The influence of ward capacity strain on outcomes among survivors of acute respiratory failure
病房容量紧张对急性呼吸衰竭幸存者预后的影响
基本信息
- 批准号:10627125
- 负责人:
- 金额:$ 5.4万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2019
- 资助国家:美国
- 起止时间:2019-08-26 至 2024-07-31
- 项目状态:已结题
- 来源:
- 关键词:Acute respiratory failureAmericanAwardCaringClinicalComplementCritical CareCritical IllnessDisciplineEnrollmentFaceFellowshipFundingGeneral HospitalsGoalsGrantHospitalsImpaired cognitionIntensive Care UnitsIntervention TrialK-Series Research Career ProgramsLength of StayLongitudinal cohort studyLungMaster of ScienceMeasuresMechanical ventilationMediatingMentorsMethodsMorbidity - disease rateNational Heart, Lung, and Blood InstituteOutcomePatient-Focused OutcomesPatientsPhysiciansPostdoctoral FellowProcessPublic HealthQuality of CareRandomized Controlled TrialsResearchResearch PersonnelResourcesRetrospective cohort studyStaff Work LoadStructureSurvivorsSystemTestingTimeTrainingWait TimeWorkbasecareerclinical epidemiologydesigndeviantexperiencehealth related quality of lifehigh riskhospital readmissionimprovedimproved outcomemortalityprospectivepsychologicstemsurvivorshiptherapy developmentward
项目摘要
Project Summary/Abstract
More than 1 million Americans survive acute respiratory failure (ARF) each year. These ARF survivors often
endure health-related quality of life, physical, psychological, and cognitive impairments in the months following
discharge. This growing public health and morbidity burden associated with ARF survivorship stems, in part,
from the fact that the robust evidence to guide best practices during mechanical ventilation is unmatched by
similar evidence to guide care after the intensive care unit (ICU) stay. Because 90% of ARF survivors transition
from ICUs to general hospital wards during their recoveries, the quality of ward-based care may strongly
influence patients’ outcomes. However, the methods needed to assess and improve ward systems practices
for ARF survivors do not exist. The candidate’s Master of Science in Clinical Epidemiology (MSCE) and F32
work defined the construct of “ward capacity strain,” which occurs when demand for clinical resources exceeds
availability. This work identified measures of ward patient volume and staff workload that contribute to ward
capacity strain, and demonstrated that increased strain was associated with prolonged ICU discharge wait
times and 30-day hospital readmissions among critical care survivors. This Career Development Award builds
from that work, and seeks to achieve three aims that, together, will promote the candidate’s long-term goal of
developing and testing strategies to improve ARF survivor outcomes by mitigating ward capacity strain and
other systems-level factors. Specifically, in this award the candidate seeks to measure associations of ward
capacity strain with (1) in-hospital outcomes and (2) post-hospitalization, patient-centered outcomes among
ARF survivors, and (3) identify care processes that mediate relationships between ward capacity strain and
patient outcomes, and ward-level systems practices that modify such relationships. To complete these aims
the candidate will perform a retrospective cohort study (Aim 1), a prospective longitudinal cohort study enrolling
176 ARF survivors (Aim 2), and a mixed-methods positive deviance study enrolling 50 ward-based clinicians
who care for survivors of ARF (Aim 3). The hands-on experience she will acquire in completing these three
studies using different methods will be complemented by carefully selected didactic coursework and structured
mentoring by senior investigators from multiple disciplines. This work will lead to pilot grants and an R21 to
support development of an intervention to mitigate the untoward effects of ward capacity strain on ARF
patients’ outcomes, and to an R01 to support a randomized controlled trial of this intervention. Completing this
research will build upon the candidate’s past training, which includes an MSCE obtained with NHLBI T32
support and an NHLBI F32-supported post-doctoral fellowship, and will provide her with the protected time and
experience to achieve her career goal of becoming a leading, independently-funded outcomes researcher
focused on leveraging systems-level practices to improve outcomes among survivors of ARF and other critical
illnesses.
项目总结/文摘
项目成果
期刊论文数量(0)
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科研奖励数量(0)
会议论文数量(0)
专利数量(0)
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Rachel Kohn其他文献
Rachel Kohn的其他文献
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{{ truncateString('Rachel Kohn', 18)}}的其他基金
The influence of ward capacity strain on outcomes among survivors of acute respiratory failure
病房容量紧张对急性呼吸衰竭幸存者预后的影响
- 批准号:
10461743 - 财政年份:2019
- 资助金额:
$ 5.4万 - 项目类别:
The influence of ward capacity strain on outcomes among survivors of acute respiratory failure
病房容量紧张对急性呼吸衰竭幸存者预后的影响
- 批准号:
10684669 - 财政年份:2019
- 资助金额:
$ 5.4万 - 项目类别:
The influence of ward capacity strain on outcomes among survivors of acute respiratory failure
病房容量紧张对急性呼吸衰竭幸存者预后的影响
- 批准号:
10223428 - 财政年份:2019
- 资助金额:
$ 5.4万 - 项目类别:
The influence of ward capacity strain on outcomes among survivors of acute respiratory failure
病房容量紧张对急性呼吸衰竭幸存者预后的影响
- 批准号:
10000138 - 财政年份:2019
- 资助金额:
$ 5.4万 - 项目类别:
Defining measures of strain on hospital wards and their influence on survivors of acute respiratory failure
确定医院病房的紧张措施及其对急性呼吸衰竭幸存者的影响
- 批准号:
9395053 - 财政年份:2018
- 资助金额:
$ 5.4万 - 项目类别:
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