New York-Presbyterian NETT Consortium

纽约长老会 NTT 联盟

基本信息

批准号：
7937816
负责人：
STEPHAN A MAYER
金额：
$ 19.41万
依托单位：
NEW YORK-PRESBYTERIAN HOSPITAL
依托单位国家：
美国
项目类别：
财政年份：
2007
资助国家：
美国
起止时间：
2007-09-30 至 2012-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7937816
关键词：
Academic Medical Centers Accident and Emergency department Acute Acute Brain Injuries Admission activity Alteplase Ambulances Arts Award Beds Blood Vessels Brain Caring Cerebral hemisphere hemorrhage Clinical Clinical Research Clinical Trials Coagulation Process Collaborations Critical Care Data Emergency Medicine Emergency Situation Emergency treatment Evaluation Evidence based intervention Factor VIIa Functional Magnetic Resonance Imaging Goals Grant Healthcare Systems Heart Arrest Hemostatic Agents Hospitals Hotlines Hour Hypertension Infusion procedures Intensive Care Intensive Care Units Internet Ischemic Stroke Joints Lead Leadership Link Medical Staff Medical center Midazolam Morbidity - disease rate National Institute of Neurological Disorders and Stroke Needles Neurologic Neurological emergencies Neurology Neuroprotective Agents Neurosciences New York Patient Care Patients Performance Physicians Presbyterian Church Principal Investigator Procedures Process Protocols documentation Recombinants Recording of previous events Refractory Reperfusion Therapy Research Research Infrastructure Research Personnel Research Support Rotation Site Specialist Speed Status Epilepticus Stroke System Testing Therapeutic Thrombolytic Therapy Time Trauma Treatment Protocols United States United States National Institutes of Health X-Ray Computed Tomography acute stroke base effective therapy improved intraventricular hemorrhage mortality multidisciplinary natural hypothermia neonatal hypoxic-ischemic brain injury nervous system disorder neurosurgery patient population programs public education recombinant FVIIa response stroke recovery treatment trial

项目摘要

DESCRIPTION (provided by applicant): The two "hub" academic medical centers of the New York Presbyterian (NYP) Healthcare System - Columbia University Medical Center (CUMC) and Weill-Cornell Medical Center (WCMC) - have helped lead the way in developing promising new treatments for neurological emergencies. These include the application of therapeutic hypothermia after cardiac arrest, the Merci' clot retriever for acute ischemic stroke, midazolam infusion for refractory status epilepticus, and clinical trials evaluating neuroprotective agents for acute stroke, thrombolytic therapy for intraventricular hemorrhage, and ultra-early hemostatic therapy with recombinant activated factor VII for intracerebral hemorrhage. Columbia University Medical Center is one of seven NIH SPOTRIAS research centers; central to this effort is the multidisciplinary SPEED team, led by emergency medicine, which continuously evaluates acute stroke care at both of our hubs and has driven substantial reductions in door-to-needle times for IV t-PA. These cooperative efforts between emergency medicine and neurology are further supported by an established infrastructure that facilitates collaboration throughout the NYP Healthcare System, including a Stroke Center Clinical Council, Emergency Medicine System Forum, and one of the largest independent ambulance systems in the United States. The overall goal of the present application is to build on our existing expertise in clinical research, our history of collaboration between emergency medicine and the clinical neurosciences at our two hub hospitals, and our track record of well-coordinated efforts throughout the NYP Healthcare System, in order to develop a 10-hospital New York-Presbyterian NETT Consortium for conducting neuroemergency clinical trials. Collectively these 10 emergency departments treat an ethnically diverse patient population that exceeds one half million patients per year. We will pursue the following specific aims: (1) Establish a leadership group of four co-principal investigators representing emergency medicine and neurology from both of our hub hospitals, supported by two half-time NETT project coordinators; (2) Organize emergency medicine and neurology co-investigators at 8 additional NYP network hospitals, each supported by a part- time NETT coordinators; (3) Create a 24-hour physician coverage system to provide clinical and research support to our regional emergency departments; (4) Develop a new EMS-triggered pre-hospital warning system to reduce the time needed to trigger clinical trial procedures; (5) Formally link the NYP Stroke Center Clinical Council, NYP Emergency Medicine System Forum, and the SPOTRIAS Speed Team; and (6) Develop unified time-based performance standards for managing neuroemergency patients, and implement an internet-based surveillance system to provide continuous quality improvement (CQI) data for our sites.

描述（由申请人提供）：纽约长老会 (NYP) 医疗保健系统的两个“中心”学术医疗中心 - 哥伦比亚大学医学中心 (CUMC) 和威尔康奈尔医学中心 (WCMC) - 帮助引领了发展有前景的神经紧急情况新疗法。其中包括心脏骤停后低温治疗的应用、急性缺血性中风的 Merci' 血栓回收器、难治性癫痫持续状态的咪达唑仑输注，以及评估急性中风神经保护剂、脑室内出血溶栓治疗和超早期止血治疗的临床试验重组激活因子 VII 治疗脑出血。哥伦比亚大学医学中心是 NIH SPOTRIAS 七个研究中心之一；这项工作的核心是由急诊医学领导的多学科 SPEED 团队，该团队不断评估我们两个中心的急性中风护理，并大幅缩短了 IV t-PA 的上门到注射时间。急诊医学和神经病学之间的这些合作努力得到了现有基础设施的进一步支持，该基础设施促进了整个纽约市医疗保健系统的合作，包括中风中心临床委员会、急诊医学系统论坛和美国最大的独立救护车系统之一。本申请的总体目标是建立在我们现有的临床研究专业知识、我们两家中心医院的急诊医学和临床神经科学之间的合作历史以及我们在整个纽约市医疗保健系统中协调良好的工作记录的基础上，旨在建立一个由 10 家医院组成的纽约长老会 NTT 联盟来进行神经急诊临床试验。这 10 个急诊科每年共同治疗超过 50 万名不同种族的患者。我们将追求以下具体目标： (1) 建立一个由四名联合首席研究员组成的领导小组，他们代表我们两家中心医院的急诊医学和神经病学，并由两名半职NETT项目协调员提供支持； (2) 在另外 8 家 NYP 网络医院组织急诊医学和神经病学联合研究者，每家医院均由一名兼职 NETT 协调员提供支持；（3）建立24小时医生覆盖体系，为区域急诊科室提供临床和科研支持；（4）开发新的EMS触发的院前预警系统，以减少触发临床试验程序所需的时间； (5) 正式链接 NYP 中风中心临床委员会、NYP 急诊医学系统论坛和 SPOTRIAS Speed 团队； (6) 制定统一的基于时间的神经急诊患者管理绩效标准，并实施基于互联网的监测系统，为我们的站点提供持续的质量改进 (CQI) 数据。