New York-Presbyterian NETT Consortium

纽约长老会 NTT 联盟

• 批准号: 7503409
• 负责人: STEPHAN A MAYER
• 金额: $ 19.41万
• 依托单位: NEW YORK-PRESBYTERIAN HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-09-30 至 2012-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7503409
• 关键词: Academic Medical Centers; Accident and Emergency department; Acute; Acute Brain Injuries; Admission activity; Alteplase; Ambulances; Arts; Award; Beds; Blood Vessels; Brain; Caring; Cerebral hemisphere hemorrhage; Clinical; Clinical Research; Clinical Trials; Coagulation Process; Collaborations; Critical Care; Data; Education; Emergency Medicine; Emergency Situation; Emergency treatment; Evaluation; Evidence based intervention; Factor VIIa; Functional Magnetic Resonance Imaging; Goals; Grant; Healthcare Systems; Heart Arrest; Hemostatic Agents; Hospitals; Hotlines; Hour; Hypertension; Infusion procedures; Intensive Care; Intensive Care Units; Internet; Ischemic Stroke; Joints; Lead; Leadership; Link; Medical Staff; Medical Surveillance; Medical center; Midazolam; Morbidity - disease rate; Needles; Neurologic; Neurological emergencies; Neurology; Neuroprotective Agents; Neurosciences; New York; Patient Care; Patients; Performance; Physicians; Physiological reperfusion; Population; Presbyterian Church; Principal Investigator; Procedures; Process; Protocols documentation; Purpose; Recombinants; Recording of previous events; Refractory; Reperfusion Therapy; Research; Research Infrastructure; Research Personnel; Research Support; Rotation; Site; Specialist; Speed; Standards of Weights and Measures; Status Epilepticus; Stroke; System; Testing; Therapeutic; Thrombolytic Therapy; Time; Today; Trauma; Treatment Protocols; United States; United States National Institutes of Health; X-Ray Computed Tomography; acute stroke; base; improved; intraventricular hemorrhage; mortality; multidisciplinary; natural hypothermia; neonatal hypoxic-ischemic brain injury; nervous system disorder; neurosurgery; programs; recombinant FVIIa; response; stroke recovery; treatment trial

DESCRIPTION (provided by applicant): The two "hub" academic medical centers of the New York Presbyterian (NYP) Healthcare System - Columbia University Medical Center (CUMC) and Weill-Cornell Medical Center (WCMC) - have helped lead the way in developing promising new treatments for neurological emergencies. These include the application of therapeutic hypothermia after cardiac arrest, the Merci' clot retriever for acute ischemic stroke, midazolam infusion for refractory status epilepticus, and clinical trials evaluating neuroprotective agents for acute stroke, thrombolytic therapy for intraventricular hemorrhage, and ultra-early hemostatic therapy with recombinant activated factor VII for intracerebral hemorrhage. Columbia University Medical Center is one of seven NIH SPOTRIAS research centers; central to this effort is the multidisciplinary SPEED team, led by emergency medicine, which continuously evaluates acute stroke care at both of our hubs and has driven substantial reductions in door-to-needle times for IV t-PA. These cooperative efforts between emergency medicine and neurology are further supported by an established infrastructure that facilitates collaboration throughout the NYP Healthcare System, including a Stroke Center Clinical Council, Emergency Medicine System Forum, and one of the largest independent ambulance systems in the United States. The overall goal of the present application is to build on our existing expertise in clinical research, our history of collaboration between emergency medicine and the clinical neurosciences at our two hub hospitals, and our track record of well-coordinated efforts throughout the NYP Healthcare System, in order to develop a 10-hospital New York-Presbyterian NETT Consortium for conducting neuroemergency clinical trials. Collectively these 10 emergency departments treat an ethnically diverse patient population that exceeds one half million patients per year. We will pursue the following specific aims: (1) Establish a leadership group of four co-principal investigators representing emergency medicine and neurology from both of our hub hospitals, supported by two half-time NETT project coordinators; (2) Organize emergency medicine and neurology co-investigators at 8 additional NYP network hospitals, each supported by a part- time NETT coordinators; (3) Create a 24-hour physician coverage system to provide clinical and research support to our regional emergency departments; (4) Develop a new EMS-triggered pre-hospital warning system to reduce the time needed to trigger clinical trial procedures; (5) Formally link the NYP Stroke Center Clinical Council, NYP Emergency Medicine System Forum, and the SPOTRIAS Speed Team; and (6) Develop unified time-based performance standards for managing neuroemergency patients, and implement an internet-based surveillance system to provide continuous quality improvement (CQI) data for our sites.

描述（由申请人提供）：纽约长老会（NYP）医疗保健系统的两个“枢纽”学术医学中心 - 哥伦比亚大学医学中心（CUMC）和Weill -Cornell医疗中心（WCMC） - 帮助开发有前途的新型神经系统疗法。其中包括心脏骤停后治疗性低温，急性缺血性中风的梅克利凝块猎犬，麦片唑仑输注癫痫持续状态以及评估神经保护剂的临床试验，用于用于急性卒中的神经保护剂，用于急性溶栓治疗，用于内脑术和肠内血液疗法的抗肿瘤疗法，并用自超静脉输液疗法，并进行了脑膜外疗法。脑内出血。哥伦比亚大学医学中心是七个NIH现场研究中心之一；这项工作的核心是由急诊医学领导的多学科速度团队，该团队在我们的两个枢纽都不断评估急性中风护理，并驱动了IV T-PA的门到针时的大量减少。急诊医学和神经病学之间的这些合作努力得到了既定的基础设施的进一步支持，该基础设施促进了整个NYPS医疗保健系统的合作，包括中风中心临床委员会，急诊医学系统论坛，以及美国最大的独立救护系统之一。本应用程序的总体目的是建立我们在临床研究中现有的专业知识，我们在两家枢纽医院的急诊医学与临床神经科学之间的合作历史，以及我们在NYPS Healthcare系统中良好协调的努力的记录，以开发10个纽约 - 普雷斯比尔 - 普雷斯比尔 - 普雷斯比尔·纽约州Nett Consortium，用于进行神经临床临床试验。这10个急诊科总共对每年超过一百万患者的种族多样化的患者群体进行治疗。我们将追求以下具体目标：（1）建立一个由四个共同竞选研究人员组成的领导小组，代表我们两家枢纽医院的急诊医学和神经病学，并得到两个半场Nett项目协调员的支持； （2）在另外8家NYP Network Hospitals的急诊医学和神经病学共同评估器中，每个医院都由零件NetT协调员支持； （3）创建一个24小时的医师覆盖系统，为我们的区域急诊室提供临床和研究支持； （4）开发一种新的EMS触发的院前警告系统，以减少触发临床试验程序所需的时间； （5）正式将NYP Stroke Center临床委员会，NYP急诊医学系统论坛和Spotrias速度团队链接； （6）为管理神经紧急患者的管理制定统一的基于时间的绩效标准，并实施基于Internet的监视系统，以为我们的网站提供持续的质量改进（CQI）数据。