Identifying novel system-level factors associated with the quality of acute stroke care delivery

识别与急性卒中护理服务质量相关的新系统级因素

• 批准号: 9980340
• 负责人: Korilyn Sauser Zachrison
• 金额: $ 15.56万
• 依托单位: MASSACHUSETTS GENERAL HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-08-16 至 2021-10-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9980340
• 关键词: Identifying; novel; system; level; factors

 DESCRIPTION (provided by applicant): This K08 award will enable the candidate, Kori L. Sauser, MD, MSc, to become an independent physician scientist focused on acute stroke systems of care specifically dedicated to improving the efficiency of evidence translation in order to improve patient outcomes. Acute ischemic stroke is common, yet there is broad variation in the care of stroke patients between hospitals. Many eligible patients do not receive disability-�reducing treatment; this results in greater neurologic damage and long-­‐term disability for patients, and large societal costs. Dr. Sauser's proposed study aims to better understand the organization of U.S. hospitals in the delivery of acute stroke care by creating a map of the U.S. stroke hospital transfer network, and then using this map to determine how performance and high-­‐quality care are disseminated between connected hospitals. To achieve these goals, this proposal includes an integrated curriculum consisting of intensive mentorship and didactic coursework in network analysis methodology, advanced statistical modeling, and organizational culture and implementation research. Her development and training activities also include building a research network, engaging with stakeholders in regional stroke networks, and participating in national scientific meetings. The rich academic environment at Massachusetts General Hospital and Harvard University is ideal for Dr. Sauser's training and has enabled her to assemble a mentorship team of national leaders with expertise in stroke health services research, epidemiology, network analysis methodology, healthcare quality measurement, and advanced statistical modeling. Dr. Sauser will utilize a linked dataset containing Medicare claims linked with the Get with the Guidelines-­‐Stroke clinical registry to create a map of the U.S. acute ischemic stroke transfer network. With this map she will: 1) describe factors related to choice of hospital transfer destination for transferred acute ischemic stroke patients (such as perceived hospital quality); 2) examine whether hospitals that are connected by frequent transfer of patients have more similar performance and quality of acute stroke care delivery; and 3) longitudinally examine these network relationships to understand the diffusion of performance and quality between hospitals in the network. Completion of this proposed project will produce a map of the U.S. stroke network and an understanding of how best practices for stroke flow through the network. This will help explain variation in quality at the hospital level, and inform next steps for improving stroke care delivery. Completing the proposed project and didactic training plan will also facilitate Dr. Sauser's transition to an independent health services investigator focused on improving the delivery of stroke care in the U.S.

 DESCRIPTION (provided by applicant): This K08 award will enable the candidate, Kori L. Sauser, MD, MSc, to become an independent physician scientist focused on acute stroke systems of care specifically dedicated to improving the efficiency of evidence translation in order to improve patient outcomes. Acute ischemic stroke is common, yet there is broad variation in the care of stroke patients between hospitals. Many eligible patients do not receive disability-�reducing treatment; this results in greater neurologic damage and long-­‐term disability for patients, and large societal costs. Dr. Sauser's proposed study aims to better understand the organization of U.S. hospitals in the delivery of acute stroke care by creating a map of the U.S. stroke hospital transfer network, and then using this map to determine how performance and high-­‐quality care are disseminated between connected hospitals. To achieve these goals, this proposal includes an integrated curriculum consisting of intensive mentorship and didactic coursework in network analysis methodology, advanced statistical modeling, and organizational culture and implementation research. Her development and training activities also include building a research network, engaging with stakeholders in regional stroke networks, and participating in national scientific meetings. The rich academic environment at Massachusetts General Hospital and Harvard University is ideal for Dr. Sauser's training and has enabled her to assemble a mentorship team of national leaders with expertise in stroke health services research, epidemiology, network analysis methodology, healthcare quality measurement, and advanced statistical modeling. Dr. Sauser will utilize a linked dataset containing Medicare claims linked with the Get with the Guidelines-­‐Stroke clinical registry to create a map of the U.S. acute ischemic stroke transfer network. With this map she will: 1) describe factors related to choice of hospital transfer destination for transferred acute ischemic stroke patients (such as perceived hospital quality); 2) examine whether hospitals that are connected by frequent transfer of patients have more similar performance and quality of acute stroke care delivery; and 3) longitudinally examine these network relationships to understand the diffusion of performance and quality between hospitals in the network. Completion of this proposed project will produce a map of the U.S. stroke network and an understanding of how best practices for stroke flow through the network. This will help explain variation in quality at the hospital level, and inform next steps for improving stroke care delivery. Completing the proposed project and didactic training plan will also facilitate Dr. Sauser's transition to an independent health services investigator focused on improving the delivery of stroke care in the U.S.

项目成果

Changes in Virtual and In-Person Health Care Utilization in a Large Health System During the COVID-19 Pandemic.

• DOI: 10.1001/jamanetworkopen.2021.29973
• 发表时间: 2021-10-01
• 期刊: JAMA network open
• 影响因子: 13.8
• 作者: Zachrison KS;Yan Z;Schwamm LH
• 通讯作者: Schwamm LH

The White Whale.

白鲸。

• DOI: 10.1161/strokeaha.119.025262
• 发表时间: 2019
• 期刊: Stroke
• 影响因子: 8.3
• 作者: Zachrison,KoriS;Goldstein,JoshuaN
• 通讯作者: Goldstein,JoshuaN

Screening for Health-Related Social Needs of Emergency Department Patients.

• DOI: 10.1016/j.annemergmed.2020.08.010
• 发表时间: 2021-01
• 期刊: Annals of emergency medicine
• 影响因子: 6.2
• 作者: Samuels-Kalow ME;Boggs KM;Cash RE;Herrington R;Mick NW;Rutman MS;Venkatesh AK;Zabbo CP;Sullivan AF;Hasegawa K;Zachrison KS;Camargo CA Jr
• 通讯作者: Camargo CA Jr

Resource utilisation among patients transferred for intracerebral haemorrhage.

脑出血转院患者的资源利用。

• DOI: 10.1136/svn-2019-000255
• 发表时间: 2019
• 期刊: Stroke and vascular neurology
• 影响因子: 5.9
• 作者: Zachrison,KoriSauser;Aaronson,Emily;Mahmood,Sadiqa;Rosand,Jonathan;Viswanathan,Anand;Schwamm,LeeH;Goldstein,JoshuaN
• 通讯作者: Goldstein,JoshuaN

Frequency of early rapid improvement in stroke severity during interfacility transfer.

设施间转移期间中风严重程度早期快速改善的频率。

• DOI: 10.1212/cpj.0000000000000667
• 发表时间: 2019
• 期刊: Neurology. Clinical practice
• 作者: Zachrison,KoriS;Leslie-Mazwi,ThabeleM;Boulouis,Gregoire;Goldstein,JoshuaN;Regenhardt,RobertW;Viswanathan,Anand;Lauer,Arne;Siddiqui,KhawdjaAhmer;Charidimou,Andreas;Rost,Natalia;Schwamm,LeeH
• 通讯作者: Schwamm,LeeH