Improving Prehospital Pediatric Emergency Readiness with Telemedicine

通过远程医疗提高院前儿科急救准备

基本信息

批准号：
10055020
负责人：
Tehnaz Parakh Boyle
金额：
$ 16.63万
依托单位：
BOSTON MEDICAL CENTER
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-09-01 至 2025-08-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10055020
关键词：
Acute Adoption Adult Adverse event Ambulances Assessment tool Award Basic Science Blinded Boston Caring Child Child Care Childhood Childhood Injury Clinical Clinical Trials Design Communities Critical Illness Data Development Plans Early Intervention Education Educational Intervention Educational workshop Effectiveness Emergency Care Emergency Department Physician Emergency Situation Emergency medical service Emergency research Equipment Ethics Event Evidence based intervention Focus Groups Funding Future Goals Grant Heart Diseases Hospitals Human Human Subject Research Improve Access Individual Infant Informed Consent Infrastructure Internships Intervention Intervention Trial Interview Knowledge Life Massachusetts Measurable Measures Mentors Methods Modeling Outcome Outcome Measure Paramedical Personnel Participant Patients Pediatrics Performance Pharmaceutical Preparations Phase Physician Assistants Physicians Positioning Attribute Pre-hospital setting Pre-hospitalization care Prehospital Emergency Care Procedures Process Protocols documentation Provider Quality of Care Questionnaires Radio Randomized Randomized Controlled Trials Readiness Regulation Reporting Research Research Ethics Research Personnel Research Priority Research Training Respiratory Failure Respiratory distress Resuscitation Safety Sample Size Savings Scientist Specialist Stroke Structure Surveys System Technology Teleconsultations Telemedicine Testing Time Training Training Programs Treatment Efficacy Universities Videoconferencing Work Workload acute care arm base care systems career career development child protection child services clinical effect clinical practice community partnership design efficacy trial emergency service responder experience field study handheld mobile device human subject improved improved outcome innovation medical specialties meetings models and simulation multidisciplinary novel open label patient oriented patient oriented research patient safety pediatric emergency pediatric patients practice setting pre-clinical primary outcome professor programs recruit research study respiratory risk minimization rural underserved secondary outcome service providers severe injury simulation skills success telehealth theories tool treatment arm treatment as usual usability

项目摘要

PROJECT SUMMARY Dr. Boyle proposes a 5-year mentored research training program to become an independent clinician investigator leading prehospital pediatric emergency care research. She has a strong background in basic science research and is a board-certified Pediatric Emergency Physician and Assistant Professor of Pediatrics at Boston University. Her current research focuses on testing system-level interventions to improve patient- oriented outcomes of critically ill and injured children. This proposal focuses on teleconsultation as an innovative intervention to improve prehospital treatment of children with acute respiratory emergencies and to facilitate transitions of care to acute care hospitals. Dr. Boyle’s career development plan includes systematic education and mentoring in intervention optimization; the use of simulation as a research tool for early phase intervention testing; clinical trial design and analysis; and training in the ethics of prehospital emergency care research, including emergency exceptions to informed consent and protection of children as human subjects. She has assembled a multidisciplinary expert team to support her on this project, led by primary mentor, James Feldman, MD, MPH, FACEP and co-mentor, Carlos Camargo, MD, DrPH, FACEP. Her training plan includes a combination of formal coursework and workshops, scientific seminars and meetings, and a focused research ethics internship. These will be paired with mentored research studies where she will test the central hypothesis that pediatric teleconsultation (intervention) by Emergency Medical Service (EMS) providers will result in measurably safer care for children with life-threatening respiratory illness as compared to usual care. Dr. Boyle has partnered with local Massachusetts EMS systems and an affiliated pediatric specialty transport system to refine and pilot test the intervention in simulated and real pediatric respiratory emergencies. The specific aims of this career development proposal are to: (1) Identify predictors of stakeholder acceptance of prehospital teleconsultation for children with a mixed methods study; (2) Estimate intervention acceptability, feasibility, and effect size for prehospital team resuscitation performance in simulated pediatric respiratory emergencies using a pilot randomized controlled trial; and (3) Field test acceptability and feasibility of using a mobile video-conferencing platform for remote assessment of children transported by ambulance for respiratory distress. This proposal serves the dual purpose of supporting Dr. Boyle’s transition to independence as a clinician investigator in patient-oriented research, as well as generating important pilot data to estimate clinical effect, provide sample size justification, and establish the acceptability and feasibility of using a teleconsultation platform optimized for prehospital providers to guide future definitive trials of efficacy. If funded, this research will determine whether teleconsultation, a promising intervention to increase access to high quality care in rural and underserved settings, can improve prehospital emergency care for children.

项目摘要博伊尔博士提出一项为期5年的指导研究培训计划，成为独立的临床研究人员领导院前小儿急诊研究。她的基本背景很强科学研究，是董事会认证的小儿急诊医师和儿科助理教授在波士顿大学。她目前的研究重点是测试系统级干预措施，以改善患者 - 重症儿童和受伤儿童的定向结果。该提案的重点是电信创新的干预措施以改善急性呼吸紧急情况儿童的院前治疗，并促进过渡到急诊医院的过渡。博伊尔博士的职业发展计划包括系统干预优化的教育和心理；将模拟用作早期研究工具干预测试；临床试验设计和分析；以及院前急诊伦理的培训研究，包括知情同意和保护儿童作为人类受试者的紧急例外。她已经组建了一个多学科专家团队，以支持她，由主要导师领导，詹姆斯·费尔德曼（James Feldman），医学博士，MPH，FACEP和CO-ENCEMOR，CARLOS CAMARGO，医学博士，DRPH，FACEP。她的培训计划包括正式的课程和讲习班，科学的半手和会议的结合以及集中的研究伦理实习。这些将与指导研究配对，她将测试中央假设急诊医疗服务（EMS）提供者的小儿电信（干预）将与通常的护理相比，对威胁生命的呼吸道疾病的儿童可衡量的更安全的护理。博伊尔博士与当地马萨诸塞州EMS系统和会员小儿专业交通合作完善和试点测试模拟和实际儿科呼吸紧急情况的系统。该职业发展建议的具体目的是：（1）确定利益相关者接受的预测因素与混合方法研究的儿童的院前电信；（2）估计干预可接受性，院前团队复苏性能的可行性和效果大小在模拟的小儿呼吸道使用飞行员随机对照试验的紧急情况；（3）现场测试可接受性和使用用于远程评估救护车运送儿童的移动视频会议平台呼吸窘迫。该建议的目的是支持博伊尔博士过渡到独立作为以患者为导向的研究的临床研究者，并生成重要的试点数据为了估计临床效应，提供样本量的理由，并确定使用针对院前提供商进行优化的远程培养平台，以指导未来的确定性效率试验。如果资助后，这项研究将确定远程培养，承诺干预措施是否增加了访问权限在粗糙和服务不足的环境中，高质量的护理可以改善儿童院前急诊护理。