Rwanda 912: an mHealth Application to Improve Quality of Trauma and Emergency Care in Kigali, Rwanda

卢旺达 912​​：用于提高卢旺达基加利创伤和紧急护理质量的移动医疗应用程序

• 批准号: 10880474
• 负责人: Sudha Jayaraman
• 金额: $ 25.74万
• 依托单位: UNIVERSITY OF UTAH
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-08-10 至 2026-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10880474
• 关键词: Acceleration; Accident and Emergency department; Accounting; Address; Ambulances; Caring; Cessation of life; Clinical; Collaborations; Communication; Computer software; Country; Data; Data Collection; Emergency Care; Emergency Situation; Emergent care; Ensure; Equipment; Fostering; Foundations; Funding; Future; Health; Hospitals; Income; Interruption; Intervention; Lead; Location; Medical emergency; Methods; Mobile Health Application; Modeling; Myocardial Ischemia; Outcome; Outcome Measure; Patients; Phase; Positioning Attribute; Pre-hospitalization care; Prehospital Emergency Care; Process; Process Measure; Proctor framework; Public Health; Readiness; Registries; Respiratory Tract Infections; Running; Rwanda; Series; Services; Stroke; Students; Subgroup; System; Teaching Hospitals; Testing; Time; Training; Trauma; Trauma patient; Triage; Universities; Voice; World Bank; acceptability and feasibility; clinical outcome assessment; design; doctoral student; effectiveness evaluation; effectiveness/implementation design; electronic data; implementation evaluation; improved; injured; innovation; low and middle-income countries; mHealth; mortality; novel; post implementation; prevent; preventable death; primary outcome; research and development; secondary outcome; simulation; tool; trauma care; trauma centers; years of life lost

PROJECT SUMMARY/ABSTRACT Prompt, high-quality emergency care saves lives. Despite this, formal trauma and emergency medical systems are rare in most LMICs. In this application, we propose to establish “Rwanda912” as an innovative mHealth platform to improve the existing prehospital system by accurately locating patients and facilitating communication between dispatch, ambulance and emergency triage staff. We will conduct this study in two phases: an R21 phase to establish baseline outcome measures, and develop and test the intervention, and an R33 phase to evaluate the intervention using a type 2 hybrid effectiveness/implementation design. In the R21 phase, we will establish baseline prehospital care time-based outcomes using a pilot software application to collect time data and exploratory clinical outcomes for trauma patients using the existing WHO Trauma Registry in Kigali, Rwanda. Then will develop the innovative Rwanda912 mHealth platform using the accelerated-create-to-sustainment (ACTS) model and assess for accuracy, reliability and stakeholder acceptability through a mixed-methods approach. In the R33 phase, we will implement and optimize the Rwanda912 platform for the clinical setting again using the ACTS model and then evaluate the implementation to determine acceptability, feasibility and fidelity using the Proctor framework. We will determine effectiveness based on an anticipated 10% reduction in total prehospital time with 90% power using a Type 2 hybrid implementation/effectiveness design. We will use an interrupted time series statistical design to evaluate the primary outcome based on one year of ambulance deployments pre and post implementation (n=6600). This project will leverage our established collaboration in this setting, foster mHealth development and research capacity in four Masters student, one PhD student and four software developers in Kigali. This will create a foundation for future funding applications to develop, implement and evaluate additional platform features such as a public interface. Study findings will serve as a model for developing a similar communication platform to support pre-hospital emergency care in other LMIC settings.

项目概要/摘要 尽管如此，及时、高质量的紧急护理仍可以挽救生命。 在大多数中低收入国家中很少见。在此应用中，我们建议建立“Rwanda912”作为创新的移动医疗。 通过准确定位患者并促进沟通来完善现有院前系统的平台 我们将分两个阶段进行这项研究：R21 阶段建立基线结果测量，并开发和测试干预措施，以及 R33 阶段 在 R21 阶段，我们将使用 2 类混合有效性/实施设计来评估干预措施。 使用试点软件应用程序收集时间数据，建立基于时间的基线院前护理结果 以及利用卢旺达基加利现有的世界卫生组织创伤登记处对创伤患者进行探索性临床结果。 然后将利用加速创建到维持的方式开发创新的 Rwanda912 移动医疗平台 (ACTS) 通过混合方法对准确性、可靠性和利益相关者的可接受性进行建模和评估 在R33阶段，我们将针对临床环境实施和优化Rwanda912平台。 再次使用 ACTS 模型，然后评估实施情况以确定可接受性、可行性和 我们将根据预期减少 10% 来确定有效性。 我们将使用 2 类混合实施/有效性设计，以 90% 的功率计算院前总时间。 中断时间序列统计设计，用于评估基于一年救护车的主要结果 实施前后的部署（n=6600）。该项目将利用我们在以下方面建立的合作。 在此背景下，培养四名硕士生、一名博士生和 基加利的四名软件开发商这将为未来的资金申请开发奠定基础， 实施和评估其他平台功能，例如公共界面，研究结果将作为一个平台。 开发类似的通信平台以支持其他中低收入国家的院前急救护理的模型 设置。

项目成果

Challenges Locating the Scene of Emergency: A Qualitative Study of the EMS System in Rwanda.

定位紧急情况现场的挑战：卢旺达 EMS 系统的定性研究。

• 发表时间: 2024
• 影响因子: 2.4
• 作者: Hunt, McKenna;Niyonsaba, Mediatrice;Uwitonze, Jean Marie;Nyinawankusi, Jeanne D'Arc;Davies, Justine;Maine, Rebecca;Nkeshimana, Menelas;Jayaraman, Sudha;Watt, Melissa H
• 通讯作者: Watt, Melissa H