Implementation science to improve cardiovascular outcomes among liver transplant recipients

项目摘要/摘要 这个职业发展奖将为Lisa VanWagner博士提供作为一个独立的 研究人员使用定性研究方法将研究转化为临床实践及其实施 改善肝病患者心血管预后的科学原则。范瓦格纳博士将 利用这个奖项，用新的技能和知识加强她在临床流行病学方面现有的广泛技能 在应用以用户为中心和学习的协作方法和实施科学 优化多学科治疗团队对肝脏移植未来吸收和依从性的原则- 具体的心血管疾病指南和护理路径。这些技能将使她能够翻译 将流行病学结果应用于临床实践，以改善肝脏患者的心血管结局 疾病。她将通过职业发展计划实现这些职业目标，该计划包括 课程作业、强化指导、体验式培训和以病人为中心的研究。她的主要导师是 唐纳德·劳埃德-琼斯博士，心血管疾病结局和预防专家，多个活跃的NIH 资助金和杰出的指导记录。她的合作导师包括医疗质量和安全方面的专家 (简·霍尔博士)和定性研究方法(伊莉莎·戈登博士)，两者都在 培训独立调查人员。这将在西北大学完成。西北大学 为VanWagner博士提供1)胃肠病和肝病科的专门支持， 医学系；2)她的多学科导师团队；3)多门课程和专业 与她的职业发展相关的互动，包括西北大学临床和 翻译科学研究所和公共卫生与医学研究所；4)研究基础设施， 包括机构电子数据收集计划和生物统计学支持；以及5)广泛的临床 基础设施。研究战略的总体目的是创建、实施和测试 改善肝移植(CVD被子)心血管疾病质量的护理路径 包括使用多学科治疗团队的肝移植特定心血管疾病指南 接近。这项研究的发现将针对减少高危人群的心血管疾病： 从稀缺的捐赠器官中接受救命器官移植的肝病患者。这个 研究将在一家学术医院进行。特定目标一将创建特定于肝脏移植的 心血管疾病临床实践指南。具体目标二将运用质的研究方法 通过设计评估和解决实施和遵守指南的障碍和促进者 和开发CVD被子护理路径。具体目标三将检验……的可行性 实施心血管被以改善肝移植受者的心血管疾病护理。

PROJECT SUMMARY/ABSTRACT This career development award will provide Dr. Lisa VanWagner the opportunity to develop as an independent researcher translating research into clinical practice using qualitative research methods and implementation science principles to improve cardiovascular outcomes among patients with liver disease. Dr. VanWagner will use this award to enhance her existing extensive skills in clinical epidemiology with new skills and knowledge in the application of user-centered and learning collaborative approaches and implementation science principles to optimize future uptake and adherence by multidisciplinary treatment teams of a liver transplant- specific cardiovascular disease Guideline and Care Pathway. These skills will allow her to translate epidemiologic findings into clinical practice in order to improve cardiovascular outcomes in patients with liver disease. She will achieve these career goals through a career development plan that consists of formal coursework, intensive mentorship, experiential training, and patient-oriented research. Her primary mentor is Dr. Donald Lloyd-Jones, an expert in cardiovascular disease outcomes and prevention with multiple active NIH grants and an outstanding record of mentoring. Her co-mentors include experts in healthcare quality and safety (Dr. Jane Holl), and qualitative research methods (Dr. Elisa Gordon), both with outstanding track records in training independent investigators. This will be accomplished at Northwestern University. Northwestern provides Dr. VanWagner with 1) dedicated support from the Division of Gasteroenterology and Hepatology, Department of Medicine; 2) her multidisciplinary team of mentors; 3) numerous courses and professional interactions relevant to her career development, including the Northwestern University Clinical and Translational Sciences Institute and the Institute for Public Health and Medicine; 4) research infrastructure that includes an institutional electronic data collection program and biostatistical support; and 5) extensive clinical infrastructure. The overall purpose of the research strategy is to create, implement, and test the feasibility of a Cardiovascular Disease Quality Improvement in Liver Transplantation (CVD QUILT) Care Pathway that includes a liver transplant-specific cardiovascular disease guideline, using a multidisciplinary treatment team approach. The findings of this study will target reducing cardiovascular disease in a high-risk population: patients with liver disease who have received life-saving organ transplants from scarce donated organs. The study will be conducted at a single academic hospital. Specific Aim One will create liver transplant-specific cardiovascular disease clinical practice guidelins. Specific Aim Two will use qualitative research methods to assess and address barriers and facilitators to the implementation and adherence to the Guideline by design and development of the CVD QUILT Care Pathway. Specific Aim Three will test the feasibility of implementation of CVD QUILT to improve cardiovascular disease care in liver transplant recipients.