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Implementing and Sustaining Complex Interdisciplinary Healthcare Interventions: Learning from Medication Reconciliation

Award Number: K01HS025486
ORGANIZATION: AGENCY FOR HEALTH CARE RESEARCH AND QUALITY
OPDIV: AHRQ
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: TRAINING/TRAINEESHIP
PERIOD OF PERFORMANCE START DATE: 09/30/2017
PERIOD OF PERFORMANCE END DATE: 09/29/2021

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Implementing and Sustaining Complex Interdisciplinary Healthcare Interventions: Learning from Medication Reconciliation - PROJECT SUMMARY/ABSTRACT Approximately 50% of patients in U.S. hospitals experience at least 1 unintentional medication discrepancy and 52% of these discrepancies have the potential for significant harm. Medication reconciliation (MedRec) can reduce the number of medication discrepancies by more than 60%. However, the complexity and contextual barriers associated with MedRec have stunted implementation, and best practices to foster effective implementation and sustainability remain largely unknown. Published MedRec studies usually have an inadequate description of the implementation methods and the contextual factors driving their selection. A lack of both long-term outcome studies and valid measures of sustainability have further limited our understanding of how to best sustain effective MedRec interventions. Identifying how implementation strategies and contextual factors (i.e., capacity, leadership, goal alignment, climate, readiness for change, and team cohesion) predict sustainability and long-term effectiveness of MedRec interventions, would provide important guidance for hospitals nationally and improve patient safety. This proposal describes a career development plan that enables the candidate to gain expertise in advanced research methods and implementation science, through mentored research and didactic training. It leverages the AHRQ-funded, “Implementation of a Medication Reconciliation Protocol to Improve Patient Safety,” study (MARQUIS2, R18 HS023757), which is investigating MedRec in 18 diverse U.S. hospitals, and provides a unique opportunity to study organizational context and sustainability at these facilities. The Specific Aims are: 1) Describe implementation strategies and examine their association with contextual factors; 2) Develop and validate a sustainability measure; and, 3) Investigate the relationship of contextual factors and implementation strategies with the sustainability of MedRec interventions. The candidate is highly qualified as a PhD prepared nurse who has studied sustainability in other contexts. The career development plan builds on this foundation to provide: a) advanced skills in research methods (e.g., focus groups and multi-level modeling), implementation science, and instrument development; b) scientific writing skills through manuscript preparation and grant writing; and, c) an interdisciplinary mentored research experience with experts in implementation research. The institutional environment is exceptional, including research centers in implementation research and qualitative methods. This career development award will allow the candidate to develop a deep understanding of implementation methods and expertise in measurement to study the sustainability of complex, interdisciplinary interventions in healthcare organizations. This award will position the candidate to become an R01-funded independent investigator who develops evidence-based implementation practices for optimizing the sustainability of complex healthcare interventions to improve patient safety and quality of care.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2019 ( Subtotal = $144,721 )
2019	2019	VANDERBILT UNIVERSITY, THE	2301 VANDERBILT PL	NASHVILLE	TN	37235	DAVIDSON	USA	Research on Healthcare Costs, Quality and Outcomes	000	3	8/27/2019	NON-COMPETING CONTINUATION	$144,721
														Subtotal = $144,721

Issue Date FY: 2018 ( Subtotal = $144,055 )
2018	2018	VANDERBILT UNIVERSITY, THE	2301 VANDERBILT PL	NASHVILLE	TN	37235	DAVIDSON	USA	Research on Healthcare Costs, Quality and Outcomes	000	2	9/17/2018	NON-COMPETING CONTINUATION	$144,055
														Subtotal = $144,055

Issue Date FY: 2017 ( Subtotal = $138,059 )
2017	2017	VANDERBILT UNIVERSITY, THE	211 KIRKLAND HALL	NASHVILLE	TN	37240	DAVIDSON	USA	Research on Healthcare Costs, Quality and Outcomes	000	1	9/8/2017	NEW	$138,059
														Subtotal = $138,059

Grand Total All Awards = $426,835

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Implementing and Sustaining Complex Interdisciplinary Healthcare Interventions: Learning from Medication Reconciliation

Award Number: K01HS025486

ORGANIZATION: AGENCY FOR HEALTH CARE RESEARCH AND QUALITY

OPDIV: AHRQ

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: TRAINING/TRAINEESHIP

PERIOD OF PERFORMANCE START DATE: 09/30/2017

PERIOD OF PERFORMANCE END DATE: 09/29/2021

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