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CHANGE OF GRANTEE INSTITUTION K23 HL146890 A Systems Approach to Align ICU Care with Patient Treatment Goals

Award Number: K23HL146890
ORGANIZATION: NATIONAL HEART, LUNG, & BLOOD INSTITUTE
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: TRAINING/TRAINEESHIP
PERIOD OF PERFORMANCE START DATE: 05/01/2020
PERIOD OF PERFORMANCE END DATE: 10/31/2024

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CHANGE OF GRANTEE INSTITUTION K23 HL146890 A Systems Approach to Align ICU Care with Patient Treatment Goals - ABSTRACT The support of this career development award will help Jacqueline M Kruser, MD MS become an independent physician-investigator with the training and experience necessary to improve communication and treatment decision making for patients with critical illness. Dr. Kruser will use this award to build on her existing foundation in health services and outcomes research to achieve two career development goals: (1) Develop expertise in the application of systems engineering principles and methods in healthcare, and (2) Gain knowledge and experience in the conduct of clinical trials of complex behavioral interventions. These skills will expand Dr. Kruser's research focus beyond individual-level interventions to address the complex, system-level factors that influence treatment decision making and end-of-life care for patients with life-threatening illness, specifically in chronic critical illness. Dr. Kruser will achieve these career objectives through a 5-year career development plan that involves structured didactics, patient-oriented experiential research, and intensive mentoring. Dr. Kruser's career development will be mentored by Jane L Holl MD MPH, a physician with experience in applying systems engineering methods in healthcare, with over 20 years of sustained extramural funding, and an outstanding record of mentorship. The co-mentors of this award are experts in clinical trials and outcomes research in critical care (Richard G Wunderink, MD), and end-of-life decision making and behavioral intervention development (Margaret Schwarze, MD MPP). Dr. Kruser's career development will be supported by the exceptional institutional environment of Northwestern University, including the (1) Dedicated resources from the Division of Pulmonary and Critical Care Medicine and Department of Medicine, (2) Strong research infrastructure of the interprofessional Center for Healthcare Studies (directed by Dr. Holl), and (3) Established, productive collaborations between the McCormick School of Engineering and the Feinberg School of Medicine. Nearly 400,000 people in the US develop chronic critical illness each year, and most older adults with this condition will not survive beyond one year. Studies suggest that many older adults with chronic critical illness who are near the end of life receive unwanted care that does not reflect their goals, values, or preferences, referred to as “goal-discordant” care. Thus, the overall research objective of this award is to apply the tools of systems engineering to adapt an existing individual-level communication tool, “Best Case/Worst Case,” to reduce goal-discordant care in older adults at risk for chronic critical illness. Specific Aim 1 will identify the most impactful ICU system failures in communication and treatment decision-making through a Failure Mode, Effects, and Criticality Analysis. Next, Specific Aim 2 will use user-centered design engineering and simulation testing to adapt “Best Case/Worst Case” to the complex ICU system. Finally, Specific Aim 3 will test the feasibility and acceptability of the novel intervention through a two-site, pilot clinical trial.


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: 2025 ( Subtotal = -$44,218 )
2025	2023	UNIVERSITY OF WISCONSIN SYSTEM	21 N PARK ST STE 6301	MADISON	WI	53715	DANE	USA	Cardiovascular Diseases Research	000	5	4/24/2025	NON-COMPETING CONTINUATION	-$44,218
														Subtotal = -$44,218

Issue Date FY: 2023 ( Subtotal = $185,172 )
2023	2023	UNIVERSITY OF WISCONSIN SYSTEM	21 N PARK ST STE 6301	MADISON	WI	53715	DANE	USA	Cardiovascular Diseases Research	000	5	5/22/2023	NON-COMPETING CONTINUATION	$185,172
														Subtotal = $185,172

Issue Date FY: 2022 ( Subtotal = $188,423 )
2022	2022	UNIVERSITY OF WISCONSIN SYSTEM	21 N PARK ST STE 6301	MADISON	WI	53715	DANE	USA	Cardiovascular Diseases Research	001	4	5/22/2022	NON-COMPETING CONTINUATION	$188,423
2022	2021	UNIVERSITY OF WISCONSIN SYSTEM	21 N PARK ST STE 6301	MADISON	WI	53715	DANE	USA	Cardiovascular Diseases Research	000	3	5/21/2022	CHANGE OF GRANTEE / TRAINING INSTITUTION / AWARDING INSTITUTION	$0
														Subtotal = $188,423

Issue Date FY: 2021 ( Subtotal = $167,783 )
2021	2021	UNIVERSITY OF WISCONSIN SYSTEM	21 N PARK ST STE 6401	MADISON	WI	53715	DANE	USA	Cardiovascular Diseases Research	001	3	5/15/2021	CHANGE OF GRANTEE / TRAINING INSTITUTION / AWARDING INSTITUTION	$167,783
2021	2021	UNIVERSITY OF WISCONSIN SYSTEM	21 N PARK ST STE 6301	MADISON	WI	53715	DANE	USA	Cardiovascular Diseases Research	003	3	8/9/2021	CHANGE OF GRANTEE / TRAINING INSTITUTION / AWARDING INSTITUTION	$57,333
2021	2020	NORTHWESTERN UNIVERSITY	633 CLARK ST	EVANSTON	IL	60208	COOK	USA	Cardiovascular Diseases Research	002	2	8/9/2021	NON-COMPETING CONTINUATION	-$57,333
2021	2020	NORTHWESTERN UNIVERSITY	633 CLARK ST	EVANSTON	IL	60208	COOK	USA	Cardiovascular Diseases Research	000	2	5/14/2021	NON-COMPETING CONTINUATION	$0
														Subtotal = $167,783

Issue Date FY: 2020 ( Subtotal = $168,050 )
2020	2020	NORTHWESTERN UNIVERSITY	633 CLARK ST	EVANSTON	IL	60208	COOK	USA	Cardiovascular Diseases Research	000	2	4/29/2020	NON-COMPETING CONTINUATION	$168,050
														Subtotal = $168,050

Issue Date FY: 2019 ( Subtotal = $167,724 )
2019	2019	NORTHWESTERN UNIVERSITY	633 CLARK ST	EVANSTON	IL	60208	COOK	USA	Cardiovascular Diseases Research	000	1	4/19/2019	NEW	$167,724
														Subtotal = $167,724

Grand Total All Awards = $832,934

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CHANGE OF GRANTEE INSTITUTION K23 HL146890 A Systems Approach to Align ICU Care with Patient Treatment Goals

Award Number: K23HL146890

ORGANIZATION: NATIONAL HEART, LUNG, & BLOOD INSTITUTE

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: TRAINING/TRAINEESHIP

PERIOD OF PERFORMANCE START DATE: 05/01/2020

PERIOD OF PERFORMANCE END DATE: 10/31/2024

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