Dr. David Wallace has received a K08 grant for his project titled, “Understanding Regional Critical Care Delivery in Acute Respiratory Failure.” The objective of Dr. Wallace’s project is to empirically evaluate the outcome benefit of regionalized critical care for patients with acute respiratory failure. The project is scheduled to run from December 15, 2014 until November 30, 2018.
Acute respiratory failure puts a tremendous burden on the U.S. health care system, both in terms of high costs ($27 billion annually) and high mortality (40-50%). Regionalized care is a strategy to improve quality wherein patients are triaged to highly resourced referral centers with consistently higher volumes. Despite interest in this approach to improving patient outcomes, a lack of empirical evidence hinders implementation. Dr. Wallace’s project seeks to fill in this knowledge gap, answering the questions: (1) Does regionally centralized critical care improve region-level outcomes, including mortality and length-of-stay? and (2) Are there features of regions that encourage or hinder regionally centralized care?
This innovative project employs a unique approach toward regionalization, using newly conceived referral regions and novel methods for evaluating the approach. The ultimate goal of the project is to set the stage for research evaluating centralized care of other time-sensitive conditions in a comprehensive R01-funded project. Overall, the project will position Dr. Wallace as a future leader in the use of geographic modeling to improve outcomes for critically ill patients.
David John Wallace, MD, MPH, RDMS, is an Assistant Professor of Critical Care Medicine and Emergency Medicine, University of Pittsburgh School of Medicine.