Disseminating NIH Evidence Based Sickle Cell Recommendations in North Carolina

摘要 该项目将提高镰状细胞病患者的医疗保健效率和质量 通过实施共同管理模式来控制疾病、服务不足和高危人群 关心。许多镰状细胞病 (SCD) 患者主要接受专科治疗 医生和急诊科（ED），从而导致缺乏初级保健和高 急诊就诊和住院次数。研究小组成员将分发一个工具箱 决策支持工具，基于国家心肺血液研究所 (NHLBI) 发表了《镰状细胞病的循证管理：专家小组报告，2014 年》， 北卡罗来纳州和南方部分地区的初级保健和急诊科提供者 卡罗莱纳.目标是改善 PCP 和 SCD 专家的共同管理。我们将调查 提供者对工具的认识、使用和可接受性的看法。我们会 调查患者对共同管理模式的认知度和可接受性。我们会 还进行探索性成本分析。本次演示的总体目的和 传播项目是评估与患者和系统相关的结果 向北卡罗来纳州和北卡罗来纳州的 PCP 和 ED 提供者分发决策支持工具工具箱 SC。该项目的具体目标是： 1. 检查决策支持工具对研究结果的影响 [教育部访问、 住院治疗、30 天内再次住院、PCP 和/或 SCD 专科就诊、联合治疗 管理，以及 HU 处方配药] 在项目开始前的 12 个月内以及整个过程中 该项目在北卡罗来纳州和南卡罗来纳州为期 3.5 年。 1.1.确定哪个患者（年龄、性别、农村居住地）和执业水平（具体 CCNC 网络、特定 PCP 实践）特征以及传播工具的接收情况） 预测研究结果。 2. 评估各个提供商报告的认知度、可接受性和提供商报告的使用情况 PCP、SCD 工具箱中的每个健康维护表和算法 北卡罗来纳州和南卡罗来纳州的专家和 ED 提供商在项目开始时以及整个项目期间每年都会提供帮助。 2.1.探索患者报告的对共同管理模式的认识和可接受性 NC 和 SC 的护理。 3. 对 SCD 合作的传播和实施进行探索性成本分析 管理模式及其对医疗资源利用的影响

Abstract This project will improve the efficiency and quality of healthcare for persons with sickle cell disease, an under-served and at risk population by implementing a co-management model of care. Many patients with sickle cell disease (SCD) receive care primarily from specialty physicians and emergency departments (ED), thus resulting in a lack of primary care and a high number of ED visits and hospitalizations. Study team members will disseminate a toolbox of decision support tools, based upon the National Heart, Lung and Blood Institute (NHLBI) published “Evidence-Based Management of Sickle Cell Disease: Expert Panel Report, 2014”, to primary care and emergency department providers in North Carolina and portions of South Carolina. The goal is to improve PCP and SCD specialist co-management. We will survey providers about their perception of the awareness, use and acceptability of the tools. We will survey patients about the awareness and acceptability of the co-management model. We will also conduct an exploratory cost analysis. The overall purpose of this demonstration and dissemination project is to evaluate patient and system outcomes associated with the dissemination of a toolbox of decision support tools to PCP’s and ED providers across NC and SC. The specific aims of the project are to: 1. Examine the effects of the decision support tools on study outcomes [ED visits, hospitalization, re-hospitalization within 30 days, PCP and/or SCD specialty visits, co- management, and HU prescription fills] during the 12 months prior to project start and across the 3.5 years of the project in NC and SC. 1.1. Determine which patient (age, gender, rural residence) and practice level (specific CCNC networks, specific PCP practices) characteristics, and receipt of the dissemination tools) predict study outcomes. 2. Evaluate individual provider-reported awareness, acceptability, and provider-reported use of each of the health maintenance tables and algorithms in the toolbox amongst PCPs, SCD specialists, and ED providers in NC and SC at project start and yearly across the project. 2.1. Explore patient-reported awareness and acceptability of a co-management model of care in NC and SC. 3. Conduct an exploratory cost analysis of the dissemination and implementation of the SCD co- management model and its effect on healthcare resource utilization.