Project Grant R34HL180904

The National Heart, Lung, and Blood Institute awarded The Washington University $272,125 on September 1, 2026, under the Cardiovascular Diseases Research program (CFDA 93.837) to refine and pilot-test the PACE (Process for Adopting Clinical Evidence) tool, a digital implementation science platform designed to help hospital units identify and substitute low-value clinical practices with evidence-based alternatives.

The project targets unnecessary procedures that expose patients to avoidable risk—including routine chest X-rays, prolonged urinary catheter use, and other low-value practices—that waste over $345 billion annually. The recipient's team has demonstrated 50% reductions in unnecessary emergency department chest X-rays and 80% reductions in indwelling urinary catheters in ICU settings through targeted substitution strategies. This R34 award funds feasibility testing to prepare for a larger multi-site R01 application.

Work in Aim 1 refines the PACE tool for usability and real-world deployment through human-centered design workshops across two health systems (one academic, one community). Clinicians, nurses, and educators from four clinical units—two emergency departments and two ICUs—will test and improve the tool's interface and workflow. Aim 2 pilot-tests feasibility and acceptability through a randomized comparison of PACE-guided versus standard implementation across four clinical units.

Performance occurs in St. Louis, Missouri. The award period runs from September 1, 2026, through June 30, 2029. This is a Project Grant assistance type.