ED-lead: emergency departments leading the transformation of alzheimer's and dementia care

Active Cooperative Agreement Awarded Last action

Award ID
U19AG078105
Recipient
Awarding agency
Obligated
$51,417,148

Award facts

Assistance listing
93.866 Aging Research
Completion date 62% complete
Place of performance
New York, NY 10016, USA

Award details come from USAspending.gov.

Description

As the agency reported it.

Abstract
In persons living with dementia (plwd), an emergency department (ED) visit is a critical event and an opportunity to address the unmet needs that preceded the visit. Our multiple PI (MPI) team have together conducted cluster-randomized, multi-site trials in >50 EDS as well as multiple hospice and home health agencies, and are uniquely poised to address previous shortcomings in the development of scalable models of care for plwd. Through this work, and that of our CO-investigators, we have developed and tested three interventions relevant to plwd and their care partners who visit the ED: 1) emergency care redesign (UH3AT009844) of new and intentional workflows for emergency providers reinforced by digital alerts and structured collaboration between sites, already shown to increase identification of advance care plans and enlisted multidisciplinary support; 2) a nurse-led telephonic care program (pcori) that increased advance care planning and connected patients to hospice; and 3) a community paramedic-led structured coaching intervention (R01AG050504) that reduced the odds of an ED revisit within 30 days by 75%. Building on this evidence, the overarching goal of EDS leading the transformation of alzheimer's and dementia care (ED- lead) is to turn an ED visit from a crisis into an opportunity to improve the well-being of plwd and their care partners. ED-lead will be embedded in a diverse group of 14 health systems, including 80 EDS with substantial racial and ethnic diversity, with the ED as the unit of randomization. An administrative core will oversee completion of all administrative milestones including integrating expertise and guidance from two NIA- funded networks and an external advisory board. An implementation core will: 1) harmonize core functions and processes; 2) optimize clinical decision support; and 3) and enable intervention fidelity across the three interventions. Finally, a statistical analysis core will provide biostatistical and data management support. Our specific aims are to: 1) optimize a concurrently run emergency care redesign, nurse-led telephonic care, and community paramedic-led transitions intervention in plwd for feasibility, fidelity and usability in two EDS; 2) study the effectiveness of these three interventions, alone and in combination, for plwd with serious illness in a cluster-randomized multifactorial trial embedded within 80 EDS on: ED revisits, hospitalizations, and healthy days at home following the index ED visit; and 3) determine site, provider, patient, and care partner-level characteristics within a diverse population associated with variation in implementation of each intervention. ED- lead will address shortcomings noted in the national academies of sciences, engineering, and medicine report on plwd by providing high-quality, real-world evidence that may improve the lives and reduce suffering of plwd and their care partners. IT will address key strategic goals of NIA and the national alzheimer's plan to "implement and evaluate new care models to support effective care transitions", and provide health systems with the necessary evidence to scale interventions for this vulnerable population.

Transactions

Action Obligated Date
Amendment $6,885,204
Amendment $16,848,854
Amendment $0
Amendment $17,240,889
Original award $10,442,201

Subawards

Subrecipient Amount Awarded
Brigham & Womens Hospital Inc. ED-lead $88,538
Brigham & Womens Hospital Inc. $112,058
Brigham & Womens Hospital Inc. $286,604
Brigham & Womens Hospital Inc. $71,958
Mayo Clinic $200,910
Mayo Clinic $31,946
University Of Wisconsin System $700,680
The Johns Hopkins University $852,523
University Of Wisconsin System $39,122
University Of Wisconsin System $57,179
University Of Rochester $646,576
University Of Rochester $70,116
University Of Rochester $175,616
University Of Rochester $194,742
Northwestern University $438,994
Northwestern University $495,398
Northwestern University $43,702
The Regents Of The University Of Colorado $1,878,292
Northwestern University $148,517
The Regents Of The University Of Colorado $1,331,484
The Regents Of The University Of Colorado $298,284
The Regents Of The University Of Colorado $534,396
The Johns Hopkins University ED-LEAD: Emergency Departments LEading the transformation of Alzheimer’s and Dementia care (Resubmission) $171,002
Alzheimers Disease And Related Disorders, New York City, Inc. $245,920
Ochsner Bayou LLC $691,013
Memorial Sloan-Kettering Cancer Center $1,855,999
Henry Ford Health System $1,095,292
Yale Univ $189,950
University Of Pittsburgh - Of The Commonwealth System Of Higher Education $1,429,311
North Shore University Hospital $2,489,512
Brigham & Womens Hospital Inc. $119,266
University Of Alabama At Birmingham $128,573
University Of Wisconsin System $2,321,295
University Of Connecticut Health Center $89,553
Northwestern University $1,520,904
Mayo Clinic $703,477
Kaiser Foundation Hospitals $108,327
Icahn School Of Medicine At Mount Sinai $83,084
University Of Rochester $275,038
The Johns Hopkins University $159,489
Show all 40

Quick answers

Who received award U19AG078105?

U19AG078105 was awarded to New York University by National Institute on Aging (National Institutes of Health) on September 15, 2023.

How much is award U19AG078105 worth?

$51,417,148 has been obligated on U19AG078105.

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