R01AI169293

Dissemination and Implementation of COVID-19 Care Innovations in ED Settings - Summary/Abstract

During a public health emergency such as the COVID-19 pandemic, rapid dissemination of information to clinicians about emerging innovations is critical to ensuring the best outcomes for patients. However, little is known about how clinicians obtain information about innovations, make decisions about implementation and de-implementation during uncertain times.

As SARS-CoV-2 made its initial, rapid spread across the nation, clinicians feared that the impending surge of critically ill patients would overwhelm capacity, causing patient deaths due to a lack of ventilators and other essential resources. Additionally, shortages of personal protective equipment posed a challenge to following the usual standards to protect clinicians from infection.

In a massive response to prevent worst-case scenarios from materializing, emergency department (ED) staff have rapidly innovated to deliver effective care, protect frontline workers, and ensure a sustainable supply of personal protective equipment. In response to these unusual conditions, ED clinicians turned to nontraditional sources of information—such as Twitter, Facebook, podcasts, and pre-print journal publications—to learn about innovations they could use to care for COVID-19 patients in EDs. While these sources of information provided easy access to information about innovations, they also spread misinformation.

Little research has been done to optimize dissemination and implementation of innovations during a public health emergency. Before the pandemic, an expansion of online platforms facilitating the exchange of information about innovations had already occurred, and many more exist now. Information is also shared through professional societies and social media. However, the understanding of the diffusion of innovations among EDs during the pandemic is currently limited due to the volume of sharing that happened during COVID-19, the urgency and fear associated with these innovations, and the need for deimplementation of interventions that were found to be ineffective or even dangerous. It is not clear how these processes happened and whether they might have differed based on the demographics of ED clinicians or the communities and populations they serve.

A comprehensive evaluation of the flow of innovations will lead to insights into how disseminators and implementers can improve practices during a pandemic and rapidly evolving emergencies, as well as how processes can be optimized for more steady-state conditions. Our study incorporates a strong interdisciplinary and mixed methods approach. Our strong team will work with study partners representing emergency physicians and nurses and experts in other disciplines in the ED. Study methods combine advanced natural language processing techniques with interviews (Aim 1), focus groups with a survey of ED professionals (Aim 2), and systematic synthesis of results to identify strategies for improving diffusion of ED care innovations (Aim 3). The study will also provide results in actionable formats, such as a toolkit of dissemination and implementation strategies.

RAND Corporation

TO ASSIST PUBLIC AND PRIVATE NONPROFIT INSTITUTIONS AND INDIVIDUALS TO ESTABLISH, EXPAND AND IMPROVE BIOMEDICAL RESEARCH AND RESEARCH TRAINING IN INFECTIOUS DISEASES AND RELATED AREAS, TO CONDUCT DEVELOPMENTAL RESEARCH, TO PRODUCE AND TEST RESEARCH MATERIALS. TO ASSIST PUBLIC, PRIVATE AND COMMERCIAL INSTITUTIONS TO CONDUCT DEVELOPMENTAL RESEARCH, TO PRODUCE AND TEST RESEARCH MATERIALS, TO PROVIDE RESEARCH SERVICES AS REQUIRED BY THE AGENCY FOR PROGRAMS IN INFECTIOUS DISEASES, AND CONTROLLING DISEASE CAUSED BY INFECTIOUS OR PARASITIC AGENTS, ALLERGIC AND IMMUNOLOGIC DISEASES AND RELATED AREAS. PROJECTS RANGE FROM STUDIES OF MICROBIAL PHYSIOLOGY AND ANTIGENIC STRUCTURE TO COLLABORATIVE TRIALS OF EXPERIMENTAL DRUGS AND VACCINES, MECHANISMS OF RESISTANCE TO ANTIBIOTICS AS WELL AS RESEARCH DEALING WITH EPIDEMIOLOGICAL OBSERVATIONS IN HOSPITALIZED PATIENTS OR COMMUNITY POPULATIONS AND PROGRESS IN ALLERGIC AND IMMUNOLOGIC DISEASES. BECAUSE OF THIS DUAL FOCUS, THE PROGRAM ENCOMPASSES BOTH BASIC RESEARCH AND CLINICAL RESEARCH. SMALL BUSINESS INNOVATION RESEARCH (SBIR) PROGRAM EXPANDS AND IMPROVES PRIVATE SECTOR PARTICIPATION IN BIOMEDICAL RESEARCH. THE SBIR PROGRAM INTENDS TO INCREASE AND FACILITATE PRIVATE SECTOR COMMERCIALIZATION OF INNOVATIONS DERIVED FROM FEDERAL RESEARCH AND DEVELOPMENT, TO INCREASE SMALL BUSINESS PARTICIPATION IN FEDERAL RESEARCH AND DEVELOPMENT, AND TO FOSTER AND ENCOURAGE PARTICIPATION OF SOCIALLY AND ECONOMICALLY DISADVANTAGED SMALL BUSINESS CONCERNS AND WOMEN-OWNED SMALL BUSINESS CONCERNS IN TECHNOLOGICAL INNOVATION. THE SMALL BUSINESS TECHNOLOGY TRANSFER (STTR) PROGRAM STIMULATES AND FOSTERS SCIENTIFIC AND TECHNOLOGICAL INNOVATION THROUGH COOPERATIVE RESEARCH AND DEVELOPMENT CARRIED OUT BETWEEN SMALL BUSINESS CONCERNS AND RESEARCH INSTITUTIONS, TO FOSTER TECHNOLOGY TRANSFER BETWEEN SMALL BUSINESS CONCERNS AND RESEARCH INSTITUTIONS, TO INCREASE PRIVATE SECTOR COMMERCIALIZATION OF INNOVATIONS DERIVED FROM FEDERAL RESEARCH AND DEVELOPMENT, AND TO FOSTER AND ENCOURAGE PARTICIPATION OF SOCIALLY AND ECONOMICALLY DISADVANTAGED SMALL BUSINESS CONCERNS AND WOMEN-OWNED SMALL BUSINESS CONCERNS IN TECHNOLOGICAL INNOVATION. RESEARCH CAREER DEVELOPMENT AWARDS SUPPORT THE DEVELOPMENT OF SCIENTISTS DURING THE FORMATIVE STAGES OF THEIR CAREERS. INDIVIDUAL NATIONAL RESEARCH SERVICE AWARDS (NRSAS) ARE MADE DIRECTLY TO APPROVE APPLICANTS FOR RESEARCH TRAINING IN SPECIFIED BIOMEDICAL SHORTAGE AREAS. IN ADDITION, INSTITUTIONAL NATIONAL RESEARCH SERVICE AWARDS ARE MADE TO ENABLE INSTITUTIONS TO SELECT AND MAKE AWARDS TO INDIVIDUALS TO RECEIVE TRAINING UNDER THE AEGIS OF THEIR INSTITUTIONAL PROGRAM.

93.855 - Allergy and Infectious Diseases Research

National Institute of Allergy and Infectious Diseases (NIAID) [HHS - NIH]

Santa Monica, California 904013208 United States

Single Zip Code

Dissemination and Implementation Research in Health (R01 Clinical Trial Optional) (PAR-19-274)

Amendment Since initial award the total obligations have increased 282% from $845,104 to $3,230,156.