Enhancing Quality in Pediatrics Sepsis with Shock Prediction and Early Electronic Decision Support (EQUIP with SPEED)

通过电击预测和早期电子决策支持 (EQUIP with SPEED) 提高儿科脓毒症治疗质量

• 批准号: 10457306
• 负责人: Halden F Scott
• 金额: $ 14.85万
• 依托单位: UNIVERSITY OF COLORADO DENVER
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-08-01 至 2024-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10457306
• 关键词: Enhancing; Quality; Pediatrics; Sepsis; Shock

PROJECT SUMMARY / ABSTRACT Pediatric septic shock is a leading cause of childhood death, in which morbidity-free survival depends on timely diagnosis and treatment. Although the medical community, general public and state legislatures have increasingly recognized that delays in diagnosing septic shock in children are an important cause of preventable morbidity, there are no validated predictive models to improve early sepsis diagnosis in children. The candidate, Dr. Halden Scott, is a pediatric emergency physician at Children's Hospital Colorado and the University of Colorado School of Medicine. She has critically evaluated early diagnostic strategies in an Electronic Health Record (EHR)-derived pediatric sepsis registry that she designed that will support the proposed research. She is seeking to develop into an independent health services researcher, through the proposed mentored research with the following goals: 1) Derive and test models to predict septic shock in an existing EHR-derived dataset, comparing models derived with two modern modeling techniques; 2) create an EHR decision support tool for the early recognition of septic shock; 3) conduct a pilot implementation trial of decision support in community and academic pediatric emergency care settings within the Children's Hospital Colorado network. This implementation and feasibility data will inform a future multicenter pragmatic trial of computerized decision support in diagnosis of pediatric septic shock, which Dr. Scott will propose in an R01 application before the end of the K award. Dr. Scott's research trajectory is facilitated and enriched by strong institutional clinical, informatics and administrative support, and her involvement in the Pediatric Emergency Care Applied Research Network and international sepsis guidelines committees. This award would support Dr. Scott's career development goals: acquire skills in predictive modeling, the use of health information technology in learning health systems, and pragmatic trials. Dr. Scott's nationally renowned mentors will support these goals: Dr. Kempe, expert in pragmatic trials, program evaluation and implementation research; Dr. Fairclough, expert in statistics and modeling; Dr. Kahn, expert in research and clinical informatics. Additional advisors contribute expertise in machine learning, clinical pediatric emergency research, critical care and sepsis. This proposal responds to AHRQ priorities: improving health care quality through information systems, improving safety and quality by synthesizing evidence, and focuses on AHRQ priority populations including children and those with chronic care needs. The research, mentorship and training plan proposed are ideally suited to provide Dr. Scott with the skills needed to develop into an independent health services researcher focused on improving the quality of care for pediatric emergency conditions, particularly sepsis, through the use of health information technology in learning health systems, and conduct of pragmatic trials to test implementation of evidence-based practice in emergency settings.

项目摘要/摘要

项目成果

Development and Validation of a Model to Predict Pediatric Septic Shock Using Data Known 2 Hours After Hospital Arrival.

使用到达医院后 2 小时已知的数据开发和验证预测小儿感染性休克的模型。

• DOI: 10.1097/pcc.0000000000002589
• 发表时间: 2021
• 期刊: Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies
• 作者: Scott,HaldenF;Colborn,KathrynL;Sevick,CarterJ;Bajaj,Lalit;DeakyneDavies,SaraJ;Fairclough,Diane;Kissoon,Niranjan;Kempe,Allison
• 通讯作者: Kempe,Allison

The Legacy of Pediatric Sepsis State Legislation.

儿科败血症州立法的遗产。

• DOI: 10.1542/peds.2020-1525
• 发表时间: 2020
• 期刊: Pediatrics
• 影响因子: 8
• 作者: Scott,HaldenF;Balamuth,Fran;Alpern,ElizabethR
• 通讯作者: Alpern,ElizabethR

Thiamine in Pediatric Sepsis: A Motivating Study.

硫胺素在儿童脓毒症中的作用：一项激动人心的研究。

• DOI: 10.1097/pcc.0000000000002084
• 发表时间: 2019
• 期刊: Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies
• 作者: Scott,HaldenF

Managing Diagnostic Uncertainty in Pediatric Sepsis Quality Improvement with a Two-Tiered Approach.

使用两层方法管理儿科脓毒症质量改进的诊断不确定性。

• DOI: 10.1097/pq9.0000000000000244
• 发表时间: 2020
• 期刊: Pediatric quality & safety
• 影响因子: 1.1
• 作者: Scott,HaldenF;Kempe,Allison;DeakyneDavies,SaraJ;Krack,Paige;Leonard,Jan;Rolison,Elise;Mackenzie,Joan;Wathen,Beth;Bajaj,Lalit
• 通讯作者: Bajaj,Lalit

"These Are Our Kids": Qualitative Interviews With Clinical Leaders in General Emergency Departments on Motivations, Processes, and Guidelines in Pediatric Sepsis Care.

“这些是我们的孩子”：对普通急诊科临床领导者关于儿科败血症护理的动机、过程和指南的定性访谈。

• DOI: 10.1016/j.annemergmed.2022.05.030
• 发表时间: 2022
• 期刊: Annals of emergency medicine
• 影响因子: 6.2
• 作者: Scott,HaldenF;Kempe,Allison;Bajaj,Lalit;Lindberg,DanielM;Dafoe,Ashley;DorseyHolliman,Brooke
• 通讯作者: DorseyHolliman,Brooke