The Role of Hearing Loss in Health Care Outcomes.

摘要 这是尼古拉斯·里德博士的K23指导患者导向职业发展奖的申请表 他最近加入了约翰斯医院耳鼻咽喉头颈外科的教职 担任霍普金斯大学医学院助理教授。拟议项目的目标是 为候选人提供启动独立研究项目所需的高级培训和技能 检查老年人的听力损失和医疗保健结果。为了促进这一目标，候选人有 组建了一个拥有流行病学专业知识的多学科指导和协作团队， 生物统计学、实施学、老年学、卫生系统和政策、护理、精神错乱和听力 损失。他提出了一个全面的训练计划，包括课程作业、观察、实践训练、 参与研讨会、研讨会和工作组，以及临床领域的建设性研究会议 以及约翰·霍普金斯大学、哈佛大学、印第安纳大学、 加州、旧金山和匹兹堡大学。该组织的具体培训和发展目标 奖项包括：(1)在试验设计、流行病学和生物统计学方法方面的指导 拟议研究，(2)老龄研究和老年保健方面的培训，特别强调 关于对概念模型、测量和干预的理解，(3)指导 应用于健康的实施科学方法论、过程评估和结果研究 改善老年人护理质量的系统举措，(4)继续培训负责的老年人 开展研究，重点考虑以临床实践为基础的研究；(5)发展 以及提交建立在方法学基础上的R01拨款申请，初步 该职业发展奖的证据、出版物和合作。拟开展这方面的研究 职业发展奖针对被忽视的听力损失对医疗保健结果的影响，并 寻求改进方法来解决医疗保健系统中的听力损失问题。具体目标是(1) 调查听力损失、沟通障碍和助听器使用与健康之间的关系 老年人的护理结果，如30天再入院、住院时间和住院时间，(2)特征 有听力损失和无听力损失的住院老年人中精神错乱的发生率，以及(3)改进和评估 实施听力损失综合筛查和干预的可行性和可接受性 改善住院环境中护理结果的计划。在此职业发展结束时 获奖后，候选人将拥有独立竞争的技能、专业知识和初步证据 资助研究并设计和执行翻译研究，解决整个健康领域的听力损失问题 可以塑造数百万听力损失老年人的病人护理的护理系统。

ABSTRACT This is an application for a K23 Mentored Patient-Oriented Career Development Award for Dr. Nicholas Reed who recently joined the faculty of the Department of Otolaryngology-Head & Neck Surgery at the Johns Hopkins University School of Medicine as an Assistant Professor. The goal of the proposed project is to provide the candidate with the advanced training and skills to launch an independent research program examining hearing loss and health care outcomes among older adults. To facilitate this goal, the candidate has assembled a multidisciplinary mentorship and collaboration team with expertise that spans epidemiology, biostatistics, implementation science, gerontology, health systems and policy, nursing, delirium, and hearing loss. He proposes a comprehensive training plan that consists of coursework, observation, practical training, engagement in seminars, workshops, and working groups, and constructive research meetings across clinical and academic centers at Johns Hopkins University, Harvard University, Indiana University, University California, San Francisco, and University of Pittsburgh. The specific training and development goals of this Award include: (1) instruction in trial design, epidemiology, and biostatistics methodology to apply in the proposed research, (2) training in aging research and gerontologic care considerations with specific emphasis on understanding conceptual models, measurement of, and interventions for delirium, (3) guidance in implementation science methodology, process evaluation, and outcomes research as they apply to health systems initiatives to improve quality of care among older adults, (4) continued training in the responsible conduct of research with emphasis on considerations for clinical practice-based research, and (5) development and submission of an R01 grant application that builds upon the methodologic foundation, preliminary evidence, publications, and collaborations from this Career Development Award. The proposed research of this Career Development Award addresses the overlooked influence of hearing loss on health care outcomes and seeks to refine methods to address hearing loss in the health care system. The specific goals are to (1) investigate the association between hearing loss, communication impairment, and hearing aid use with health care outcomes such as 30-day readmission, length of stay, and hospitalization in older adults, (2) characterize incidence of delirium among hospitalized older adults with and without hearing loss, and (3) refine and assess the feasibility and acceptability of implementing a comprehensive hearing loss screening and intervention program to improve care outcomes in the inpatient setting. At the conclusion of this Career Development Award, the candidate will have the skills, expertise, and preliminary evidence to be competitive for independent research funding and design and execute translational research addressing hearing loss throughout the health care system that could shape patient-care for the millions of older adults with hearing loss.