Improving Care in HF Patients through Decision Support

描述(由申请人提供)：这是由约翰霍普金斯大学护理学院初级教员谢丽尔·丹尼森提交的修订后的申请，她在约翰霍普金斯大学医学中心创新优质患者护理中担任了一名职务。应聘者有重症监护临床医生的背景，是具有预防心脏病学专业知识的成人护士从业人员，并拥有护理博士学位。应聘者的目标是成为一名独立的临床研究员，应用严格的研究方法开发和评估创新的跨学科方法，以提高心力衰竭(HF)等慢性疾病的护理质量。心力衰竭是一个主要的公共卫生问题，影响着美国近500万美国人。预计到2007年，它在美国的流行率将翻一番。尽管5年内50%的心力衰竭死亡率最近有所下降，但心力衰竭的发病率正在达到流行的程度。尽管管理指南广为人知，但心力衰竭仍然非常普遍、无效和昂贵，这在很大程度上是因为有效的治疗方法没有得到充分利用。候选人提出的职业发展计划包括一个跨学科的培训计划，旨在提供与结构化教学课程相关联的紧张、密切指导的研究经验。在资深研究人员Jerilyn Allen博士和Peter Pronovost博士的指导下，候选人将在进行监督研究的同时，同时参加健康信息学和决策支持、护理质量、组织和提供者行为变化以及成本分析方法学的高级课程。候选人建议开发、形式化评估和试点测试一种创新的、交互式的、基于Web的临床决策支持系统(CDSS)，以改善提供者对国家循证指南的实施，从而提高心力衰竭患者的护理质量。这项研究、其他研究项目以及文中描述的职业发展计划将为这位候选人的成功职业生涯做好准备，成为一名独立、但合作的、在跨学科团队科学方面具有强烈社会性的研究人员。

DESCRIPTION (provided by applicant): This is a revised application submitted by Cheryl Dennison, a junior faculty member at the Johns Hopkins University School of Nursing with an appointment in the Johns Hopkins Medicine Center for Innovation in Quality Patient Care. The candidate has a background as a clinician in critical care, is an adult nurse practitioner with preventive cardiology expertise, and has a PhD in nursing. The candidate's goal is to become an independent clinician investigator applying rigorous research methods to develop and evaluate innovative, interdisciplinary methods to improve quality of care for chronic illnesses, such as heart failure (HF). HF is a major public health problem, affecting nearly 5 million Americans in the United States. Its prevalence is expected to double in the United States by 2007. Although HF mortality of 50% over 5 years has recently decreased, HF morbidity is reaching epidemic proportions. HF remains highly prevalent, disabling, and costly in large part due to underutilization of effective therapies despite well-publicized management guidelines. The candidate's proposed career development plan incorporates an interdisciplinary training program designed to provide an intense, closely mentored, research experience in association with structured didactic curriculum. Under the mentorship of senior investigators, Drs. Jerilyn Allen and Peter Pronovost, the candidate will conduct supervised research while concurrently enrolled in advanced coursework in Health Informatics and Decision Support, Quality of Care, Organizational and Provider Behavior Change, and Cost Analysis methodology. The candidate proposes to develop, formatively evaluate, and pilot test an innovative, interactive, Web-based clinical decision support system (CDSS) to improve provider implementation of national evidence-based guidelines and thereby improve quality of care among HF patients. This study, other research projects, and the career development plan described within will prepare this candidate for a successful career as an independent, yet collaborative, investigator strongly socialized in interdisciplinary team science.