Delirium Evaluation in the Emergency Department for Seniors (DEEDS)

简介（由申请人提供）：申请人Michael LaMantia，医学博士，公共卫生硕士，是印第安纳大学医学部普通内科和老年医学部门的老年内科医生和医学助理教授。他还是印第安纳大学老龄化研究中心和注册研究所的科学家。候选人的长期职业目标是成为一名老年医学临床研究者，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。本应用中提出的研究将提供关于在急诊科评估老年人谵妄的信息，这是改善这种严重疾病管理所需要的。候选人的直接目标是：(1)获得在该研究项目中取得成功所必需的研究技能；(2)获得领导设计和实施系统所需的背景知识，这些系统将在急性护理环境中为老年人提供更好的护理；(3)开展有指导的研究项目，评估影响急诊医生（EPs）检测谵妄的患者、提供者和工作流程因素；(4)通过询问EPs来确定用于识别谵妄的最有效认知策略；(5)扩大对在急诊科确诊或未确诊谵妄的患者的短期和长期结果的研究。在本项目结束时，候选人将应用从这些研究中获得的数据，在他的第一份R01报告中提出一种合乎逻辑且设计良好的干预措施，以提高对急诊科老年谵妄患者的识别和管理。职业发展计划提出课程作业、一个研究项目，并由具有各种相关领域（卫生服务研究、医学社会学、急诊医学和谵妄科学）专业知识的经验丰富的调查人员组成的团队提供指导，以便为拟议项目的完成提供协同建议。申请人将受益于许多本地资源，以支持他完成

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.