院前急救护理。

项目成果

期刊论文数量（11）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Hospital-Level Implementation Barriers, Facilitators, and Willingness to Use a New Regional Disaster Teleconsultation System: Cross-Sectional Survey Study.

医院级实施障碍、促进因素和使用新区域灾害远程会诊系统的意愿：横断面调查研究。

DOI：
发表时间：
2023-06-27
期刊：
影响因子：
0
作者：
Boyle, Tehnaz;Boggs, Krislyn;Gao, Jingya;McMahon, Maureen;Bedenbaugh, Rachel;Schmidt, Lauren;Zachrison, Kori Sauser;Goralnick, Eric;Biddinger, Paul;Camargo Jr, Carlos A
通讯作者：
Camargo Jr, Carlos A

A Statewide Collaboration to Deliver and Evaluate a Pediatric Critical Care Simulation Curriculum for Emergency Medical Services.

全州范围内合作提供和评估紧急医疗服务的儿科重症护理模拟课程。

DOI：
发表时间：
2022
期刊：
影响因子：
0
作者：
Farrell, Caitlin;Dorney, Kate;Mathews, Bonnie;Boyle, Tehnaz;Kitchen, Anthony;Doyle, Jeff;Monuteaux, Michael C;Li, Joyce;Walsh, Barbara;Nagler, Joshua;Chung, Sarita
通讯作者：
Chung, Sarita

Telemedicine Use in Disasters: A Scoping Review.

灾害中远程医疗的使用：范围界定审查。

DOI：
发表时间：
2022
期刊：
影响因子：
0
作者：
Litvak, Mark;Miller, Katherine;Boyle, Tehnaz;Bedenbaugh, Rachel;Smith, Christina;Meguerdichian, David;Reisman, David;Biddinger, Paul;Licurse, Adam;Goralnick, Eric
通讯作者：
Goralnick, Eric

Pediatric Telehealth Use in U.S. Emergency Departments in 2019.

2019 年美国急诊科儿科远程医疗的使用情况。

DOI：
发表时间：
2023-04
期刊：
影响因子：
0
作者：
Boggs, Krislyn M;Glew, Dorsey;Rahman, Kashfia N;Gao, Jingya;Boyle, Tehnaz P;Samuels;Sullivan, Ashley F;Zachrison, Kori S;Camargo Jr, Carlos A
通讯作者：
Camargo Jr, Carlos A

The First Statewide Implementation of a Regional Disaster Teleconsultation System to Expand Critical Care Surge Capacity: A Case Study in Vermont.

首次在全州范围内实施区域灾害远程会诊系统，以扩大重症监护激增能力：佛蒙特州的案例研究。

DOI：
发表时间：
2023-12-01
期刊：
影响因子：
0
作者：
Boyle, Tehnaz P;Mehra, Ashley;Smith, Nathanael J;Subramanian, Sanjay;Leeber, James;McMahon, Maureen;Green, Devon;Perry, Sarah;Passman, Dina;Biddinger, Paul D;Scott, Benjamin
通讯作者：
Scott, Benjamin