Targeted Healthcare Engineering for Systems Interventions in Stroke (THESIS)

项目摘要/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因。已有几种经过验证的内科和外科治疗方法可用于 急性中风。然而，诊断错误和由此导致的治疗延误会导致错过机会 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(ED)会对现有的人员和资源造成压力和耗尽，而不是 实用的解决方案。此外，不完整的问题分析和风险评估可能会导致意外 干预的后果。尽管存在用于中风评估和治疗的建议和途径 管理，没有系统地设计、设计或测试来识别和有效地解决 系统故障，尤其是诊断错误。针对系统干预的针对性医疗工程 中风(论文)研究将汇集由中风神经学组成的动态学习实验室， 3家大型多元化医疗机构的急诊医学、信息学、工程学和卫生服务专家 在芝加哥拥有系统工程、问题分析、设计和应用经验的系统 确定和测试解决方案以减少诊断错误的开发、实施和评估方法 以及由此导致急诊室急性中风患者循证治疗的延误。

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.