A Decision Support Tool for Adult Sickle Cell Emergency Department Patients

描述（由申请人提供）： 申请人是西北大学急诊医学研究助理教授。申请人的长期目标是成为一名独立的研究者，主要关注改善急诊科（艾德）环境中镰状细胞病（SCO）患者的护理。急性疼痛发作是SCD最常见的并发症。这些痛苦的发作是严重的，往往需要在急诊室（艾德）设置的护理。艾德临床医生经常认为患有SCD的人寻求药物，并且患者经常认为艾德经历令人沮丧。一些SCD患者还具有复杂的合并症和生物-心理-社会需求，可能导致频繁的艾德访视。临床医生通常没有准备好管理SCD患者在艾德环境中的急性疼痛，并且没有接受过如何进行充分的生物-心理-社会评估的培训，该评估将在艾德出院时确定个体患者的教育和转诊需求。识别这些需求可能会导致改善护理和减少返回艾德访问时，提供适当的转介。该项目的目标是开发和试点测试的生物心理社会决策支持工具（镰状细胞评估的需求和优势，SCANS），用于急诊临床医生。SCANS将1）客观评估和指导艾德镇痛管理，2）确定成人SCD患者的教育和转诊服务提供需求。SCANS将有利于急诊临床医生和SCD患者，特别是目前可能导致频繁艾德就诊的具有复杂需求的患者。在血液学、急诊医学疼痛管理、心理测量学和成瘾领域的既定调查人员的指导下，候选人提出了一个职业发展计划，该计划旨在解决申请人成为独立调查人员的长期目标。拟议培训的主要目标是：1）增加SCD的知识，2）深入了解成瘾和疼痛之间的复杂关系，3）接受定性和决策支持工具开发方法的培训。这方面的知识将定位候选人启动研究生涯作为一个调查员谁将进行旨在科学地评估机制，以改善在艾德设置SCD的人的护理项目。

DESCRIPTION (provided by applicant): The applicant is a Research Assistant Professor in Emergency Medicine at Northwestern University. The applicant's long-term goal is to become an independent investigator with a primary focus on improving the care for persons with Sickle Cell disease (SCO) in the emergency department (ED) setting. Acute pain episodes are the most frequent complication associated with SCD. These painful episodes are severe and often require care in the emergency department (ED) setting. ED clinicians frequently perceive persons with SCD to be drug seeking and patients often perceive the ED experience as frustrating. Some patients with SCD also have complex co-morbidities and bio-psycho-social needs that may contribute to frequent ED visits. Clinicians are often unprepared to manage the acute pain in the ED setting for persons with SCD and are not trained in how to perform an adequate bio-psycho-social assessment that would identify individual patient education and referral needs upon ED discharge. Identification of these needs may lead to improved care and decreased return ED visits when provided with proper referrals. The goal of this project is to develop and pilot test a bio-psycho-social decision support tool (the Sickle Cell Assessment of Needs and Strengths, SCANS) to be used by emergency clinicians. The SCANS will 1) objectively assess and guide ED analgesic management and 2) identify education and referral service delivery needs for adult patients with SCD. The SCANS will be beneficial to both emergency clinicians and patients with SCD, in particular for patients with complex needs that currently may result in frequent ED visits. Under the mentorship of established investigators in the areas of hematology, emergency medicine pain management, psychometrics and addiction the candidate proposes a career development program that addresses the applicants' long- term goal of becoming an independent investigator. Primary goals of the proposed training are to 1) increase knowledge in SCD, 2) gain an in-depth understanding of the complex relationship between addiction and pain, and 3) receive training in qualitative and decision support tool development methodologies. This knowledge will position the candidate to launch a research career as an investigator who will conduct projects aimed at scientifically evaluating mechanisms to improve the care of persons with SCD in the ED setting.