Timothy Girard, MD, MSCI Receives Grant to Study Interprofessional Education for Implementation of Evidence-based Practice

Associate professor Timothy Girard, MD, MSCI received a U01 award from the National Heart, Lung, and Blood Institute entitled “The Maximizing Extubation outcomes Through Educational and Organizational Research (METEOR) Trial.” The METEOR trial will examine innovative interprofessional education strategies designed to promote the use of two evidence-based, post-extubation respiratory therapies that reduce morbidity and mortality.

Nearly one million patients per year in the United States require invasive mechanical ventilation for acute respiratory failure, a life-threatening condition. Many of those who recover and have their breathing tube removed would benefit from mechanical ventilation delivered through a face mask as noninvasive ventilation (NIV) or oxygen delivered through a high-flow nasal cannula (HFNC), but these practices are currently underutilized.

“Clinical practice guidelines recommend these evidence-based practices, which are supported by numerous clinical trials, but multiple barriers limit their use,” said Timothy Girard, MD, MSCI, who is director of the CRISMA Center in the Department of Critical Care Medicine. “Our preliminary studies showed that one key barrier to implementation is the lack of a shared understanding about the value of these two respiratory therapies within the interprofessional ICU team. We hypothesize that interprofessional education will address this barrier.”

The METEOR trial is a cluster-randomized, stepped-wedge, type 2 hybrid effectiveness-implementation trial of ICU interprofessional education about preventive post-extubation NIV and HFNC with and without clinical protocols. The specific aims are to (1) test the effectiveness of interprofessional education on the implementation of preventive, post-extubation therapies, (2) compare the effectiveness of the two preventive, post-extubation therapies on patient-centered clinical outcomes, and (3) perform a comprehensive qualitative evaluation of the trial processes and outcomes in order to better understand mechanism, identify what worked and what didn’t, and set the stage for broader dissemination of the study findings.

Dr. Girard added, “Not only will the METEOR Trial lead to improved outcomes for hundreds of thousands of patients with acute respiratory failure, it will also provide critical insight into the role of interprofessional education as an implementation strategy in hospital settings.”

Project collaborators at the University of Pittsburgh include Jeremy Kahn, MD, MS, vice chair for Research and director for the Program on Health Policy and Management and Derek Angus, MD, MPH, executive vice president, UPMC and chief innovation officer, and chair of Department of Critical Care Medicine; Joyce Chang, PhD, professor of Medicine, Biostatistics, and Clinical and Translational Science in the Division of General Internal Medicine, Department of Medicine; Barbara E. Barnes, MD, MS, associate vice chancellor for Industry Relations and Continuing Education, Health Sciences, and associate dean for Continuing Medical Education, School of Medicine; Jennifer Seaman, PhD, assistant professor in the Department of Acute & Tertiary Care in the School of Nursing; and Jennifer Russell, PhD, chair of the Department of Educational Foundations, Organizations, and Policy in the School of Education. External collaborators include Linda Argote, PhD, the Thomas Lord professor of Organizational Behavior and Theory at Carnegie Mellon University, and Dean Hess, RRT, Med, managing editor for Respiratory Care and former assistant director of respiratory care at the Massachusetts General Hospital.