A novel implementation and social network strategy for acute pulmonary illnesses

描述（由申请人提供）：该职业发展奖将为Curtis韦斯博士提供机会，使其成为一名独立研究人员，利用实施科学和复杂网络分析将研究转化为临床实践，并改善急性肺部疾病患者的护理。由于将循证创新转化为临床实践的无效系统以及对临床医生如何学习和采用新疗法缺乏了解，目前的实施模式是有限的。韦斯博士将利用这一奖项，以加强他在实施科学和复杂网络分析的新技能现有的技能。这些技能将使他能够研究新的实施方法，以及临床医生如何学习和采用循证创新的更好模型。他将通过职业发展计划实现这些职业目标，该计划包括正式的课程，密集的指导和以患者为导向的研究。他的主要导师是大卫贝克博士，他是实施科学方面的专家，拥有多项国家卫生研究院的赠款和出色的指导记录。他的共同导师包括实施科学（Stephen Persell博士），复杂网络分析（霍华德休斯医学研究所早期职业科学家Luis Amaral博士）和ALI，急性呼吸衰竭和重症监护结果（Richard Wunderink博士）的专家。这将在西北大学和合作临床研究中心完成。西北大学提供来自肺部和重症监护医学科和内科的专业支持; 2）他的多学科导师团队; 3）与他的职业发展相关的众多课程和专业互动，包括西北临床和转化科学研究所和西北复杂系统研究所; 4）研究基础设施，包括生物信息学支持，以设计和实施电子健康记录干预措施，以及机构电子数据收集计划和生物统计支持;以及5）广泛的 临床基础设施。韦斯博士与1）研究策略的总体目的是使用实施科学和复杂网络分析来研究实施肺保护性通气和清醒和呼吸控制（ABC）脱机的综合策略，分别改善急性肺损伤（ALI）和急性呼吸衰竭患者的护理。该研究将在一家学术医院和几家社区医院进行。具体目标一将确定这两种疗法的当前使用率，并将这些使用率与医生、护士和呼吸治疗师（提供者）对这些疗法的知识和态度联系起来。具体目标二将使用复杂的网络分析，以确定在每个机构的供应商意见领袖。具体目标三将是一项临床试验，确定与常规护理相比，由意见领袖学习协作、电子警报和提醒以及审计和反馈组成的多方面、多学科干预是否会增加低潮气量通气和ABC脱机的实施率。

DESCRIPTION (provided by applicant): This career development award will provide Dr. Curtis Weiss the opportunity to develop as an independent researcher of translating research into clinical practice using implementation science and complex network analysis, and to improve the care of patients with acute pulmonary diseases. The current paradigm of implementation is limited because of an ineffective system of translating evidence-based innovations into clinician practice and a lack of understanding about how clinicians learn about and adopt new therapies. Dr. Weiss will use this award to enhance his existing skills with new skills in implementation science and complex network analysis. These skills will allow him to investigate new implementation methods and a better model of how clinicians learn about and adopt evidence-based innovations. He will achieve these career goals through a career development plan that consists of formal coursework, intensive mentorship, and patient-oriented research. His primary mentor is Dr. David Baker, an expert in implementation science with multiple active NIH grants and an outstanding record of mentoring. His co-mentors include experts in implementation science (Dr. Stephen Persell), complex network analysis (Dr. Luis Amaral, a Howard Hughes Medical Institute Early Career Scientist), and ALI, acute respiratory failure, and critical care outcomes (Dr. Richard Wunderink). This will be accomplished at Northwestern University and collaborating clinical sites. Northwestern provides dedicated support from the Division of Pulmonary and Critical Care Medicine and Department of Internal Medicine; 2) his multidisciplinary team of mentors; 3) numerous courses and professional interactions relevant to his career development, including the Northwestern Clinical and Translational Sciences Institute and the Northwestern Institute on Complex Systems; 4) research infrastructure that includes bioinformatics support to design and implement an electronic health record intervention, as well as an institutional electronic data collection program and biostatistical support; and 5) extensive clinical infrastructure. Dr. Weiss with 1) The overall purpose of the research strategy is to use implementation science and complex network analysis to investigate a comprehensive strategy that implements lung protective ventilation and Awake and Breathing Controlled (ABC) weaning, improving the care of patients with acute lung injury (ALI) and acute respiratory failure, respectively. The study will be conducted at one academic and several community hospitals. Specific Aim One will determine the current rate of utilization of these two therapies and link these rates with physician, nurse, and respiratory therapist (provider) knowledge and attitudes about these therapies. Specific Aim Two will use complex network analysis to identify provider opinion leaders at each institution. Specific Aim Three will be a clinical trial that determines whether a multi-faceted, multidisciplinary intervention comprised of opinion leader learning collaboratives, electronic alerts and reminders, and audit and feedback increases implementation rates of low tidal volume ventilation and ABC weaning compared to usual care.