Wednesday, February 5, 2025 2/5/2025

Re-engineering for Accurate, Timely, and Communicated Diagnosis of Cardiovascular Disease in Women (DREAM Lab)

Award Number: R18HS027280
ORGANIZATION: AGENCY FOR HEALTH CARE RESEARCH AND QUALITY
OPDIV: AHRQ
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: KDA (KNOWLEDGE/DEVELOPMENT/APPLICATION)

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PROJECT SUMMARY Cardiovascular disease (CVD), including heart disease and stroke, is our nation’s costliest and most devastating chronic disease, and is fraught with diagnostic error. Despite ground-breaking progress in addressing CVD through years of clinical and biological research, errors in the diagnosis, treatment, and communication of CVD disproportionately impact women. Women are nearly twice as likely as men to receive the wrong initial diagnosis following a heart attack and 30% more likely to have stroke symptoms misdiagnosed in the emergency department (ED). Even when accurately diagnosed, women are less likely to receive timely evidence-based treatments. The National Academy of Medicine report Improving Diagnosis in Healthcare defined diagnostic error as “the failure to (a) establish an accurate and timely explanation of the patient’s health problem(s) or (b) communicate that explanation to the patient”. On every dimension of that definition, women with CVD fare worse than men and the combination of gender and race is even more lethal. Transdisciplinary teams leveraging systems engineering, using novel tactics and rigorous evaluation techniques are positioned to successfully mitigate this complex problem. Our Patient Safety Learning Laboratory (PSLL) will address Re-engineering for Accurate, Timely, and Communicated Diagnosis of Cardiovascular Diseases in Women: the (DREAM) Lab. We will apply a mixed-methods systems engineering approach to understand the complex interplay of factors contributing to CVD diagnostic error in women in the ambulatory care setting, and co-design and evaluate adaptive solutions. Our population health approach will evaluate factors including but not limited to the physical environment, social and economic determinants, clinical care, health information technology, and health behaviors. The DREAM Lab will: a. Identify the contributing factors leading to diagnostic errors and inappropriate clinical management of CVD in women and develop pragmatic performance and improvement measures. b. Propose, prioritize, and co-design human-centered solutions to mitigate diagnostic risk. c. Evaluate the structure, process, and outcome effects of human-centered solutions on CVD diagnosis, clinical management, and communication in simulated and clinical environments. The proposed work sets up a clear pathway toward clinical implementation. By systematically evaluating human-centered solutions in a simulated environment with input from practicing clinicians and patients as the end-users, followed by pilot testing promising solutions in the clinical environment, we provide operationally ready solutions. The DREAM Lab’s impact, particularly for vulnerable patients disproportionately impacted by heart attacks and stroke, has the potential to influence broad-scale change and disrupt the status-quo, yielding significant improvements in care cost, quality, experience, and value for women and the healthcare system.


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 = $0 )
2025	2022	MEDSTAR HEALTH RESEARCH INSTITUTE INC	6525 BELCREST RD STE 700	HYATTSVILLE	MD	20782	PRINCE GEORGES	USA	Research on Healthcare Costs, Quality and Outcomes	000	4	12/13/2024	NON-COMPETING CONTINUATION	$0
														Subtotal = $0

Issue Date FY: 2022 ( Subtotal = $620,926 )
2022	2022	MEDSTAR HEALTH RESEARCH INSTITUTE, INC.	6525 BELCREST RD STE 700	HYATTSVILLE	MD	20782	PRINCE GEORGES	USA	Research on Healthcare Costs, Quality and Outcomes	001	4	9/15/2022	NON-COMPETING CONTINUATION	$620,926
2022	2021	MEDSTAR HEALTH RESEARCH INSTITUTE, INC.	6525 BELCREST RD STE 700	HYATTSVILLE	MD	20782	PRINCE GEORGES	USA	Research on Healthcare Costs, Quality and Outcomes	000	3	10/26/2021	NON-COMPETING CONTINUATION	$0
														Subtotal = $620,926

Issue Date FY: 2021 ( Subtotal = $619,789 )
2021	2021	MEDSTAR HEALTH RESEARCH INSTITUTE, INC.	6525 BELCREST RD STE 700	HYATTSVILLE	MD	20782	PRINCE GEORGES	USA	Research on Healthcare Costs, Quality and Outcomes	002	3	9/15/2021	NON-COMPETING CONTINUATION	$619,789
2021	2020	MEDSTAR HEALTH RESEARCH INSTITUTE, INC.	6525 BELCREST RD STE 700	HYATTSVILLE	MD	20782	PRINCE GEORGES	USA	Research on Healthcare Costs, Quality and Outcomes	001	2	7/6/2021	NON-COMPETING CONTINUATION	$0
2021	2020	MEDSTAR HEALTH RESEARCH INSTITUTE, INC.	6525 BELCREST RD STE 700	HYATTSVILLE	MD	20782	PRINCE GEORGES	USA	Research on Healthcare Costs, Quality and Outcomes	000	2	2/26/2021	NON-COMPETING CONTINUATION	$0
														Subtotal = $619,789

Issue Date FY: 2020 ( Subtotal = $619,789 )
2020	2020	MEDSTAR HEALTH RESEARCH INSTITUTE, INC.	6525 BELCREST RD STE 700	HYATTSVILLE	MD	20782	PRINCE GEORGES	USA	Research on Healthcare Costs, Quality and Outcomes	000	2	9/14/2020	NON-COMPETING CONTINUATION	$619,789
														Subtotal = $619,789

Issue Date FY: 2019 ( Subtotal = $623,541 )
2019	2019	MEDSTAR HEALTH RESEARCH INSTITUTE, INC.	6525 BELCREST RD STE 700	HYATTSVILLE	MD	20782	PRINCE GEORGES	USA	Research on Healthcare Costs, Quality and Outcomes	000	1	9/12/2019	NEW	$623,541
														Subtotal = $623,541

Grand Total All Awards = $2,484,045

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Re-engineering for Accurate, Timely, and Communicated Diagnosis of Cardiovascular Disease in Women (DREAM Lab)

Award Number: R18HS027280

ORGANIZATION: AGENCY FOR HEALTH CARE RESEARCH AND QUALITY

OPDIV: AHRQ

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: KDA (KNOWLEDGE/DEVELOPMENT/APPLICATION)

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