A quality and cost analysis of interprofessional team continuity in icus
Active Project Grant Awarded Last action
- Award ID
- R01HS028438
- Recipient
-
The Johns Hopkins University UEI FTMTDMBR29C7
- Awarding agency
-
Division of Grants Management
Agency for Healthcare Research and Quality, Department of Health and Human Services
- Obligated
- $4,338,983
Award facts
- Assistance listing
- 93.226 Research on Healthcare Costs, Quality and Outcomes
- Completion date 86% complete
- Funding
-
- $3,952,588.00 Federal
- $386,395.00 Non-federal
- Funding agency
- Center for Evidence and Practice Improvement Agency for Healthcare Research and Quality, Department of Health and Human Services
- Place of performance
- Baltimore, MD 21218, USA
Award details come from USAspending.gov.
Description
- Abstract
- Critical care is the most complex, resource-intensive and costly care setting contributing over $130 billion to national health expenditures annually. Approximately 4 million patients are admitted to intensive care units (icus) each year with average mortality rate ranging from 8-19. Recently covid-19 has highlighted that staffing interprofessional teams in icus is quite challenging. One feature of healthcare staffing that has received much attention in settings outside of the ICU is continuity of care - whereby a patient is cared for by a small team of identified professionals over time - has been long recognized as an essential attribute of high- quality, patient-centered care. In primary care, greater continuity of patient care is associated with fewer emergency department visits and hospitalizations, lower healthcare costs, and higher patient satisfaction. Continuity-based acute care staffing models also exist, but are rarely adopted and sustained in practice, particularly in icus where continuity-based assignments can be challenging to operationalize. Importantly, although critical care is delivered by interprofessional teams of physicians, nurses, and respiratory therapists, continuity of interprofessional ICU teams has never been conceptualized or measured before. Without this knowledge, IT is difficult to know whether hospitals and administrators should prioritize continuity of ICU care, which could be a missed opportunity to improve quality of patient care and outcomes in this critically ILL, costly patient population. The overall goal of our study is to examine the effect of continuity of ICU interprofessional teams on patient outcomes and organizational economic outcomes, in order to develop an interprofessional assignment decision-support tool that optimizes the continuity of interprofessional ICU team care. We propose to examine the quality and costs of an interprofessional team continuity staffing approach in icus to guide future interventions in 13 icus across two different healthcare systems using data from over 2 years. We will examine interprofessional team continuity of shift-level ICU clinician teams (a nurse, a physician, and a respiratory therapist) assigned to each patient during the ICU stay. We define two dimensions of team continuity: intra-professional continuity, measuring each of the clinician's experience caring for the patient previously during the patient's stay, and inter-professional continuity, measuring the clinicians' joint experience working together as a team. We hypothesize that care delivered by shift-level ICU teams with higher intra- and inter-professional continuity will result in improved patient outcomes and reduced costs. Our research team has a strong record of joint publications on attributes of patient care teams including continuity of care with expertise in health economics, critical care nursing and medicine and engineering. Completion of the study will generate the most robust evidence, to date, to inform organizational priorities about continuity-based interprofessional staffing in icus, to improve care for critically ILL ICU patients.
Transactions
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| Amendment | $386,395 | $0 | |
| Amendment | $386,395 | $386,395 | |
| Original award | $386,395 | $0 |
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Subawards
| Subrecipient | Amount | Awarded |
|---|---|---|
| Yale Univ | $348,859 | |
| Marquette University | $69,675 |
Quick answers
Who received award R01HS028438?
R01HS028438 was awarded to The Johns Hopkins University by Division of Grants Management (Agency for Healthcare Research and Quality) on September 1, 2022.
How much is award R01HS028438 worth?
$4,338,983 has been obligated on R01HS028438: $3,952,588 in federal funding and $386,395 in non-federal funding.
Which agency awarded R01HS028438?
Division of Grants Management (Agency for Healthcare Research and Quality) awarded R01HS028438, with funding from Center for Evidence and Practice Improvement (Agency for Healthcare Research and Quality).
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