A Decision Support Tool for Adult Sickle Cell Emergency Department Patients

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DESCRIPTION (provided by applicant): The applicant is a Research Assistant Professor in Emergency Medicine at Northwestern University. The applicant's long-term goal is to become an independent investigator with a primary focus on improving the care for persons with Sickle Cell disease (SCO) in the emergency department (ED) setting. Acute pain episodes are the most frequent complication associated with SCD. These painful episodes are severe and often require care in the emergency department (ED) setting. ED clinicians frequently perceive persons with SCD to be drug seeking and patients often perceive the ED experience as frustrating. Some patients with SCD also have complex co-morbidities and bio-psycho-social needs that may contribute to frequent ED visits. Clinicians are often unprepared to manage the acute pain in the ED setting for persons with SCD and are not trained in how to perform an adequate bio-psycho-social assessment that would identify individual patient education and referral needs upon ED discharge. Identification of these needs may lead to improved care and decreased return ED visits when provided with proper referrals. The goal of this project is to develop and pilot test a bio-psycho-social decision support tool (the Sickle Cell Assessment of Needs and Strengths, SCANS) to be used by emergency clinicians. The SCANS will 1) objectively assess and guide ED analgesic management and 2) identify education and referral service delivery needs for adult patients with SCD. The SCANS will be beneficial to both emergency clinicians and patients with SCD, in particular for patients with complex needs that currently may result in frequent ED visits. Under the mentorship of established investigators in the areas of hematology, emergency medicine pain management, psychometrics and addiction the candidate proposes a career development program that addresses the applicants' long- term goal of becoming an independent investigator. Primary goals of the proposed training are to 1) increase knowledge in SCD, 2) gain an in-depth understanding of the complex relationship between addiction and pain, and 3) receive training in qualitative and decision support tool development methodologies. This knowledge will position the candidate to launch a research career as an investigator who will conduct projects aimed at scientifically evaluating mechanisms to improve the care of persons with SCD in the ED setting.