Rwanda 912: an mHealth Application to Improve Quality of Trauma and Emergency Care in Kigali, Rwanda

卢旺达 912​​：用于提高卢旺达基加利创伤和紧急护理质量的移动医疗应用程序

• 批准号: 10880474
• 负责人: Sudha Jayaraman
• 金额: $ 25.74万
• 依托单位: UNIVERSITY OF UTAH
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-08-10 至 2026-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10880474
• 关键词: Acceleration; Accident and Emergency department; Accounting; Address; Ambulances; Caring; Cessation of life; Clinical; Collaborations; Communication; Computer software; Country; Data; Data Collection; Emergency Care; Emergency Situation; Emergent care; Ensure; Equipment; Fostering; Foundations; Funding; Future; Health; Hospitals; Income; Interruption; Intervention; Lead; Location; Medical emergency; Methods; Mobile Health Application; Modeling; Myocardial Ischemia; Outcome; Outcome Measure; Patients; Phase; Positioning Attribute; Pre-hospitalization care; Prehospital Emergency Care; Process; Process Measure; Proctor framework; Public Health; Readiness; Registries; Respiratory Tract Infections; Running; Rwanda; Series; Services; Stroke; Students; Subgroup; System; Teaching Hospitals; Testing; Time; Training; Trauma; Trauma patient; Triage; Universities; Voice; World Bank; acceptability and feasibility; clinical outcome assessment; design; doctoral student; effectiveness evaluation; effectiveness/implementation design; electronic data; implementation evaluation; improved; injured; innovation; low and middle-income countries; mHealth; mortality; novel; post implementation; prevent; preventable death; primary outcome; research and development; secondary outcome; simulation; tool; trauma care; trauma centers; years of life lost

PROJECT SUMMARY/ABSTRACT Prompt, high-quality emergency care saves lives. Despite this, formal trauma and emergency medical systems are rare in most LMICs. In this application, we propose to establish “Rwanda912” as an innovative mHealth platform to improve the existing prehospital system by accurately locating patients and facilitating communication between dispatch, ambulance and emergency triage staff. We will conduct this study in two phases: an R21 phase to establish baseline outcome measures, and develop and test the intervention, and an R33 phase to evaluate the intervention using a type 2 hybrid effectiveness/implementation design. In the R21 phase, we will establish baseline prehospital care time-based outcomes using a pilot software application to collect time data and exploratory clinical outcomes for trauma patients using the existing WHO Trauma Registry in Kigali, Rwanda. Then will develop the innovative Rwanda912 mHealth platform using the accelerated-create-to-sustainment (ACTS) model and assess for accuracy, reliability and stakeholder acceptability through a mixed-methods approach. In the R33 phase, we will implement and optimize the Rwanda912 platform for the clinical setting again using the ACTS model and then evaluate the implementation to determine acceptability, feasibility and fidelity using the Proctor framework. We will determine effectiveness based on an anticipated 10% reduction in total prehospital time with 90% power using a Type 2 hybrid implementation/effectiveness design. We will use an interrupted time series statistical design to evaluate the primary outcome based on one year of ambulance deployments pre and post implementation (n=6600). This project will leverage our established collaboration in this setting, foster mHealth development and research capacity in four Masters student, one PhD student and four software developers in Kigali. This will create a foundation for future funding applications to develop, implement and evaluate additional platform features such as a public interface. Study findings will serve as a model for developing a similar communication platform to support pre-hospital emergency care in other LMIC settings.

项目摘要/摘要 迅速，高质量的紧急护理可挽救生命。尽管如此，正式的创伤和紧急医疗系统 在大多数LMIC中都是罕见的。在此应用程序中，我们建议将“ Rwanda912”建立为创新的MHealth 通过准确找到患者并支持沟通来改善现有院前系统的平台 在派遣，救护车和紧急分类人员之间。我们将分为两个阶段进行这项研究：R21 建立基线结果度量，制定和测试干预措施的阶段，以及R33阶段 使用2型混合有效性/实施设计评估干预措施。在R21阶段，我们将 使用试点软件应用程序来建立基线前护理前的基于时间的结果来收集时间数据 以及使用现有在卢旺达基加利（Kigali）现有的创伤注册中心的创伤患者的探索性临床结果。 然后，将使用加速创建的苏维护开发创新的卢旺达912 MHealth平台 （ACT）模型和评估通过混合方法的准确性，可靠性和利益相关者的可接受性 方法。在R33阶段，我们将实施和优化临床环境的卢旺达912平台 再次使用ACTS模型，然后评估实施以确定可接受性，可行性和 使用Proctor框架的保真度。我们将根据预期的10％降低的效力 使用2型混合实施/有效性设计的院前时间具有90％的功率。我们将使用 一个中断的时间序列统计设计，以根据救护车一年来评估主要结果 部署前和实施后（n = 6600）。该项目将利用我们既定的合作 该环境，四名硕士学生，一名博士生和 基加利的四个软件开发人员。这将为未来的资助应用程序创造基础，以开发， 实现并评估其他平台功能，例如公共接口。研究结果将作为 开发类似的通信平台以支持其他LMIC的院前急诊护理的模型 设置。