PI: Monica Vavilala, University of Washington
Site PI: Michael Bell, University of Pittsburgh
Co-Investigators: Mark Wainwright, Northwestern University, Christopher Giza, UCLA
Funding: NIH - R01NS072308 (Project period: 9/1/10 to 8/31/15)
Traumatic brain injury (TBI) is the leading killer of children over one year of age. In 2003, the evidence based Guidelines for the Acute Medical Management of Severe Pediatric Traumatic Brain Injury was published. Yet, here are no strategies to increase adherence to these guidelines. Our project goal is to use an adherence scorecard to examine the association between adherence and patient outcomes, develop a value stream map illustrating factors impacting adherence, and use computer simulation to create a best practices blueprint for adherence. The guiding hypothesis is that organizational factors predict, adherence predicts outcomes and that a best practices blueprint will result in both adherence and favorable outcomes after severe pediatric TBI.
Specific Aim # 1: To develop a national adherence scorecard that characterizes national variation in adherence to the Pediatric Guidelines, and to use the scorecard to examine the relationship between adherence and patient outcomes. Specific Aim # 2: To create a value stream map that readily identifies remediable high priority provider and organizational factors which impact adherence to the Pediatric Guidelines and examine whether these factors vary by adopter status (defined in Aim # 1). Aim # 3: To use computer simulation to develop and disseminate a best practices blueprint for adherence to the Pediatric Guidelines. Strategies to increase adherence to the Pediatric Guidelines for severe traumatic brain injury are not known. We will use implementation science methods, such as value stream maps and iterative computer simulation, to develop and disseminate a best practices blueprint that increases adherence to the Pediatric Guidelines.