Using Digital Solutions to Improve Transition of Care for Patients with Acute Kidney Injury

标题：使用数字解决方案改善急性肾损伤患者的护理过渡 建议的指导性患者导向职业发展奖（K23）的总体目标是 制定一个急性肾损伤（阿基）研究计划，利用行为科学原理和数字 健康解决方案，促进吴博士发展成为一名独立的研究人员。 阿基是一种肾功能突然下降的疾病，发生在16-25%的住院患者中。如果未解决阿基 在护理从医院过渡到门诊的过程中，患者有复发阿基的风险， 再次住院实现阿基护理的最佳过渡是具有挑战性的，因为阿基信息很少， 与门诊提供者和患者沟通。门诊提供者无法解决阿基 在不了解患者阿基状态的情况下，他们无法监测并发症，也无法监测肾功能。此外，患者 缺乏阿基的知识和自我管理技能（例如，遵循肾脏特定的饮食限制或避免 对肾脏有害的药物）。为了改善阿基信息流向提供者和患者，候选人 建议调整和评价：1）出院总结的阿基部分; 2）文本的可行性 支持患者教育和自我管理的信息。具体目标是：（a）调整现有的 出院总结，包括阿基信息和测试可用性; 1b）设计和调整文本消息， 阿基管理和教育工具（AKI-MET）; 2）评估可行性、可接受性和初步 在2项连续的先导性RCT中评估干预成分的疗效。 吴博士在宾夕法尼亚大学完成了临床流行病学硕士学位， 她获得了流行病学、生物统计学和研究设计方面的经验。她以前的训练和 在阿基流行病学研究和定性研究方面的经验使她准备从事这项工作 在研究中提出。吴博士将利用这一奖项，在世界各地开展独立的研究事业。 丰富的研究和培训环境在霍夫斯特拉/诺斯韦尔医学院的扎克。通过她 建议的职业发展，她寻求获得技能：1）健康信息技术的应用， 数字健康干预; 2）行为科学和行为干预设计; 3）RCT设计，实施， 和分析，包括试点试验的纵向数据分析;和4）专业发展。伍博士 成立了一个由该领域专家领导的多学科导师小组。在完成这些K23 活动，她将有能力提交R 01进行更大规模的RCT，以评估阿基的有效性 改善健康结果的过渡护理工具。

Title: Using Digital Solutions to Improve Transition of Care for Patients with Acute Kidney Injury The overarching objective of the proposed mentored patient-oriented career development award (K23) is to develop an acute kidney injury (AKI) research program that utilizes behavioral science principles and digital health solutions, fostering Dr. Ng’s development to an independent researcher. AKI, a sudden decline in kidney function, occurs in 16-25% of hospitalized patients. If AKI is not addressed during the transition of care from the hospital to outpatient setting, patients are at risk for recurrent AKI and rehospitalization. Achieving optimal transition of care for AKI is challenging, because AKI information is poorly communicated both to outpatient providers and patients. Outpatient providers cannot address AKI complications nor monitor kidney function, when they are unaware of patient’s AKI status. Additionally, patients lack the knowledge and self-management skills for AKI (e.g., follow kidney-specific dietary restrictions or avoid medications harmful to the kidneys). To improve AKI information flow to providers and patients, the candidate proposes to adapt and evaluate: 1) an AKI section for discharge summary; and 2) the feasibility of a text messages to support patient education and self-management. The Specific Aims are: 1a) adapt existing discharge summary to include AKI information, and test usability; 1b) design and adapt text messages for an AKI management and education tool (AKI-MET); and 2) evaluate the feasibility, acceptability, and preliminary efficacy of intervention components in a 2 sequential pilot RCTs. Dr Ng has completed a master’s degree in clinical epidemiology at the University of Pennsylvania, through which she gained experience in epidemiology, biostatistics, and study design. Her previous training and experience in AKI epidemiology research and qualitative research have prepared her to engage in the work proposed in the studies. Dr Ng is positioned to use this award to launch an independent research career in the rich research and training environment at the Zucker School of Medicine at Hofstra/Northwell. Through her proposed career development, she seeks to gain skills in: 1) application of health information technology and digital health intervention; 2) behavioral science and behavioral intervention design; 3) RCT design, conduct, and analysis, including longitudinal data analysis from the pilot trial; and 4) professional development. Dr. Ng has assembled a multi-disciplinary mentorship team led by experts in the field. Upon completion of these K23 activities, she will be well-positioned to submit an R01 for a larger RCT to assess the effectiveness of AKI transition-of-care tool in improving health outcomes.