Improving Recognition and Management of Chronic Kidney Disease in Primary Care

项目摘要/摘要 这一职业发展奖扩大了应聘者目前在卫生服务领域的经验 研究包括使用电子病历提高质量。该奖项将进一步聚焦于 候选人在质量改进和健康信息技术(HIT)领域的职业发展。 此应用程序的所有目标都旨在为应聘者提供必要的培训 成为如何最有效地利用HIT来提高交付质量的专家 医疗保健。该奖项四年课程的短期目标是让候选人成为 独立调查员，能够领导大规模的质量改进项目，并指导 初级保健实践研究网络(PBRN)。在此获奖期间，候选人计划 根据本研究项目的成果，发表5-7篇稿件。到本授权期结束时， 候选人还预期已获得随后的拨款支持，以广泛实施和评估 临床决策支持(CDS)工具在慢性病管理中的应用。培训活动 在本申请中提出的建议包括由成功的卫生服务研究人员进行持续监督指导， 课程包括获得医学信息学研究生证书，以及在 研讨会和国家会议。 研究提案中提出的活动的目的是确定改进 初级保健中慢性肾脏病(CKD)患者的识别和后续处理 全美的实践，重点是如何命中，更具体地说，CDS工具嵌入到 电子病历，可以用来实现这一目标。这些有计划的活动的结果是 可能适用于任何慢性病。该奖项研究计划的具体目标包括(1) 选择一套初级保健CKD质量指标，(2)按季度纳入这些CKD指标 将实践绩效报告分发给PBRN内的初级保健实践，(3)开发CDS工具 可用于在初级保健中加强对慢性肾脏病患者的护理，以及(4)实施和评估 这些临床决策支持工具在使用有效干预措施的其中10种实践中的影响。 该奖项针对的是医疗研究和质量机构(AHRQ)的使命，即改善 为所有美国人提供质量、安全、效率和有效性的医疗保健，主要目的是 处理AHRQ感兴趣的“卫生信息技术”优先领域，特别是如何处理HIT 可用于改善医疗保健决策。此外，由于患者教育和处方都是 建议是计划干预的一个组成部分，该项目还将涉及研究领域(1) HIT提高用药管理的质量和安全性；(2)HIT支持以患者为中心 关心。此外，尽管回应了AHRQ的关注领域，但这项研究计划也是一致的 与其他AHRQ组合，包括相对有效性、预防和护理管理，以及 创新和不断涌现的想法。与AHRQ的目标一致，该研究项目旨在改善 提高所有美国人的医疗保健质量，促进循证决策。

Project Summary/Abstract This career development award expands upon the candidate's current experience in areas of health services research including improving quality using electronic medical records. The award will further focus the candidate's career development in the areas of quality improvement and health information technology (HIT). All of the goals of this application have been designed to provide the candidate with the training necessary to become an expert on how HIT can be most effectively utilized to improve the delivery of quality healthcare. The short term goal for the four year course of this award is for the candidate to become an independent investigator, capable of leading large scale quality improvement projects and directing a primary care practice-based research network (PBRN). During this award period, the candidate plans to publish 5-7 manuscripts based on the results of this research project. By the end of this award period, the candidate also expects to have obtained subsequent grant support to broadly implement and assess the utility of clinical decision support (CDS) tools on the management of chronic diseases. Training activities proposed in this application include continued supervised mentoring by successful health services researchers, coursework including obtaining a Graduate Certificate in Medical Informatics, and presentation of findings at both seminars and national meetings. The purpose of the activities proposed in the research proposal is to identify methods to improve the identification and subsequent management of patients with chronic kidney disease (CKD) in primary care practices across the United States, focusing on how HIT, and more specifically CDS tools embedded in an electronic medical record, can be employed to achieve this goal. The findings from these planned activities are likely to be applicable to any chronic disease. The specific aims for the research plan for this award include (1) selecting a set of CKD quality indicators for primary care, (2) incorporating these CKD indicators in quarterly practice performance reports distributed to primary care practices within a PBRN, (3) developing CDS tools that can be used to enhance care of patients with CKD in primary care, and (4) implementing and evaluating the impact of these clinical decision support tools in ten of these practices using validated interventions. This award addresses the Agency for Healthcare Research and Quality's (AHRQ) mission to improve the quality, safety, efficiency, and effectiveness of healthcare for all Americans, and is primarily intended to address the AHRQ's "Health Information Technology" priority area of interest, particularly addressing how HIT can be used to improve health care decision making. In addition, since both patient education and prescribing recommendations are a component of the planned intervention, the project will also address research areas (1) HIT to improve the quality and safety of medication management and (2) HIT to support patient-centered care. Moreover, although responsive to the AHRQ's HIT area of interest, this research plan is also consistent with other AHRQ portfolios, including comparative effectiveness, prevention and care management, and innovations and emerging ideas. Consistent with AHRQ's goals, the research project is designed to improve the quality of healthcare for all Americans and to promote evidence-based decision making.