Implementing Research Findings for Practice Improvement

描述（由申请人提供）：背景：杜克初级保健研究联盟（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疗中心和周边社区的学术和社区实践组成。 PCRC共有185名家庭医生，内科医生和儿科医生，他们在成人和儿科研究中合作。 PCRC包括23个实践与29个地点位于八个县的皮埃蒙特地区的北卡罗来纳州。 我们的使命是参与研究，这将改善医疗保健服务和病人的结果，加上产生的结果，以支持实践的循证医学。 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PCRC的目标是建立基础设施，将研究转化为杜克卫生系统内的初级保健实践。 这将需要（1）规划实施循证护理，包括测量组织、提供者和患者的准备程度;（2）探索临床医生之间的沟通方法，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计划实施一项实践改进项目，评估在初级保健实践中哮喘患者的流感免疫接种率。 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）确定组织和患者对哮喘患者流感免疫接种的障碍，（2）随机分配患者以传播研究结果，（3）定制干预措施以改善哮喘患者的免疫接种。 主要结果是流感疫苗接种率，通过流感疫苗的临床程序代码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，但干预措施工具箱应适用于其他高危儿童和成人人群，包括少数民族和服务不足的人群。 该试点项目旨在衡量流感免疫转化工作的影响，未来的目标是扩展到其他预防性健康行为（其他疫苗，筛查方式），并扩展到慢性病的循证管理。

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.