Tailored Adaptation of the AHRQ VTE QI Guide to Local Hospital Context

AHRQ VTE QI 指南根据当地医院情况进行定制调整

• 批准号: 10740991
• 负责人: Anthony D. Yang
• 金额: $ 14.88万
• 依托单位: INDIANA UNIV-PURDUE UNIV AT INDIANAPOLIS
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-11-16 至 2024-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10740991
• 关键词: Address; Adherence; Area; Award; Caring; Centers for Disease Control and Prevention (U.S.); Cessation of life; Characteristics; Chemoprophylaxis; Clinical; Communities; Companions; Complication; Deep Vein Thrombosis; Defect; Development; Devices; Early Ambulation; Elements; Environment; Evaluation; Failure; Funding; Future; Goals; Health; Health Policy; Health Services; Healthcare; Hospitals; Illinois; Inpatients; Institution; K-Series Research Career Programs; Knowledge; Leadership; Learning; Length of Stay; Manuals; Master of Science; Measurement; Measures; Medicine; Mentors; Methods; Modeling; Morbidity - disease rate; Operative Surgical Procedures; Outcome; Patients; Performance; Postoperative Period; Process; Prophylactic treatment; Protein Structure Initiative; Public Health; Pulmonary Embolism; Quality of Care; Quantitative Evaluations; Reporting; Research; Research Methodology; Research Personnel; Resources; Role; Safety; Shapes; United States; United States Agency for Healthcare Research and Quality; United States Centers for Medicare and Medicaid Services; career; contextual factors; dissemination science; effectiveness evaluation; effectiveness/implementation study; experience; health care quality; implementation measures; implementation science; implementation strategy; improved; innovation; insight; interdisciplinary collaboration; medical schools; mortality; novel; patient safety; post implementation; prevent; preventable death; professor; programs; prospective; skills; surgery outcome; venous thromboembolism

Project Summary / Abstract Dr. Yang is an Assistant Professor in the Department of Surgery, Surgical Outcomes and Quality Improvement Center (SOQIC), and the Center for HealthCare Studies (CHS) – Institute for Public Health and Medicine at the Feinberg School of Medicine. CHS and SOQIC conduct cutting-edge research about the safety and quality of healthcare through interdisciplinary collaborations of health services and outcomes researchers in order to inform and shape healthcare policy and to improve healthcare practices and the health of the nation. Dr. Yang's career goal is to become an independently funded investigator combining advanced quantitative and qualitative analytics with expertise in implementation and dissemination science to facilitate effective healthcare quality improvement locally, regionally, and nationally. To fulfill this goal, he will augment his Master's Degree in Healthcare Quality and Patient Safety by gaining expertise in three areas during this award period: (1) implementation and dissemination science, (2) qualitative and mixed methods research, and (3) quantitative evaluation methods. He will apply the new knowledge and skills experientially to the proposed project. Venous thromboembolism (VTE), defined as either a deep venous thrombosis or pulmonary embolism (PE), is a common, preventable cause of postoperative morbidity and mortality. PE is the leading cause of in-hospital preventable death in the United States. The currently quality measures for VTE have important flaws that limit the ability of hospitals to identify actionable targets for quality improvement (QI). Therefore, at the request of the Centers for Medicare and Medicaid Services, our group created and validated a new VTE Prophylaxis Composite Measure that includes the three best practice elements of postoperative VTE prophylaxis: (1) chemoprophylaxis, (2) sequential compression devices, and (3) early ambulation. The measure helps hospitals easily identify actionable QI targets for VTE prophylaxis. This application proposes to use an intensive, mixed methods evaluation in twelve hospitals of four key types (large academic; large community; small/medium community with QI experience; small/medium community with little/no QI experience) to examine how hospitals differentially adapt and utilize the resource, ““Preventing Hospital-Associated Venous Thromboembolism: A Guide for Effective Quality Improvement” (VTE QI Guide) to address QI targets identified by the VTE Prophylaxis Composite Measure, while taking into account their hospital-specific contexts. The lessons learned will culminate in the development of “Tailored Adaptations of the AHRQ VTE QI Guide,” a companion to the VTE QI Guide, which will equip hospitals with practical strategies to adapt and implement the VTE QI Guide within their hospital type and local context. Finally, the value of tailored use of the VTE QI Guide will be assessed by comparing pre- and post-implementation adherence to the VTE Prophylaxis Composite Measure in the twelve hospitals.

项目概要/摘要 杨医生是外科、手术结果和质量系的助理教授 改善中心 (SOQIC) 和医疗保健研究中心 (CHS) – 公共卫生和健康研究所 范伯格医学院 (Feinberg School of Medicine) 和 SOQIC 开展有关安全性的前沿研究。 通过卫生服务和结果研究人员的跨学科合作，提高医疗保健质量 为了告知和制定医疗保健政策并改善医疗保健实践和国民健康。 杨博士的职业目标是成为一名独立资助的研究者，结合先进的定量研究 以及具有实施和传播科学专业知识的定性分析，以促进有效 为了实现这一目标，他将加强他的硕士学位。 在此奖励期内获得三个领域的专业知识，获得医疗保健质量和患者安全学位：(1) 实施和传播科学，(2) 定性和混合方法研究，以及 (3) 定量 他将根据经验将新的知识和技能应用到拟议的项目中。 静脉血栓栓塞（VTE），定义为深静脉血栓形成或肺栓塞（PE）， 是术后发病率和死亡率的常见且可预防的原因，也是院内发生的主要原因。 美国目前的 VTE 质量措施存在严重缺陷，限制了其可预防的死亡。 因此，应医院的要求，医院确定质量改进 (QI) 的可行目标的能力。 在医疗保险和医疗补助服务中心，我们的团队创建并验证了一种新的 VTE 预防组合 措施包括术后 VTE 预防的三个最佳实践要素：(1) 化学预防， (2) 顺序加压装置，以及 (3) 早期下床活动 该措施有助于医院轻松识别。 VTE 预防的可行 QI 目标。 本申请建议对四种关键类型的 12 家医院使用强化、混合方法评估 （大型学术界；大型社区；具有 QI 经验的小型/中型社区；具有 QI 经验的小型/中型社区 很少/没有 QI 经验）来检查医院如何差异化地适应和利用资源，“”预防 医院相关静脉血栓栓塞：有效质量改进指南”（VTE QI 指南） 解决 VTE 预防综合措施确定的 QI 目标，同时考虑其 所吸取的经验教训将最终形成“量身定制的适应方案”。 AHRQ VTE QI 指南”是 VTE QI 指南的姊妹篇，将为医院提供实用策略，以 根据医院类型和当地情况调整和实施 VTE QI 指南 最后，量身定制的价值。 将通过比较实施前和实施后对 VTE 的遵守情况来评估 VTE QI 指南的使用情况 十二家医院的预防综合措施。

项目成果

An Empirical National Assessment of the Learning Environment and Factors Associated With Program Culture.

对学习环境和项目文化相关因素的实证国家评估。

• 发表时间: 2019
• 影响因子: 9
• 作者: Ellis, Ryan J;Hewitt, D Brock;Hu, Yue;Johnson, Julie K;Merkow, Ryan P;Yang, Anthony D;Potts 3rd, John R;Hoyt, David B;Buyske, Jo;Bilimoria, Karl Y
• 通讯作者: Bilimoria, Karl Y

Assessment of hospital-level adjusted breast cancer sentinel lymph node positivity rates.

医院级别调整后乳腺癌前哨淋巴结阳性率的评估。

• 发表时间: 2019-01
• 影响因子: 2.5
• 作者: Berger, Elizabeth R;Bilimoria, Karl Y;Kinnier, Christine V;Minami, Christina A;Bethke, Kevin P;Hansen, Nora M;Merkow, Ryan P;Winchester, David P;Yang, Anthony D
• 通讯作者: Yang, Anthony D

Short-Term Risk of Performing Concurrent Procedures with Hepatic Artery Infusion Pump Placement.

与肝动脉输液泵放置同时进行手术的短期风险。

• 发表时间: 2020-12
• 影响因子: 3.7
• 作者: Brajcich, Brian C;Bentrem, David J;Yang, Anthony D;Cohen, Mark E;Ellis, Ryan J;Mahalingam, Devalingam;Mulcahy, Mary F;Lidsky, Michael E;Allen, Peter J;Merkow, Ryan P
• 通讯作者: Merkow, Ryan P

National Use of Chemotherapy in Initial Management of Stage I Pancreatic Cancer and Failure to Perform Subsequent Resection.

全国在 I 期胰腺癌初始治疗和未能进行后续切除术中使用化疗。

• 发表时间: 2020-03
• 影响因子: 3.7
• 作者: Ellis, Ryan J;Ho, Jessie W;Schlick, Cary Jo R;Merkow, Ryan P;Bentrem, David J;Bilimoria, Karl Y;Yang, Anthony D
• 通讯作者: Yang, Anthony D

National Evaluation of Needlestick Events and Reporting Among Surgical Residents.

全国外科住院医师针刺事件评估和报告。

• 发表时间: 2019
• 影响因子: 5.2
• 作者: Yang, Anthony D;Quinn, Christopher M;Hewitt, D Brock;Chung, Jeanette W;Zembower, Teresa R;Jones, Andrew;Buyske, Jo;Hoyt, David B;Nasca, Thomas J;Bilimoria, Karl Y
• 通讯作者: Bilimoria, Karl Y