Organizational strategies for improving evidence-uptake in intensive care

摘要 近几十年来，多项备受瞩目的临床试验为 护理需要机械通气的急性呼吸衰竭患者。然而，许多患者仍然 不要接受这些被证明可以拯救生命的循证治疗。我们的首要目标是 研究方案就是通过界定ICU组织之间的关系来解决这一问题 重症监护中的行为和证据收集。从快速发展的组织领域中剥离 心理学、决策科学和生物医学信息学，我们将广泛研究 ICU团队成员的互动行为既能促进效率又能阻碍效率 将证据转化为实践。我们将推行三条综合和互补的路线 研究：(1)开发和完善衡量危重护理绩效的新策略；(2) 研究集体智力和交互记忆作为关键社会学中介的作用 (3)提高新型决策支持工具的价值，如 作为检查表和电子提示使用循证做法。要执行此操作，请执行 我们将利用与州和地区卫生系统的现有合作以及 首席调查员的专业知识，一位具有15年以上研究经验的内科科学家 ICU组织与危重病患者预后之间的联系。共同努力，我们的结果 将为医院和临床医生提供创新工具，以提高重症监护性能 全国范围内，直接导致急性呼吸衰竭和其他疾病患者预后的改善 各种形式的危重疾病。

ABSTRACT In recent decades multiple high-profile clinical trials have provided a rigorous evidence base for the care of patients with acute respiratory failure requiring mechanical ventilation. Yet many patients still do not receive these evidence-based treatments proven to save lives. The overarching goal of our research program is to address this issue by defining the relationship between ICU organizational behavior and evidence-uptake in critical care. Drawing off the rapidly evolving fields of organizational psychology, decision science, and biomedical informatics, we will broadly investigate the ways in which the interactive behaviors of the ICU team members can both facilitate and hinder efficient translation of evidence into practice. We will pursue three integrated and complimentary lines of research: (1) developing and refining novel strategies for measuring critical care performance; (2) investigating the role of collective intelligence and transactive memory as key sociological mediators of evidence-uptake in critical care; and (3) improving the value of novel decisional support tools such as checklists and electronic prompting for the use of evidence-based practice. To perform this research we will leverage existing collaborations with state and regional health systems as well as the expertise of the principal investigator, a physician-scientist with over 15 years’ experience studying the link between ICU organization and outcome for patients with critical illness. Together, our results will provide hospitals and clinicians with innovative tools for improving critical care performance on a national scale, directly leading improved outcomes for patients with acute respiratory failure and other forms of critical illness.