Targeted Healthcare Engineering for Systems Interventions in Stroke (THESIS)

项目总结/摘要 美国每年有近80万人受到中风的影响，中风仍然是主要原因 成人残疾和第五大死亡原因。存在几种经证实的药物和手术治疗方法， 急性中风然而，诊断错误和由此导致的治疗延误导致错过了机会， 减少急性中风患者的死亡和残疾。不分青红皂白的神经科咨询和过度测试， 急诊科（艾德）将加重和消耗现有工作人员和资源， 切实可行的解决办法。此外，不完整的问题分析和风险评估可能导致意外的 干预的后果。尽管存在中风评估的建议和途径， 管理，没有一个被系统地设计，设计或测试，以确定和有效地解决 系统故障，尤其是诊断错误。系统干预的目标医疗保健工程 在中风（论文）研究将汇集动态学习实验室组成的中风神经学， 急诊医学，信息学，工程和卫生服务专家在3个大型，多样化的医疗保健 在芝加哥的系统工程，问题分析，设计和 开发、实施和评估方法，以确定和测试解决方案，减少诊断错误 并导致ED中急性卒中患者循证治疗的延迟。

Project Summary/Abstract Nearly 800,000 people in the United States each year are affected by stroke, which remains the leading cause of adult disability and 5th leading cause of death. Several proven medical and surgical treatments exist for acute stroke. However, diagnostic error and resultant treatment delays contribute to missed opportunities to reduce death and disability in acute stroke patients. Indiscriminate neurologic consultation and over-testing in the emergency department (ED) will stress and deplete currently available staff and resources and are not practical solutions. Furthermore, incomplete problem analysis and risk assessments can lead to unintended consequences of an intervention. Although recommendations and pathways exist for stroke evaluation and management, none has been systematically engineered, designed, or tested to identify and effectively address system failures especially in diagnostic error. The Targeted Healthcare Engineering for Systems Interventions in Stroke (THESIS) study will bring together dynamic learning laboratories consisting of stroke neurology, emergency medicine, informatics, engineering, and health services experts at 3 large, diverse healthcare systems in Chicago with experience in the application of systems engineering, problem analysis, design and development, implementation, and evaluation methods to identify and test solutions to reduce diagnostic error and resultant delays to evidence-based treatments for acute stroke patients in the ED.