An evaluation of sensor technology to monitor and report compliance with an evidence-based intervention to prevent ventilator-associated pneumonia

 应聘者描述：Nishi Rawat是约翰霍普金斯大学麻醉学和重症医学系的重症监护内科医生和助理教授。她的目标是成为一名独立调查员，专注于推进质量改进领域，以提高向美国人提供的医疗保健的质量，同时降低成本，重点是应用信息技术来评估绩效、最大限度地减少浪费和消除冗余。这位候选人作为两个减少呼吸机相关性肺炎(VAP)合作项目的联合研究员的初步工作表明，有强烈的动力来消除可预防的危害，如VAP，但现有的方法和资源很薄弱。迫切需要一种有效和廉价的方法来跟踪循证干预措施的交付情况，以提高质量。这项拟议的研究旨在填补这一测量空白。在这项建议中，她评估了传感器方法在测量和改善护理质量方面的效用，重点是VAP预防干预性能。这些目标建议：通过将传感器技术捕获的VAP流程测量性能估计值与通过传统人工数据收集获得的估计值进行比较，评估传感器方法在衡量VAP预防干预合规性方面的效用(目标1)；设计并试行一项战略，向提供者提供传感器过程测量合规性的实时反馈(目标2)；通过比较实施实时反馈战略前后的合规性，评估传感器方法对VAP过程测量合规性的影响(目标3)。拟议的工作可能从根本上改变医疗保健监测和报告重要护理干预措施的方式，并有可能使质量改进更加高效、廉价和可扩展。这位候选人是唯一有资格承担拟议工作的人。她拥有重症护理和急救医学双学位证书，并已完成患者安全和质量奖学金。她领导了多个地方质量改进倡议，并作为国家特别工作组的一部分，致力于降低ICU成本，目前是大型国家感染预防协作项目的联合调查员。正是决心、热情和强烈的职业道德使她能够在这些研究活动和沉重的临床承诺之间取得平衡。她现在需要受保护的时间来进行研究和职业发展，才能成为一名独立调查员。

 DESCRIPTION (provided by applicant): The candidate, Nishi Rawat, is a Critical Care physician and Assistant Professor in the Department of Anesthesiology and Critical Care Medicine at Johns Hopkins. Her goal is to become an independent investigator focused on advancing the field of quality improvement to improve the quality of health care delivered to Americans, while simultaneously reducing costs, with an emphasis on the application of information technology to evaluate performance, minimize waste and eliminate redundancies. The candidate's preliminary work as a co-investigator for two collaboratives to reduce ventilator-associated pneumonia (VAP) suggests that there is a strong drive to eliminate preventable harms such as VAP, but weak available methodologies and resources to do so. There is a dire need for an effective and inexpensive methodology to track the delivery of evidence-based interventions for the purpose of quality improvement. The proposed research intends to fill this measurement gap. In this proposal, she evaluates the utility of the sensor approach for measuring and improving quality of care, focusing on VAP prevention intervention performance. The aims propose: evaluate the utility of the sensor approach for measuring compliance with a VAP prevention intervention by comparing VAP process measure performance estimates captured by sensor technology to estimates obtained by traditional manual data collection (Aim 1); design and pilot a strategy to provide real-time feedback of sensor process measure compliance to providers (Aim 2); evaluate the impact of the sensor approach on VAP process measure compliance by comparing compliance before and after the implementation of the real-time feedback strategy (Aim 3). The proposed work could fundamentally change how healthcare monitors and reports important care interventions, and has the potential to make quality improvement more efficient, inexpensive and scalable. The candidate is uniquely qualified to undertake the proposed work. She is double-board certified in Critical Care and Emergency Medicine, and has completed a Patient Safety and Quality fellowship. She has led multiple local quality improvement initiatives, and worked to decrease ICU costs as part of a national task force, and is currently co-investigator of large national infection prevention collaborative. It isher determination, enthusiasm and strong work ethic which have enabled her to balance these research activities with a heavy clinical commitment. She now needs protected time for research and career development to become an independent investigator.