Optimization and Implementation Trial of a User-Centered Emergency Care Planning Tool for Infants with Medical Complexity

以用户为中心的医疗复杂性婴儿紧急护理计划工具的优化和实施试验

• 批准号: 10678867
• 负责人: Christian Donald Pulcini
• 金额: $ 15.54万
• 依托单位: UNIVERSITY OF VERMONT & ST AGRIC COLLEGE
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-08-08 至 2027-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10678867
• 关键词: Academy; Accident and Emergency department; Address; Admission activity; Adoption; American; Caregivers; Child; Child Advocacy; Child Care; Childhood; Chronic; Clinical Investigator; Clinical Trials; Clinical Trials Design; Complex; Cost Effectiveness Analysis; Cost Measures; Data; Dedications; Development; Disparity; Dissemination and Implementation; Dose; Emergency Care; Emergency Department Physician; Emergency Health Services; Emergency Medicine; Emergency Situation; Emergency department visit; Ensure; Expert Opinion; Family; Future; Goals; Health; Health Services; Health Services Research; Healthcare; Infant; Infant Care; Inpatients; Intervention; Interview; Length; Life; Maternal and Child Health; Measures; Medical; Medical Technology; Mentors; Mentorship; Monitor; Outcome; Pediatrics; Pharmaceutical Preparations; Physicians; Positioning Attribute; Professional Organizations; Provider; Publishing; Quality of Care; Randomized; Randomized, Controlled Trials; Recommendation; Research; Research Training; Resources; Rural Population; Scientist; Site; Structure; Subgroup; Surveys; Time; Training; Training Programs; Vermont; Vulnerable Populations; Work; acute care; care outcomes; care providers; career development; clinical care; college; cost; design; dissemination science; ethnic minority; experience; family burden; feasibility trial; health care disparity; health care service utilization; high risk; implementation barriers; implementation process; implementation science; implementation tool; implementation trial; improved; improved outcome; infant outcome; innovation; low socioeconomic status; medical vulnerability; meetings; patient population; patient subsets; pediatric emergency; racial minority; rural area; rural setting; skills; tool; uptake; user centered design

PROJECT SUMMARY/ABSTRACT Dr. Pulcini proposes a five-year research training program to support his development into an independent physician-scientist dedicated to improving emergency care of children with medical complexity, which account for approximately 20% of all pediatric emergency department (ED) visits and 33% of all healthcare spending among children. Dr. Pulcini’s project goal is to optimize and implement a user-centered emergency care planning tool to improve outcomes for infants with medical complexity (notably those in rural areas), a particularly vulnerable subset of this patient population. Under the first aim of the proposal, Dr. Pulcini will optimize an existing emergency care planning tool that, despite advocacy for children with medical complexity by two professional societies, has been poorly implemented to date. Dr. Pulcini will optimize the emergency care planning tool for infants with medical complexity through iterative semi-structured and targeted interviews and surveys of tool users: providers, local interdisciplinary collaborators, and families. Under the second aim, Dr. Pulcini will design and conduct a randomized feasibility trial of the user-centered emergency care planning tool’s implementation, measuring resultant emergency health care outcomes. As part of the trial implementation process, Dr. Pulcini will monitor barriers to implementation, as well as measure key emergency health service research measures with plans for cost-effectiveness analysis for a full-scale future randomized controlled trial to be submitted as an R01. Dr. Pulcini’s training program is focused on dissemination and implementation (D&I) science, supplemented with training in clinical trials and health services measure development. The training in D&I science builds upon Dr. Pulcini’s previous training in pediatric emergency medicine and maternal and child health. Dr. Pulcini’s research will be supported by an accomplished group of mentors with expertise in D&I science, clinical trials, pediatric emergency medicine and health services research. His mentors are dedicated to ensuring his career development into an independent clinical investigator through successful conduct of the proposed project and training plan. By providing Dr. Pulcini with the skills and mentored experience necessary to complete this proposal, he will be well positioned to succeed as an independent scientist and significantly improve the emergency care of children with medical complexity.

项目总结/摘要 博士普尔奇尼提出了一个为期五年的研究培训计划，以支持他发展成为一个独立的 医生，科学家致力于改善儿童的紧急护理与医疗复杂性，其中帐户 约占所有儿科急诊科（艾德）就诊的20%和所有医疗保健支出的33 在儿童中。Pulcini博士的项目目标是优化和实施以用户为中心的紧急护理 一种改善医疗复杂性婴儿（特别是农村地区的婴儿）结局的规划工具， 尤其是这个病人群体中的弱势群体。根据提案的第一个目标，普尔奇尼博士将 优化现有的紧急护理规划工具，尽管倡导对具有医疗复杂性的儿童 由两个专业学会提出的《关于妇女地位的公约》迄今为止执行情况不佳。普契尼医生会优化紧急情况 通过反复的半结构化和有针对性的访谈为具有医学复杂性的婴儿制定护理计划工具 以及对工具使用者的调查：提供者、当地跨学科合作者和家庭。在第二个目标下， 博士Pulcini将设计并进行一项以用户为中心的紧急护理计划的随机可行性试验 工具的实施，衡量由此产生的紧急医疗保健结果。作为试验的一部分 在执行过程中，Pulcini博士将监测执行障碍，并衡量关键紧急情况 卫生服务研究措施与计划的成本效益分析，为全面的未来随机 对照试验作为R 01提交。 博士Pulcini的培训计划侧重于传播和实施（D&I）科学， 接受过临床试验和卫生服务措施开发方面的培训。D&I科学的培训建立在 博士普尔奇尼以前接受过儿科急诊医学和妇幼保健方面的培训。普契尼医生 研究将得到一组在D&I科学，临床试验， 儿科急诊医学和卫生服务研究。他的导师致力于确保他的职业生涯 通过成功开展拟议项目，发展成为独立的临床研究者， 培训计划。通过为Pulcini博士提供必要的技能和指导经验， 他将有能力成功地成为一名独立的科学家，并显着提高 医疗复杂性儿童的紧急护理。

项目成果

A Holistic Approach to Childhood Firearm Injuries.

儿童枪伤的整体治疗方法。

• DOI: 10.1542/peds.2023-063322
• 发表时间: 2024
• 期刊: Pediatrics
• 影响因子: 8
• 作者: Pulcini,ChristianD;Hoffmann,JenniferA;Alpern,ElizabethR;Chaudhary,Sofia;Ehrlich,PeterF;Fein,JoelA;Fleegler,EricW;Goyal,MonikaK;Hall,Matt;Jeffries,KristynN;Myers,Rachel;Sheehan,KarenM;Zamani,Mark;Zima,BonnieT;Hargarten
• 通讯作者: Hargarten