权益分类	功能权益	普通用户	{{item.name}}会员
{{category.name}}	{{benefitItem.name}}

Building Better Interdisciplinary Pain Teams Across Disciplines

建立更好的跨学科跨学科疼痛团队

基本信息

批准号：
10595508
负责人：
Karleen Frances Giannitrapani
金额：
--
依托单位：
VETERANS ADMIN PALO ALTO HEALTH CARE SYS
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-01-01 至 2026-12-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10595508
关键词：
Address Affect Award Behavior Binding Caring Clinical Cluster randomized trial Collaborations Complex Dimensions Discipline Education Elements Emotional Empirical Research Ensure Epidemic Evaluation Exhibits Future Goals Homogeneously Staining Region Intervention Interview Leadership Learning Literature Logic Mediation Medicine Mentors Mentorship Methodology Methods Modeling Opioid Pain Pain management Patient Care Patients Perception Pharmacists Positioning Attribute Practical Robust Implementation and Sustainability Model Primary Care Process Production Provider Randomized Randomized, Controlled Trials Reaction Time Research Resources Role Scientist Site Specialist Structure Team Process Techniques Testing Thinking Training Twin Multiple Birth Veterans Work academic preparation acceptability and feasibility arm base career career networking chronic pain chronic pain management clinical care design experience implementation science improved innovation insight interdisciplinary approach intervention mapping novel novel strategies opioid tapering opioid use pilot test primary care patient primary care setting primary care team process improvement programs randomized controlled design randomized trial randomized, controlled study recruit scaffold skills social systematic review theories therapy design therapy development treatment arm treatment as usual trial design user centered design

项目摘要

Background: Chronic pain disproportionately affects Veterans and is often managed in VA primary care. Because chronic pain may exhibit physical, emotional, social, and existential dimensions, individualized, interdisciplinary approaches are clinically important. Various pain team models have been implemented in diverse clinical settings, and some are effective. However, to meet the complex needs of specific patients, pain teams often benefit from dynamic membership and different providers (e.g., pharmacist) fulfilling specific roles or tasks (e.g., opioid tapering). The providers who come together around one patient may or may not work together regularly or in the same combinations on other patients. In fact, dynamic teams and bounded teams often overlap. Compared with bounded teams, dynamic teaming, which I refer to hereafter as “teaming”, is a more complex process with a smaller empiric research base. Whether teams are bounded or dynamic (and often they have elements of both), they need to coordinate/negotiate and understand their mutual roles and role boundaries to serve patients effectively. Facilitating “teaming”, through establishing scaffolds, represents a strategy for organizing providers with dynamic membership around shared patient care goals. Significance/Impact: Developing a “teaming” intervention to facilitate collaboration around the numerous tasks involved in providing good and safe pain management is particularly timely as it aligns with the VA ORD clinical priorities. This work will be done in partnership with Veterans, providers, and operational leaders from the national pain program office to ensure alignment with VA pain and opioid initiatives. Innovation: The proposed intervention will create team scaffolds and a teaming facilitation process for interdisciplinary providers that participate in pain care tasks. The integration of organizational theory and co- design principals and strategies to produce and test a teaming intervention represents a novel approach for improving processes of pain care in the VA. Specific Aims: This proposal seeks to address scientific gaps through three projects. AIM1: Identify roles, structures and processes of interdisciplinary providers involved in primary care based chronic pain management. AIM2: Co-design an intervention to improve interdisciplinary “teaming” with VA providers and Veterans. AIM3: Pilot test the feasibility and acceptability of a teaming intervention for improved pain management at one site. Methodology: To yield insights on teams, teamwork and teaming and AIM3 study features for trial design, AIM1a will complete a systematic review of randomized controlled trials of chronic pain care in primary care settings. To characterize the concept of dynamic teaming and garner insights on teaming for chronic pain in PACTs, 1b will use semi-structured interviews to explore experiences and perceptions of PACT providers, pharmacists, pain specialists, non-pharmacologic providers, and supervisors/leadership (n=45). Building on AIM1 insights and principles and processes of co-design, I will build a logic model 1) of the problem and 2) for the desired change. I will conduct 3) theory-based design and 4) intervention production with providers and Veterans, followed by 5) implementation planning with the practical, robust implementation and sustainability Model (PRISM), and 6) evaluation planning. Patients (n=30) and interdisciplinary PACT teams (n=10) involved in “teaming” around chronic pain management at the VA Palo Alto will be recruited for the pilot of an intervention arm to inform feasibility and acceptably of a subsequent randomized trial. Following this pilot work, I will apply for an HSR&D IIR to conduct a two-arm cluster randomized trial (usual pain processes vs. “teaming” intervention). Implementation/Next Steps: Through the successful execution of this work, we will be prepared to submit a VA HSR&D merit award application for a fully powered trial of the “teaming” intervention in comparison to usual care. The co-design process and resultant teaming intervention will serve as a model to develop strategies to support clinicians teaming in a diverse array of VA settings.

背景：慢性疼痛不成比例地影响退伍军人，并且经常在VA初级保健中进行管理。

项目成果

期刊论文数量（14）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Meeting high-risk patient pain care needs through intensive primary care: a secondary analysis.

DOI：
10.1136/bmjopen-2023-080748
发表时间：
2024-01-02
期刊：
BMJ open
影响因子：
2.9
作者：
通讯作者：

Interdisciplinary interventions that improve patient-reported outcomes in perioperative cancer care: A systematic review of randomized control trials.

DOI：
10.1371/journal.pone.0294599
发表时间：
2023
期刊：
PLOS ONE
影响因子：
3.7
作者：
Maheta, Bhagvat J.;Singh, Nainwant K.;Lorenz, Karl A.;Fereydooni, Sarina;Dy, Sydney M.;Wong, Hong-nei;Bergman, Jonathan;Leppert, John T.;Giannitrapani, Karleen F.
通讯作者：
Giannitrapani, Karleen F.

Facilitators of palliative care quality improvement team cohesion: Lessons from a seven-site implementation project in India.

姑息治疗质量改进团队凝聚力的促进者：印度七个地点实施项目的经验教训。

DOI：
10.1097/hmr.0000000000000368
发表时间：
2023
期刊：
Health care management review
影响因子：
2.5
作者：
Connell,NatalieB;Zupanc,SophiaN;Lorenz,KarlA;Bhatnagar,Sushma;Fereydooni,Soraya;Gamboa,RazielC;Ganesh,Archana;Satija,Aanchal;Singh,Nainwant;Spruijt,Odette;Giannitrapani,KarleenF
通讯作者：
Giannitrapani,KarleenF

Qualitative interview study of strategies to support healthcare personnel mental health through an occupational health lens.

定性访谈研究研究了通过职业健康镜头支持医疗人员心理健康的策略。