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

标题：利用数字化解决方案改善急性肾损伤患者的护理过渡 拟议的以病人为导向的导师职业发展奖(K23)的首要目标是 开发利用行为科学原理和数字技术的急性肾损伤(AKI)研究计划 健康解决方案，促进吴博士发展为独立研究人员。 AKI是一种肾功能突然下降的疾病，在16%-25%的住院患者中会发生。如果未解决AKI 在从医院到门诊的过渡期间，患者有复发AKI和 再次住院治疗。实现AKI护理的最佳过渡是具有挑战性的，因为AKI信息很差 与门诊提供者和患者进行沟通。门诊提供者无法解决AKI问题 当他们不知道患者的AKI状态时，他们也不会监测并发症或肾功能。此外，患者 缺乏AKI的知识和自我管理技能(例如，遵循针对肾脏的饮食限制或避免 对肾脏有害的药物)。为了改善对提供者和患者的AKI信息流，候选人 建议调整和评估：1)AKI一节，用于出院总结；2)案文的可行性 支持患者教育和自我管理的信息。具体目标是：1)适应现有的 发放摘要以包括AKI信息，并测试可用性；1b)设计和改编文本消息 AKI管理和教育工具(AKI-MET)；以及2)评估可行性、可接受性和初步 2个序贯飞行员随机对照试验中干预成分的有效性。 吴博士已在宾夕法尼亚大学完成临床流行病学硕士学位，通过 她在流行病学、生物统计学和研究设计方面获得了经验。她之前的训练和 在AKI流行病学研究和定性研究方面的经验为她从事这项工作做好了准备 在研究中提出的。吴博士将利用这一奖项在 在霍夫斯特拉/诺斯韦尔的扎克医学院拥有丰富的研究和培训环境。通过她 建议的职业发展，她寻求在以下方面获得技能：1)应用健康信息技术和 数字健康干预；2)行为科学和行为干预设计；3)随机对照试验设计、实施、 和分析，包括来自试点试验的纵向数据分析；以及4)专业发展。吴博士 组建了一支由该领域专家领导的多学科导师团队。在这些K23完成后 为了更好地评估AKI的有效性，她将很好地提交R01，以进行更大规模的随机对照试验 护理过渡工具在改善健康结果方面的作用。

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.