Tailored Adaptation of the AHRQ VTE QI Guide to Local Hospital Context

AHRQ VTE QI 指南根据当地医院情况进行定制调整

• 批准号: 10740991
• 负责人: Anthony D. Yang
• 金额: $ 14.88万
• 依托单位: INDIANA UNIV-PURDUE UNIV AT INDIANAPOLIS
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-11-16 至 2024-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10740991
• 关键词: Address; Adherence; Area; Award; Caring; Centers for Disease Control and Prevention (U.S.); Cessation of life; Characteristics; Chemoprophylaxis; Clinical; Communities; Companions; Complication; Deep Vein Thrombosis; Defect; Development; Devices; Early Ambulation; Elements; Environment; Evaluation; Failure; Funding; Future; Goals; Health; Health Policy; Health Services; Healthcare; Hospitals; Illinois; Inpatients; Institution; K-Series Research Career Programs; Knowledge; Leadership; Learning; Length of Stay; Manuals; Master of Science; Measurement; Measures; Medicine; Mentors; Methods; Modeling; Morbidity - disease rate; Operative Surgical Procedures; Outcome; Patients; Performance; Postoperative Period; Process; Prophylactic treatment; Protein Structure Initiative; Public Health; Pulmonary Embolism; Quality of Care; Quantitative Evaluations; Reporting; Research; Research Methodology; Research Personnel; Resources; Role; Safety; Shapes; United States; United States Agency for Healthcare Research and Quality; United States Centers for Medicare and Medicaid Services; career; contextual factors; dissemination science; effectiveness evaluation; effectiveness/implementation study; experience; health care quality; implementation measures; implementation science; implementation strategy; improved; innovation; insight; interdisciplinary collaboration; medical schools; mortality; novel; patient safety; post implementation; prevent; preventable death; professor; programs; prospective; skills; surgery outcome; venous thromboembolism

Project Summary / Abstract Dr. Yang is an Assistant Professor in the Department of Surgery, Surgical Outcomes and Quality Improvement Center (SOQIC), and the Center for HealthCare Studies (CHS) – Institute for Public Health and Medicine at the Feinberg School of Medicine. CHS and SOQIC conduct cutting-edge research about the safety and quality of healthcare through interdisciplinary collaborations of health services and outcomes researchers in order to inform and shape healthcare policy and to improve healthcare practices and the health of the nation. Dr. Yang's career goal is to become an independently funded investigator combining advanced quantitative and qualitative analytics with expertise in implementation and dissemination science to facilitate effective healthcare quality improvement locally, regionally, and nationally. To fulfill this goal, he will augment his Master's Degree in Healthcare Quality and Patient Safety by gaining expertise in three areas during this award period: (1) implementation and dissemination science, (2) qualitative and mixed methods research, and (3) quantitative evaluation methods. He will apply the new knowledge and skills experientially to the proposed project. Venous thromboembolism (VTE), defined as either a deep venous thrombosis or pulmonary embolism (PE), is a common, preventable cause of postoperative morbidity and mortality. PE is the leading cause of in-hospital preventable death in the United States. The currently quality measures for VTE have important flaws that limit the ability of hospitals to identify actionable targets for quality improvement (QI). Therefore, at the request of the Centers for Medicare and Medicaid Services, our group created and validated a new VTE Prophylaxis Composite Measure that includes the three best practice elements of postoperative VTE prophylaxis: (1) chemoprophylaxis, (2) sequential compression devices, and (3) early ambulation. The measure helps hospitals easily identify actionable QI targets for VTE prophylaxis. This application proposes to use an intensive, mixed methods evaluation in twelve hospitals of four key types (large academic; large community; small/medium community with QI experience; small/medium community with little/no QI experience) to examine how hospitals differentially adapt and utilize the resource, ““Preventing Hospital-Associated Venous Thromboembolism: A Guide for Effective Quality Improvement” (VTE QI Guide) to address QI targets identified by the VTE Prophylaxis Composite Measure, while taking into account their hospital-specific contexts. The lessons learned will culminate in the development of “Tailored Adaptations of the AHRQ VTE QI Guide,” a companion to the VTE QI Guide, which will equip hospitals with practical strategies to adapt and implement the VTE QI Guide within their hospital type and local context. Finally, the value of tailored use of the VTE QI Guide will be assessed by comparing pre- and post-implementation adherence to the VTE Prophylaxis Composite Measure in the twelve hospitals.

项目总结/摘要 杨医生是外科、手术结果和质量系的助理教授 改善中心（SOQIC）和卫生保健研究中心（CHS）-公共卫生和 在Feinberg医学院的医学。CHS和SOQIC进行关于安全的前沿研究 通过卫生服务和成果研究人员的跨学科合作， 以便为卫生保健政策提供信息和制定政策，并改善卫生保健做法和国民健康。 杨博士的职业目标是成为一名独立资助的研究人员， 在实施和传播科学方面具有专业知识的定性分析， 提高地方、区域和国家的医疗质量。为了实现这一目标，他将增加他的主人的 医疗质量和患者安全学位，在此期间获得三个领域的专业知识：（1） 实施和传播科学，（2）定性和混合方法研究，（3）定量 评价方法他将把新的知识和技能经验性地应用到拟议的项目中。 静脉血栓栓塞（VTE），定义为深静脉血栓形成或肺栓塞（PE）， 是术后发病率和死亡率的常见、可预防的原因。PE是住院患者的首要原因 在美国可预防的死亡。目前的质量措施，静脉血栓栓塞有重要的缺陷，限制 医院识别质量改进（QI）的可操作目标的能力。因此，应秘书长的请求， 医疗保险和医疗补助服务中心，我们的小组创建并验证了一个新的VTE预防复合 包括术后VTE预防的三个最佳实践要素的措施：（1）化学预防， (2)序贯加压装置;（3）早期Ambassador。该措施有助于医院轻松识别 预防VTE的可行QI目标。 该应用程序建议在四种关键类型的十二家医院中使用密集的混合方法进行评估 （大型学术;大型社区;具有QI经验的小型/中型社区;具有QI经验的小型/中型社区） 很少/没有QI经验），以检查医院如何差异化地适应和利用资源，““预防 医院相关静脉血栓栓塞：有效质量改进指南”（VTE QI指南）， 解决由VTE预防综合措施确定的QI目标，同时考虑其 医院的具体情况。吸取的经验教训将最终导致制定“有针对性地调整 AHRQ职业技术教育质量指数指南”，职业技术教育质量指数指南的配套指南，将为医院提供实用的策略， 在其医院类型和当地环境中调整和实施职业技术教育质量指数指南。最后，定制的价值 通过比较实施前后对职业技术教育质量标准的遵守情况，对职业技术教育质量标准指南的使用情况进行评估 12家医院的预防综合措施。

项目成果

Variation in Hospital Utilization of Minimally Invasive Distal Pancreatectomy for Localized Pancreatic Neoplasms.

用于局部胰腺肿瘤的微创远端胰腺切除术的医院利用率变化。

• DOI: 10.1007/s11605-019-04414-7
• 发表时间: 2020-12
• 期刊: Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract
• 作者: Ellis RJ;Zhang LM;Ko CY;Cohen ME;Bentrem DJ;Bilimoria KY;Yang AD;Talamonti MS;Merkow RP
• 通讯作者: Merkow RP

Development of the Illinois Surgical Quality Improvement Collaborative (ISQIC): Implementing 21 Components to Catalyze Statewide Improvement in Surgical Care.

• DOI: 10.1097/as9.0000000000000258
• 发表时间: 2023-03
• 期刊: Annals of surgery open : perspectives of surgical history, education, and clinical approaches

Update on Pheochromocytoma and Paraganglioma from the SSO Endocrine/Head and Neck Disease-Site Work Group. Part 1 of 2: Advances in Pathogenesis and Diagnosis of Pheochromocytoma and Paraganglioma.

• DOI: 10.1245/s10434-020-08220-3
• 发表时间: 2020-05
• 期刊: Annals of surgical oncology
• 影响因子: 3.7
• 作者: Patel D;Phay JE;Yen TWF;Dickson PV;Wang TS;Garcia R;Yang AD;Solórzano CC;Kim LT
• 通讯作者: Kim LT

Amalgamation of cloud-based colonoscopy videos with patient-level metadata to facilitate large-scale machine learning.

将基于云的结肠镜检查视频与患者级元数据合并，以促进大规模的机器学习。

• DOI: 10.1055/a-1326-1289
• 发表时间: 2021-03
• 期刊: Endoscopy international open
• 影响因子: 2.6
• 作者: Keswani RN;Byrd D;Garcia Vicente F;Heller JA;Klug M;Mazumder NR;Wood J;Yang AD;Etemadi M
• 通讯作者: Etemadi M

A comprehensive national survey on thoughts of leaving residency, alternative career paths, and reasons for staying in general surgery training.

一项关于离开住院医师实习的想法、替代职业道路以及继续接受普外科培训的原因的全面全国调查。

• DOI: 10.1016/j.amjsurg.2019.10.040
• 发表时间: 2020
• 期刊: American journal of surgery
• 影响因子: 3
• 作者: Ellis,RyanJ;Holmstrom,AmyL;Hewitt,DBrock;Engelhardt,KathrynE;Yang,AnthonyD;Merkow,RyanP;Bilimoria,KarlY;Hu,Yue-Yung
• 通讯作者: Hu,Yue-Yung