Implementing Research Findings for Practice Improvement

描述(由申请人提供)：背景：杜克大学初级保健研究联盟(PCRC)成立于1997年，是一个初级保健研究网络，由杜克大学卫生系统、达勒姆退伍军人事务医学中心和周边社区的学术和社区实践组成。PCRC总共为185名家庭医生、内科医生和儿科医生提供服务，他们在成人和儿科研究中进行合作。PCRC由23个诊所组成，29个地点位于北卡罗来纳州皮埃蒙特地区的8个县。我们的使命是参与将改善医疗保健提供和患者结果的研究，并产生支持循证医学实践的结果。杜克PCRC正在申请这两类发展资金。 第一类，基础设施项目：杜克大学PCRC的目标是建立基础设施，将研究转化为杜克大学卫生系统内的初级保健实践。这将需要(1)规划循证护理的实施，包括衡量组织、提供者和患者的准备情况；(2)探索临床医生之间的沟通方法，并传播和实施研究结果；(3)开发和测试用于收集医生和患者数据的手持设备。 第二类，试点研究项目：杜克PCRC计划实施一个实践改进项目，评估在初级保健实践中遵循的哮喘患者的流感疫苗接种率。美国肺脏协会哮喘研究中心最近发表了一项交叉研究，证明了流感疫苗对哮喘患者的安全性。我们的目标是(1)确定哮喘患者接种流感疫苗的组织和患者障碍，(2)随机选择患者传播研究结果，以及(3)为改善哮喘患者的免疫接种而量身定做的干预措施。主要结果是流感免疫接种率，通过流感疫苗临床程序代码的比例和患者自我报告来衡量。虽然重点是哮喘患者的免疫接种，但干预措施的工具箱应该适用于其他高危儿童和成人人群，包括少数群体和服务不足的人群。这一试点项目旨在衡量流感免疫方面的翻译工作的影响，未来的目标是扩大到更多的预防性健康行为(其他疫苗、筛查方式)，并扩大到慢性疾病的循证管理。

DESCRIPTION (provided by applicant): Background: The Duke Primary Care Research Consortium (PCRC) was established in 1997 as a primary care research network composed of academic and community practices within the Duke University Health System, the Durham Veterans Affairs Medical Center, and surrounding communities. The PCRC serves a total of 185 family practitioners, internists, and pediatricians who collaborate in adult and pediatric studies. The PCRC consists of 23 practices with 29 sites located in eight counties of the Piedmont area of North Carolina. Our mission is to participate in studies that will improve health care delivery and patient outcomes, plus generate findings to support the practice of evidence-based medicine. The Duke PCRC is applying for both categories of developmental funding. Category I, Infrastructure Project: The goal of the Duke PCRC is to build the infrastructure for translation of research into the primary care practices within the Duke Health System. This will entail (1) planning for implementation of evidence-based care, including the measurement of organizational, provider, and patient readiness; (2) exploration of methods for communication among clinicians and the dissemination and implementation of research findings; and (3) the development and testing of handheld devices for collecting physician and patient data. Category II, Pilot Research Project: Duke PCRC plans to implement a practice improvement project assessing the rates of influenza immunization in asthma patients followed within the primary care practices. The American Lung Association Asthma Research Centers recently published a crossover study demonstrating the safety of influenza vaccine for asthmatics. Our goal is to (1) identify the organizational and patient barriers to influenza immunization of asthma patients, (2) randomize patients to dissemination of the research findings, and (3) tailor interventions to improve immunization of asthma patients. The primary outcome is the rate of influenza immunization, measured by the proportion of clinic procedure codes for influenza vaccine and though patient self-report. While the focus is immunization of asthma patients, the toolbox of interventions should be applicable to other high-risk pediatric and adult populations, including minority and underserved populations. This pilot project aims to measure the impact of translation efforts in influenza immunization, with the future goal for expansion into additional preventive health behaviors (other vaccines, screening modalities) and expansion into evidence-based management of chronic illnesses.