AHRQ Mentored Clinical Scientist Research Career Development Award (K08): Maya Dewan

项目摘要 儿科住院期间心脏骤停最常发生在儿科重症监护病房， 广泛的发病率和死亡率。这份提案描述了一项为期5年的研究和培训计划，该计划将 允许Maya Dewan医生通过临床决策支持解决预防儿科心脏骤停的问题 和实施学。完成了儿科重症监护医学的团契培训和 建立在改进科学、流行病学/生物统计学和临床信息学的背景下 申请者寻求发展新的知识和技能，以使用设计知情的临床决策支持和 实施科学，以改善对危重儿童的护理和预后。 这项申请旨在解决预防儿童心脏骤停的问题。预防心脏骤停事件是 这是可行的，因为儿童通常在病情恶化之前就表现出警告迹象。申请人的初步研究 证明预测儿科高危患者的临床恶化是可行的。具体的 拟议调查的目的是：1)前瞻性地验证PICU警告工具以预测 临床恶化，2)评估增加人工高频对预测和情景意识的影响。 自动PICU警告工具的风险标准，3)阐明系统设计中将改进的因素 实施PICU警告工具。 这项工作具有重要意义，因为它侧重于开发和实施有效的健康信息 技术干预，提高医疗质量。它利用健康信息的能力 提高高风险儿科患者护理的质量、效率和效果的技术。而当 这项培训基金的重点是在改进科学工作中实施卫生信息技术，它还解决了 研究领域包括设计、使用和对结果的影响。通过类型1的有效性-实施 混合设计，Dewan博士将确定实施的障碍和促进者，以促进成功 从学术研究工具到实施良好的临床决策支持工具 例行练习。

PROJECT ABSTRACT Pediatric in-hospital cardiac arrest most commonly occurs in the pediatric intensive care unit and carries extensive morbidity and mortality. This proposal describes a 5-year research and training program that will allow Dr. Maya Dewan to address the prevention of pediatric cardiac arrest through clinical decision support and implementation science. Having completed fellowship training in pediatric critical care medicine and building on a background of improvement science, epidemiology/biostatistics, and clinical informatics the applicant seeks to develop new knowledge and skills to use design informed clinical decision support and implementation science to improve the care and outcomes for critically ill children. This application seeks to address prevention of pediatric cardiac arrest. Prevention of cardiac arrest events is feasible because children often display warning signs prior to deterioration. The applicant’s preliminary studies demonstrate that prediction of pediatric patients at high-risk for clinical deterioration is feasible. The specific aims of the proposed investigations are to: 1) To prospectively validate the PICU Warning Tool to predict clinical deterioration, 2) To evaluate the impact on prediction and situational awareness of adding manual high- risk criteria to the automated PICU Warning Tool, 3) To elucidate factors in system design that will improve implementation of the PICU Warning Tool. This work is significant as it focuses on the development and implementation of an effective health information technology intervention to improve health care quality. It leverages the capability of health information technology to improve quality, efficiency, and effectiveness of care for the highest risk pediatric patients. While this training grant focuses on the implementation of health IT in improvement science work, it also addresses the research areas of design, use, and impact on outcomes. Through a Type 1 effectiveness-implementation hybrid design, Dr. Dewan will identify barriers and facilitators to implementation to facilitate a successful translation from an academic research tool to a well implemented clinical decision support tool suitable for routine practice.