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Implementation Fidelity and Benefits of the Critical Care Pediatric Guideline Adherence and Outcomes Program in Traumatic Brain Injury

Award Number: R01NS106560
ORGANIZATION: NATIONAL INSTITUTE OF NEUROLOGICAL DISORDERS AND STROKE
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

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Project Summary/Abstract Traumatic brain injury (TBI) is a public health crisis for children in the US and worldwide. There are no proven therapies to treat TBI, and evidenced-based guidelines have been developed over the past 2 decades to guide best current practices. Yet, implementation strategies are lacking. In prior work, we found that adherence to the TBI guidelines was associated with 6% better outcomes in 5 leading U.S. academic centers. However, TBI guideline adherence remains low and the guidelines have limitations related to recommendation applicability across health care systems and across countries. In response, we developed and pilot tested an innovative multilevel Pediatric Guideline Adherence and Outcomes (PEGASUS) program to increase TBI guideline adherence. Preliminary data show that barriers to TBI guideline adherence are remediable and TBI guideline based intensive care benefits outcomes. This proposal is a collaboration between U.S. and Argentine TBI clinical investigators dedicated to understanding TBI guideline adherence. The overarching aim of this proposal is guided by the Theoretical Domain Framework. We propose to conduct a pragmatic cluster randomized controlled trial of the PEGASUS program (intervention) and to improve TBI guideline adherence (main outcome) in severe pediatric TBI across six Argentine study sites. Using mixed-methods, we propose 3 Specific Aims: 1) Determine the relationship between PEGASUS program implementation and TBI guideline adherence (Aim 1a), and assess system, provider, patient, implementation and guideline factors associated with TBI guideline adherence (Aim 1b), 2) Create a value stream map that readily identifies value added process of care associated with TBI guideline adherence, and 3) Use computer simulation to develop and disseminate a real world best practices blueprint for TBI guideline adherence. This is a necessary advance and a step towards implementing guideline-based TBI care for children who suffer from TBI.


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: 2024 ( Subtotal = $0 )
2024	2023	UNIVERSITY OF WASHINGTON	4333 BROOKLYN AVE NE	SEATTLE	WA	98195	KING	USA	Extramural Research Programs in the Neurosciences and Neurological Disorders	000	5	3/12/2024	NON-COMPETING CONTINUATION	$0
														Subtotal = $0

Issue Date FY: 2023 ( Subtotal = $681,212 )
2023	2023	UNIVERSITY OF WASHINGTON	4333 BROOKLYN AVE NE	SEATTLE	WA	98195	KING	USA	Extramural Research Programs in the Neurosciences and Neurological Disorders	001	5	1/31/2023	NON-COMPETING CONTINUATION	$68,121
2023	2023	UNIVERSITY OF WASHINGTON	4333 BROOKLYN AVE NE	SEATTLE	WA	98195	KING	USA	Extramural Research Programs in the Neurosciences and Neurological Disorders	000	5	12/15/2022	NON-COMPETING CONTINUATION	$613,091
														Subtotal = $681,212

Issue Date FY: 2022 ( Subtotal = $774,914 )
2022	2022	UNIVERSITY OF WASHINGTON	4333 BROOKLYN AVE NE	SEATTLE	WA	98195	KING	USA	Extramural Research Programs in the Neurosciences and Neurological Disorders	001	4	3/27/2022	NON-COMPETING CONTINUATION	$67,491
2022	2022	UNIVERSITY OF WASHINGTON	4333 BROOKLYN AVE NE	SEATTLE	WA	98195	KING	USA	Extramural Research Programs in the Neurosciences and Neurological Disorders	000	4	1/31/2022	NON-COMPETING CONTINUATION	$607,423
2022	2022	UNIVERSITY OF WASHINGTON	4333 BROOKLYN AVE NE	SEATTLE	WA	98195	KING	USA	Extramural Research Programs in the Neurosciences and Neurological Disorders	002	4	6/16/2022	SUPPLEMENT FOR EXPANSION	$100,000
														Subtotal = $774,914

Issue Date FY: 2021 ( Subtotal = $681,383 )
2021	2021	UNIVERSITY OF WASHINGTON	4333 BROOKLYN AVE NE	SEATTLE	WA	98195	KING	USA	Extramural Research Programs in the Neurosciences and Neurological Disorders	000	3	2/1/2021	NON-COMPETING CONTINUATION	$681,383
2021	2021	UNIVERSITY OF WASHINGTON	4333 BROOKLYN AVE NE	SEATTLE	WA	98195	KING	USA	Extramural Research Programs in the Neurosciences and Neurological Disorders	002	3	2/16/2021	NON-COMPETING CONTINUATION	$0
2021	2020	UNIVERSITY OF WASHINGTON	4333 BROOKLYN AVE NE	SEATTLE	WA	98195	KING	USA	Extramural Research Programs in the Neurosciences and Neurological Disorders	001	2	2/15/2021	NON-COMPETING CONTINUATION	$0
														Subtotal = $681,383

Issue Date FY: 2020 ( Subtotal = $684,573 )
2020	2020	UNIVERSITY OF WASHINGTON	4333 BROOKLYN AVE NE	SEATTLE	WA	98195	KING	USA	Extramural Research Programs in the Neurosciences and Neurological Disorders	000	2	1/14/2020	NON-COMPETING CONTINUATION	$616,115
2020	2020	UNIVERSITY OF WASHINGTON	4333 BROOKLYN AVE NE	SEATTLE	WA	98195	KING	USA	Extramural Research Programs in the Neurosciences and Neurological Disorders	001	2	2/11/2020	NON-COMPETING CONTINUATION	$68,458
														Subtotal = $684,573

Issue Date FY: 2019 ( Subtotal = $713,072 )
2019	2019	UNIVERSITY OF WASHINGTON	4333 BROOKLYN AVE NE	SEATTLE	WA	98195	KING	USA	Extramural Research Programs in the Neurosciences and Neurological Disorders	000	1	12/25/2018	NEW	$713,072
														Subtotal = $713,072

Grand Total All Awards = $3,535,154

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Implementation Fidelity and Benefits of the Critical Care Pediatric Guideline Adherence and Outcomes Program in Traumatic Brain Injury

Award Number: R01NS106560

ORGANIZATION: NATIONAL INSTITUTE OF NEUROLOGICAL DISORDERS AND STROKE

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

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