Delirium Evaluation in the Emergency Department for Seniors (DEEDS)

申请人描述(申请人提供)：申请人Michael LaMantia，医学博士，公共卫生硕士，印第安纳大学医学系普通内科和老年病学部的老年内科医生和医学助理教授。此外，他还是印第安纳大学老龄研究中心和雷根斯特里夫研究所的科学家。候选人的长期职业目标是成为一名老年病临床调查员，设计和实施护理系统，以促进和改善急诊科(ED)和其他急性护理环境中脆弱老年人的福祉。本申请中提出的研究将提供有关ED中老年人精神错乱的评估信息，这是改善这一严重情况的管理所需的。候选人的近期目标是：(1)获得在这个研究项目中取得成功所需的研究技能；(2)获得所需的背景知识，以领导在急诊护理环境中为老年人提供更好护理的系统的设计和实施；(3)进行有指导的研究项目，以评估患者、提供者和工作流程因素，这些因素影响急诊医生(EPs)对精神错乱的检测；(4)通过询问EPs来确定最有效的认知策略，以识别精神错乱；以及(5)扩大对ED确认或未确认的精神错乱患者的短期和长期结果的研究。在项目结束时，候选人将应用从这些研究中获得的数据，在他的第一份R01意见书中提出一个合乎逻辑和精心设计的干预措施，以改善对在教育部门患有精神错乱的老年人的识别和管理。职业发展计划提出课程工作、研究项目，以及由具有各种相关领域(卫生服务研究、医学社会学、急诊医学和精神错乱科学)专业知识的经验丰富的调查人员组成的团队的指导，以就拟议项目的完成提供协同建议。申请人将受益于可用于支持他完成以下工作的大量本地资源 该项目包括印第安纳大学医学院和印第安纳大学老龄研究中心；Regenstrief研究所及其广泛的Regenstrief医疗记录系统；以及印第安纳大学急诊医学系的临床资源。

DESCRIPTION (provided by applicant): The applicant, Michael LaMantia, MD, MPH is a geriatric physician and Assistant Professor of Medicine in the Division of General Internal Medicine and Geriatrics in the Department of Medicine at Indiana University. He additionally is a scientist at the Indiana University Center for Aging Research and Regenstrief Institute, Inc. The candidate's long-term career goal is to become a geriatrics clinical investigator who designs and implements systems of care to promote and improve the well-being of vulnerable older adults in the emergency department (ED) and other acute care environments. The research proposed in this application will provide information regarding the evaluation of delirium among older adults in the ED that is needed to improve the management of this serious condition. The candidate's immediate objectives are: (1) to acquire the research skills necessary to succeed in this program of research; (2) to gain the background needed to lead the design and implementation of systems that will provide better care to older adults in the acute care environment; (3) to conduct a mentored research program to evaluate the patient, provider, and workflow factors that influence the detection of delirium by emergency physicians (EPs); (4) to determine, by querying EPs the most effective cognitive strategies employed to recognize delirium; and (5) to extend the body of research regarding both short and long-term outcomes of patients whose delirium is either recognized or unrecognized in the ED . At the conclusion of this project, the candidate will apply data obtained from these studies to propose a logical and well-designed intervention to improve recognition and management of older adults with delirium in the ED in his first R01 submission. The career development plan proposes course work, a research project, and mentoring from a team of experienced investigators with expertise in a variety of relevant fields (health services research, medical sociology, emergency medicine, and delirium science) to provide synergistic advice on the accomplishment of the proposed projects. The applicant will benefit from a host of local resources available to support him in the completion of this project including the Indiana University School of Medicine and IU Center for Aging Research; the Regenstrief Institute and its extensive Regenstrief Medical Record System; as well as the clinical resources of the Indiana University Department of Emergency Medicine.