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， 在乎许多镰状细胞病（SCD）患者主要接受专科护理 医生和急诊科（艾德），从而导致缺乏初级保健和高 艾德就诊和住院次数。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《镰状细胞病循证管理：专家小组报告，2014年》， 北卡罗来纳州和南卡罗来纳州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 提供者了解他们对这些工具的认识、使用和可接受性的看法。我们将 调查患者对共同管理模式的认知度和可接受性。我们将 还进行了探索性的成本分析。本次演示的总体目的和 传播项目是为了评估患者和系统的结果与 向全国各地的PCP和艾德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[艾德访视， 住院、30天内再次住院、PCP和/或SCD专科访视、合并 项目开始前12个月内和整个项目期间， 在NC和SC的3.5年项目。 1.1.确定患者（年龄、性别、农村居住地）和执业水平（特定CCNC 网络、具体的五氯苯酚做法）特点和传播工具的接收情况） 预测研究结果。 2.评估个体提供者报告的知晓度、可接受性和提供者报告的使用情况 PCP、SCD工具箱中的每个健康维护表和算法 专家和艾德供应商在NC和SC在项目开始和每年在整个项目。 2.1.探讨患者报告的认识和接受的共同管理模式， 在NC和SC的护理。 3.对传播和执行《战略合作文件》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.