Community Paramedicine

社区辅助医疗

基本信息

  • 批准号:
    10709340
  • 负责人:
  • 金额:
    $ 232.82万
  • 依托单位:
  • 依托单位国家:
    美国
  • 项目类别:
  • 财政年份:
    2023
  • 资助国家:
    美国
  • 起止时间:
    2023-09-15 至 2028-08-31
  • 项目状态:
    未结题

项目摘要

PROJECT SUMMARY Approximately 3 million known persons living with dementia (PLWD) visit the emergency department (ED) annually. This is likely an underestimated value as most cases of dementia go unrecognized in the ED. Most PLWD are treated and released, implying that they do not need medical oversight and are on the road to recovery. Yet, for PLWD, the ED-to-home transition is associated with increased risk of ED revisits, adverse events, and mortality. The critical need for effective care transition interventions for PLWD has been identified by the NIA-funded Geriatric Emergency Care Applied Research 2.0 Network – Advancing Dementia Care. Our adaptation of the Coleman’s Care Transitions Intervention, delivered by community paramedics for community- dwelling older adults transitioning from ED-to-home, reduced the odds of ED revisits within 30 days by 75% among patients with cognitive impairment. These results lay the foundation for testing the Community Paramedic-Led Transitions Intervention (CPTI) in a large-scale embedded pragmatic clinical trial to rigorously evaluate its effectiveness in improving the ED-to-home transitions for PLWD. In this study, we will test our hypothesis that the CPTI will improve the ED-to-home transition and utilization outcomes for PLWD, both alone and when combined with other interventions. We will leverage community paramedicine, an innovative and new health care model where paramedics function outside their traditional roles to deliver community health interventions. We will optimize the CPTI across two sites in coordination with the Nurse-led Telephonic Care and ED Care Redesign for PLWD, assessing intervention acceptability and engagement. We will test the CPTI’s effectiveness alone and in combination with the other interventions in an 80-center, cluster- randomized, multifactorial embedded pragmatic clinical trial for community-dwelling PLWD and their care partners experiencing an ED visit by analyzing ED revisit rates, hospitalizations, and total days at home following an index ED visit. We will also determine site, provider, and patient-level characteristics that are associated with CPTI outcome variations using the RE-AIM framework, such that future implementation can adequately address these care gaps. Upon its completion, this study will address the important gap of overlooked ED-to-home transitions for PLWD receiving ED care. By rigorously investigating the CPTI, we will provide critical evidence on ways to improve PLWD health outcomes and enable underutilized healthcare resources for this vulnerable population.
项目总结

项目成果

期刊论文数量(0)
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MANISH N SHAH其他文献

MANISH N SHAH的其他文献

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{{ truncateString('MANISH N SHAH', 18)}}的其他基金

Institutional Career Development Core
机构职业发展核心
  • 批准号:
    9754268
  • 财政年份:
    2017
  • 资助金额:
    $ 232.82万
  • 项目类别:
Mentoring and Research in Patient-Oriented Geriatric Emergency Care
以患者为中心的老年急救护理的指导和研究
  • 批准号:
    10161670
  • 财政年份:
    2017
  • 资助金额:
    $ 232.82万
  • 项目类别:
Institutional Career Development Core
机构职业发展核心
  • 批准号:
    10199094
  • 财政年份:
    2017
  • 资助金额:
    $ 232.82万
  • 项目类别:
Mentoring and Research in Patient-Oriented Geriatric Emergency Care
以患者为中心的老年急诊护理的指导和研究
  • 批准号:
    9220095
  • 财政年份:
    2017
  • 资助金额:
    $ 232.82万
  • 项目类别:
Paramedic-coached ED Care Transitions to Help Older Adults Maintain their Health
护理人员指导的急诊护理过渡以帮助老年人保持健康
  • 批准号:
    9519834
  • 财政年份:
    2015
  • 资助金额:
    $ 232.82万
  • 项目类别:
Paramedic-coached ED Care Transitions to Help Older Adults Maintain their Health
护理人员指导的急诊护理过渡以帮助老年人保持健康
  • 批准号:
    8936196
  • 财政年份:
    2015
  • 资助金额:
    $ 232.82万
  • 项目类别:
Paramedic-coached ED Care Transitions to Help Older Adults Maintain their Health
护理人员指导的急诊护理过渡以帮助老年人保持健康
  • 批准号:
    9273307
  • 财政年份:
    2015
  • 资助金额:
    $ 232.82万
  • 项目类别:
Deriving a Prehospital Triage Decision Scheme for Injured Older Adults
制定受伤老年人的院前分诊决策方案
  • 批准号:
    8280547
  • 财政年份:
    2012
  • 资助金额:
    $ 232.82万
  • 项目类别:
Field Triage of Older Adults Who Experience Traumatic Brain Injury
对遭受脑外伤的老年人进行现场分诊
  • 批准号:
    8706665
  • 财政年份:
    2012
  • 资助金额:
    $ 232.82万
  • 项目类别:
Field Triage of Older Adults Who Experience Traumatic Brain Injury
对遭受脑外伤的老年人进行现场分诊
  • 批准号:
    8536586
  • 财政年份:
    2012
  • 资助金额:
    $ 232.82万
  • 项目类别:

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