An evaluation of sensor technology to monitor and report compliance with an evidence-based intervention to prevent ventilator-associated pneumonia

 描述（由申请人提供）：候选人Nishi Rawat是约翰霍普金斯大学麻醉学和重症监护医学系的重症监护医生和助理教授。她的目标是成为一名独立调查员，专注于推进质量改进领域，以提高向美国人提供的医疗保健质量，同时降低成本，重点是应用信息技术来评估绩效，最大限度地减少浪费和消除冗余。 候选人作为两个合作研究者的初步工作，以减少呼吸机相关性肺炎（VAP）表明，有一个强大的驱动力，以消除可预防的伤害，如VAP，但薄弱的可用方法和资源这样做。迫切需要一种有效和廉价的方法来跟踪循证干预措施的交付情况，以提高质量。拟议的研究旨在填补这一测量空白。在该提案中，她评估了传感器方法在测量和提高护理质量方面的实用性，重点是VAP预防干预性能。 这些目标提出：通过比较传感器技术捕获的VAP过程测量性能估计值与传统手动数据收集获得的估计值，评估传感器方法在测量VAP预防干预依从性方面的实用性（目标1）;设计并试行一项战略，向供应商提供传感器过程测量依从性的实时反馈（目标2）;通过比较实时反馈策略实施前后的合规性，评估传感器方法对VAP过程测量合规性的影响（目标3）。拟议的工作可能从根本上改变医疗保健监测和报告重要护理干预措施的方式，并有可能使质量改进更加有效，廉价和可扩展。 候选人是唯一有资格承担拟议的工作。她是双板认证的重症监护和急诊医学，并已完成了病人安全和质量奖学金。她领导了多个地方质量改进计划，并作为国家工作队的一部分努力降低ICU成本，目前是大型国家感染预防合作的共同研究者。她的决心，热情和强烈的职业道德使她能够平衡这些研究活动与沉重的临床承诺。她现在需要保护的时间进行研究和职业发展，成为一名独立的调查员。

 DESCRIPTION (provided by applicant): The candidate, Nishi Rawat, is a Critical Care physician and Assistant Professor in the Department of Anesthesiology and Critical Care Medicine at Johns Hopkins. Her goal is to become an independent investigator focused on advancing the field of quality improvement to improve the quality of health care delivered to Americans, while simultaneously reducing costs, with an emphasis on the application of information technology to evaluate performance, minimize waste and eliminate redundancies. The candidate's preliminary work as a co-investigator for two collaboratives to reduce ventilator-associated pneumonia (VAP) suggests that there is a strong drive to eliminate preventable harms such as VAP, but weak available methodologies and resources to do so. There is a dire need for an effective and inexpensive methodology to track the delivery of evidence-based interventions for the purpose of quality improvement. The proposed research intends to fill this measurement gap. In this proposal, she evaluates the utility of the sensor approach for measuring and improving quality of care, focusing on VAP prevention intervention performance. The aims propose: evaluate the utility of the sensor approach for measuring compliance with a VAP prevention intervention by comparing VAP process measure performance estimates captured by sensor technology to estimates obtained by traditional manual data collection (Aim 1); design and pilot a strategy to provide real-time feedback of sensor process measure compliance to providers (Aim 2); evaluate the impact of the sensor approach on VAP process measure compliance by comparing compliance before and after the implementation of the real-time feedback strategy (Aim 3). The proposed work could fundamentally change how healthcare monitors and reports important care interventions, and has the potential to make quality improvement more efficient, inexpensive and scalable. The candidate is uniquely qualified to undertake the proposed work. She is double-board certified in Critical Care and Emergency Medicine, and has completed a Patient Safety and Quality fellowship. She has led multiple local quality improvement initiatives, and worked to decrease ICU costs as part of a national task force, and is currently co-investigator of large national infection prevention collaborative. It isher determination, enthusiasm and strong work ethic which have enabled her to balance these research activities with a heavy clinical commitment. She now needs protected time for research and career development to become an independent investigator.