PORTAL: Patient Outcome Reporting Tool for emergency medicAL services
门户网站:紧急医疗服务的患者结果报告工具
基本信息
- 批准号:10301974
- 负责人:
- 金额:$ 34.6万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2021
- 资助国家:美国
- 起止时间:2021-09-01 至 2024-05-31
- 项目状态:已结题
- 来源:
- 关键词:Academic Medical CentersAcuteAcute myocardial infarctionAddressAmbulancesAmerican Heart AssociationAspirinBloodCardiacCardiovascular systemCaringChest PainClinicalCluster randomized trialCollaborationsCommunicationDataDevelopmentDiagnosisEducationEducational workshopEffectivenessElectrocardiogramEmergency CareEmergency SituationEmergency medical serviceEncapsulatedEngineeringEnvironmentEvidence based practiceFailureFeedbackFutureGoalsGuidelinesHealthHealthcareHeartHospitalsHumanInterventionInterviewIntuitionLearningLinkLogisticsLungMeasuresMedicalMedicineMethodsMindMyocardial InfarctionNational Heart, Lung, and Blood InstituteNatureNotificationOperations ResearchOutcomePatient CarePatient Outcomes AssessmentsPatient-Focused OutcomesPatientsPatternPerformancePhysician ExecutivesPre-hospital settingPre-hospitalization carePrehospital Emergency CarePreparationProcessProviderQualitative MethodsRandomized Clinical TrialsReperfusion TherapyReportingRunningSafetySecureService settingSiteStructureSurvival RateSystemTestingTimeVisualWorkacute carebasebehavioral outcomebiomedical informaticsburnoutcardiovascular emergencycare deliverycare systemsclinical centerclinical practicecompliance behaviordata exchangedesigneffective interventioneffectiveness testingemergency settingsevidence baseexperiencefield studyimplementation evaluationimplementation outcomesimplementation researchimplementation scienceimprovedimproved outcomemulti-component interventionpragmatic trialpreventprofessional atmosphereprogramsprovider adherenceprovider behaviorrandomized trialservice interventionservice providerssuccesstheoriestooltrial designuptakeuser centered designwasting
项目摘要
ABSTRACT
Nearly 28 million prehospital emergency medical services (EMS) ambulances runs occur annually for patients
with cardiovascular emergencies. The American Heart Association recognizes the value of EMS in the Chain
of Survival yet the inclusion of EMS necessitates logistically challenging communication amongst multiple
organizations. Often, prehospital providers are unaware of their own practice patterns and patient outcomes
wasting valuable opportunities to learn from experience while inadvertently reinforcing suboptimal care.
Providing feedback on clinical practice and patient outcomes is a simple and effective intervention that has
been challenging to scale. We will use human factors engineering principles (user-centered design) to develop,
refine, and implement a scalable feedback system we call “PORTAL.” PORTAL uses automated audit and
feedback, non-financial incentives, and local champions to examine the impact on provider behavior through
the performance of guideline compliant care in the setting of cardiovascular emergencies.
This application describes a mixed-methods proposal that addresses major NHLBI priorities to improve patient
health through the development and refinement of the PORTAL feedback system for EMS providers delivering
acute cardiovascular emergency care to patients with chest pain. The Specific Aims are: 1) Examine the
determinants of guideline compliance amongst EMS providers and stakeholders; 2) Refine the visual interface
for automated EMS feedback through user-centered design; and 3) Examine the feasibility and refine the
implementation of the PORTAL intervention to support a subsequent trial testing the effectiveness of the
feedback intervention.
The team is uniquely qualified to accomplish these Aims, with expertise in care transitions, healthcare
operations research, biomedical informatics, human factors engineering, implementation science, pragmatic
trial design, qualitative methods, and acute care medicine. The institutional environment at Vanderbilt
University Medical Center is outstanding, including the Center for Clinical Quality and Implementation
Research (CCQIR), nationally ranked graduate programs in the relevant fields of study; and the national CTSA
coordinating center.
This application will develop an automated feedback system for prehospital providers treating patients with
suspected cardiovascular emergencies. Taking a user-centered approach by placing the EMS provider at the
center of the design process will substantially advance the ability to enhance provider activities through the
delivery of scalable feedback using provider and stakeholder input. Advancing the delivery of prehospital
provider feedback creates a mechanism to improve the quality and safety of prehospital care through the
enhanced uptake of guideline compliant care. We propose this work in preparation for a cluster randomized
trial evaluating the impact on provider behavior and patient outcomes.
摘要
每年有近2800万辆院前紧急医疗服务(EMS)救护车为患者提供服务
有心血管急症。美国心脏协会认识到EMS在产业链中的价值
然而,包括EMS在内的EMS需要在多个
组织。通常,院前提供者不知道他们自己的实践模式和患者结果
在不经意间加强次优护理的同时,浪费了宝贵的经验学习机会。
提供对临床实践和患者结果的反馈是一种简单而有效的干预措施,它具有
在规模方面一直具有挑战性。我们将运用人因工程原则(以用户为中心的设计)来开发,
改进并实现一个可伸缩的反馈系统,我们称之为“门户”。门户使用自动审核和
反馈、非财务激励和当地冠军企业通过以下方式检查对提供商行为的影响
符合指南的护理在心血管急诊环境中的表现。
此应用程序描述了一种混合方法提案,解决了NHLBI的主要优先事项,以改善患者
通过为EMS提供者开发和完善门户反馈系统来实现健康
胸痛患者的急性心血管急救护理。具体目标是:1)考查
EMS供应商和利益相关方遵守指南的决定因素;2)改进视觉界面
通过以用户为中心的设计提供自动化的EMS反馈;以及3)研究可行性并完善
实施门户干预,以支持随后的试验,测试
反馈干预。
该团队是唯一有资格实现这些目标的团队,拥有护理过渡、医疗保健等方面的专业知识
运筹学、生物医学信息学、人因工程学、实施学、实用学
试验设计、定性方法和急性护理医学。范德比尔特的制度环境
大学医学中心是杰出的,包括临床质量和实施中心
研究(CCQIR),相关研究领域的国家排名的研究生课程;以及国家CTSA
协调中心。
这个应用程序将为院前提供者开发一个自动反馈系统,用于治疗患有
疑似心血管急症。采取以用户为中心的方法,将EMS提供商放在
设计流程的中心将大大提高通过以下方式增强提供商活动的能力
使用提供商和利益相关者的意见提供可扩展的反馈。积极推进院前接生
提供者反馈创建了一种机制,通过
加强了对指南合规护理的接受。我们提出这项工作是为了准备一个随机化的集群
试验评估对提供者行为和患者结果的影响。
项目成果
期刊论文数量(0)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
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Michael J. Ward其他文献
Potentially avoidable Inter-Facility transfer from Veterans Health Administration emergency departments: A cohort study
- DOI:
10.1186/s12913-020-4956-6 - 发表时间:
2020-02-12 - 期刊:
- 影响因子:3.000
- 作者:
Nicholas M. Mohr;Chaorong Wu;Michael J. Ward;Candace D. McNaughton;Kelly Richardson;Peter J. Kaboli - 通讯作者:
Peter J. Kaboli
Endogenous pre-stimulus activity modulates category tuning in ventral temporal cortex and influences perceptual behavior
内源性刺激前活动调节腹侧颞叶皮层的类别调整并影响感知行为
- DOI:
10.32470/ccn.2018.1079-0 - 发表时间:
2018 - 期刊:
- 影响因子:0
- 作者:
Yuanning Li;Michael J. Ward;Mark Richardson;M. G'Sell;A. Ghuman - 通讯作者:
A. Ghuman
An Asymptotic Analysis of Spike Self-Replication and Spike Nucleation of Reaction-Diffusion Patterns on Growing 1-D Domains
- DOI:
10.1007/s11538-025-01418-0 - 发表时间:
2025-02-24 - 期刊:
- 影响因子:2.200
- 作者:
Chunyi Gai;Edgardo Villar-Sepúlveda;Alan Champneys;Michael J. Ward - 通讯作者:
Michael J. Ward
Logarithmic Expansions and the Stability of Periodic Patterns of Localized Spots for Reaction–Diffusion Systems in $${\mathbb {R}}^2$$
- DOI:
10.1007/s00332-014-9206-9 - 发表时间:
2014-05-02 - 期刊:
- 影响因子:2.600
- 作者:
David Iron;John Rumsey;Michael J. Ward;Juncheng Wei - 通讯作者:
Juncheng Wei
Synchronous oscillations for a coupled cell-bulk ODE–PDE model with localized cells on $${\mathbb {R}}^2$$
- DOI:
10.1007/s10665-021-10113-7 - 发表时间:
2021-03-14 - 期刊:
- 影响因子:1.400
- 作者:
Sarafa A. Iyaniwura;Jia Gou;Michael J. Ward - 通讯作者:
Michael J. Ward
Michael J. Ward的其他文献
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{{ truncateString('Michael J. Ward', 18)}}的其他基金
Elucidating Non-Routine Events Arising from Interhospital Transfers
阐明院间转移引起的非常规事件
- 批准号:
10749448 - 财政年份:2023
- 资助金额:
$ 34.6万 - 项目类别:
PORTAL: Patient Outcome Reporting Tool for emergency medicAL services
门户网站:紧急医疗服务的患者结果报告工具
- 批准号:
10653774 - 财政年份:2021
- 资助金额:
$ 34.6万 - 项目类别:
PORTAL: Patient Outcome Reporting Tool for emergency medicAL services
门户网站:紧急医疗服务的患者结果报告工具
- 批准号:
10475726 - 财政年份:2021
- 资助金额:
$ 34.6万 - 项目类别:
Examining the role of insurance in inter-facility transfer for patients with ST-elevation myocardial infarction
探讨保险在 ST 段抬高型心肌梗死患者跨机构转运中的作用
- 批准号:
9813173 - 财政年份:2019
- 资助金额:
$ 34.6万 - 项目类别:
Enhancing Inter-Facility Transfer for Patients with Acute Myocardial Infarction
加强急性心肌梗死患者的机构间转运
- 批准号:
9198263 - 财政年份:2016
- 资助金额:
$ 34.6万 - 项目类别:
Enhancing Inter-Facility Transfer for Patients with Acute Myocardial Infarction
加强急性心肌梗死患者的机构间转运
- 批准号:
9405604 - 财政年份:2016
- 资助金额:
$ 34.6万 - 项目类别:
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