Veteran Access and Limitations to Organ Recovery (VALOR)
退伍军人器官恢复的机会和限制 (VALOR)
基本信息
- 批准号:10833392
- 负责人:
- 金额:$ 66.14万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2022
- 资助国家:美国
- 起止时间:2022-06-10 至 2027-02-28
- 项目状态:未结题
- 来源:
- 关键词:AdherenceAdvocacyAgeAmericanAreaAuthorization documentationAutomated Clinical Decision SupportAwarenessBedsCaringCase StudyCessation of lifeChronicClinicalComplexConsensusContinuity of Patient CareContractorDataDedicationsDisparityDisparity populationElderlyElectronic Health RecordEnvironmentEvaluationFailureFamilyFederal GovernmentFundingGiftsGrantHealthHealth systemHealthcareHospital AdministrationHospitalsHuman ResourcesInequityInstitutionInterventionInterviewKidneyLaboratoriesLawsLifeLiverLogicMapsMeasuresMedicalMedical centerMedicineMinorityModelingMonitorNational originOperative Surgical ProceduresOrganOrgan DonationsOrgan DonorOrgan ProcurementsOrgan TransplantationOrgan failureOrganization and AdministrationOutcomePatient CarePatient-Focused OutcomesPatientsPerceptionPerformancePhysiciansPhysiologicalPopulationPositioning AttributePractical Robust Implementation and Sustainability ModelProcessProviderQuality of CareRaceRecoveryResearchRisk FactorsRoleRuralSamplingSourceStandardizationStructureSupport SystemSurveysSystemTransplantationUnderserved PopulationUnited StatesUnited States Department of Veterans AffairsVeteransVulnerable PopulationsWaiting Listsaccess disparitiesauthoritybiomedical referral centerbody systemcare coordinationclinical decision supportcostcritical care nursingdisabilityethnic minorityexperiencefollow-uphealth practiceimprovedinterestmarginalized populationmeetingsmilitary veteranminority patientolder patientorgan procurement transplantation networkpatient advocacy grouppatient orientedpatient populationprocess improvementprogramsprospectiveracial minorityradiological imagingresponserural areascreeningsociodemographicssupport toolssymposiumvirtual
项目摘要
Abstract: Deceased donors provide lifesaving gifts to patients with chronic organ failure. Organ donation
occupies a unique position in American healthcare, as donation care is provided without cost to the patient or
their family and is mandated to be provided without bias to age, disability, race, or national origin by federal
contractors known as organ procurement organizations (OPOs). Previous regulatory measures of OPO
performance did not allow adequate objectivity, reliability, and transparency into procurement practice and
have been replaced by a new metric introduced by this study's authors. Analyses using this metric reveal that
older persons, minorities, and those living in poor, rural, and remote areas receive lesser access to organ
donation. Veterans Administration Medical Centers (VAMCs) represent the largest single hospital system in the
United States, and serve a population recognized to be underserved in many aspects of health and medicine.
We have developed preliminary data showing that VAMCs recover deceased donor organs at a rate of 4% that
of non-VA hospitals. The basis for this disparity is unclear, but given the high concentration of vulnerable and
underserved groups at VAMCs, there is a strong imperative to improve donation access for these patients.
In this proposal, we will leverage VAMCs' unparalleled electronic health records (EHRs), which offer
detailed information on longitudinal patient care and outcomes, to enumerate the potential supply of organ
donors nationwide over a 10-year historical period. We will use physiologic, laboratory, and radiographic data
to define potential donor quality and estimate transplant yields at varying levels of donation performance
relative to non-VA hospitals. We will also interview patients, critical care nurses and physicians at VAMCs, and
OPO personnel to gather their experiences and perceptions regarding barriers to more effective donor
recovery from these institutions. We will use findings from these qualitative and VA EHR studies to inform a
consensus conference on best practices for improved organ donation care at VAMCs in year 2 of our project.
Based on the findings of the first two aims in this study, we will create a model for improved VAMC
donation care using a large, nationally-representative sample of VAMCs and their attendant OPOs. We will
introduce a clinical decision support tool into VA EHR to maximize referral of potential donors. Study staff will
integrate with OPOs in responding to VAMC referrals, utilizing VA EHR sources to assist in evaluating patients
for donation. Study coordinators will facilitate workflow between VAMC and OPO staff, supporting and
monitoring adherence to best practices defined in the consensus conference. We will conduct a follow-up
stakeholder meeting to assess perceptions of the pilot program's efficacy among VAMC providers, OPO staff,
and veteran and patient advocacy groups from within the study area.
Together, this study's findings will not only help to ameliorate disparities in veterans' access to donation
care, but will inform efforts to standardize and improve donation care among other underserved populations.
摘要:已故捐赠者为慢性器官衰竭患者提供了拯救生命的礼物。器官捐献
项目成果
期刊论文数量(2)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
What is visible is fixable: Visual dashboards for multi-domain assessment of organ procurement organization performance.
可见的东西是可以修复的:用于器官采购组织绩效多领域评估的可视化仪表板。
- DOI:10.1016/j.ajt.2023.08.020
- 发表时间:2023
- 期刊:
- 影响因子:0
- 作者:Doby,BriannaL;Casey,Kylie;Ross-Driscoll,Katie;RahmanOvi,Musaddiqur;HossainBhuiyea,MdShabbir;Isty,IstiakAhmed;Lynch,RaymondJ
- 通讯作者:Lynch,RaymondJ
Opportunity to increase deceased donation for United States veterans.
有机会增加对美国退伍军人的已故捐款。
- DOI:10.1111/ajt.16773
- 发表时间:2021
- 期刊:
- 影响因子:0
- 作者:Doby,BriannaL;Brockmeier,Diane;Lee,KevinJ;Jasien,Christine;Gallini,Julia;Cui,Xiangqin;Zhang,RebeccaH;Karp,SethJ;Marklin,Gary;Lynch,RaymondJ
- 通讯作者:Lynch,RaymondJ
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Raymond J Lynch其他文献
Class II transactivator promoter activity is suppressed through regulation by a trophoblast noncoding RNA1
II 类反式激活子启动子活性通过滋养层非编码 RNA1 的调节而受到抑制
- DOI:
- 发表时间:
2003 - 期刊:
- 影响因子:6.2
- 作者:
A. Geirsson;I. Paliwal;Raymond J Lynch;A. Bothwell;G. Hammond - 通讯作者:
G. Hammond
Raymond J Lynch的其他文献
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{{ truncateString('Raymond J Lynch', 18)}}的其他基金
Veteran Access and Limitations to Organ Recovery (VALOR)
退伍军人器官恢复的机会和限制 (VALOR)
- 批准号:
10365618 - 财政年份:2022
- 资助金额:
$ 66.14万 - 项目类别:
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