The central goal of this Training Grant in Critical Care Health Policy Research is to train leading academic physician investigators who are capable of improving the quality, safety, equity, and costs of critical care delivery at the bedside, across populations, and alongside policymakers. Since its inception in 2010, this program has trained or is currently training 26 such physician investigators. Among many metrics of our success to date, of the 16 postdoctoral fellows who have completed their training, 13 (81%) remain active in clinical research and either have or are on track to receive appointments as Assistant or Associate Professors at leading academic medical centers. This application proposes to continue and enhance our program. As a core part of this training program, fellows pursue the Master of Science in Health Policy Research (MSHP) degree program offered by Penn's School of Medicine and its Wharton School of Business. The program has been highly successful in attracting, training, and graduating fellows from its first nine cohorts. Trainees receive an intensive, structured program of mentoring, didactic research training, and experiential research over two years. The program includes core courses in health economics, health policy, qualitative methods, and statistics; elective courses in advanced epidemiology or biostatistics, advanced health care economics, health care policy, statistics, survey design and measurement, social policy and demography, and grant writing; intensive mentoring in critical care health policy research by an extensive set of experts in the field; participation in multidisciplinary research and professional development seminars; instruction in the responsible conduct of research and regulatory affairs; and the development and completion of research projects in critical care medicine supervised by a multidisciplinary mentoring team. The program is designed for postdoctoral physician fellows with clinical experience in adult and pediatric critical care. The definition of critical care encompasses care for adults and children with severe acute medical problems, trauma, and post-surgical care in intensive care units (ICUs), cardiac care units, and emergency departments. It also includes the examination of strategies to improve care for patients at risk for requiring an ICU admission, and to improve long-term outcomes for patients who survive an admission and their families. The program emphasizes research designed to answer policy-relevant questions regarding how critical care is and ought to be organized, financed, managed, and delivered. This work is typically conducted by fellow-led teams that build upon and enhance Penn's traditions of collaborative and interdisciplinary science.

Public Health Relevance

The morbidity, mortality, and costs attributable to critical illness are enormous and rising. This postdoctoral program integrates clinical experience, health services research training, policy analysis, and leadership and career development opportunities for physicians trained in adult or pediatric critical care medicine. These trainees form a cadre of physician leaders capable of improving the efficiency of critical care delivery at the bedside, across populations, and alongside policymakers.

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Institutional National Research Service Award (T32)
Project #
2T32HL098054-11
Application #
9853359
Study Section
NHLBI Institutional Training Mechanism Review Committee (NITM)
Program Officer
Redmond, Nicole
Project Start
2010-05-01
Project End
2025-04-30
Budget Start
2020-05-01
Budget End
2021-04-30
Support Year
11
Fiscal Year
2020
Total Cost
Indirect Cost
Name
University of Pennsylvania
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
042250712
City
Philadelphia
State
PA
Country
United States
Zip Code
19104
Krutsinger, Dustin C; McMahon, Jacqueline; Stephens-Shields, Alisa J et al. (2018) Randomized evaluation of trial acceptability by INcentive (RETAIN): Study protocol for two embedded randomized controlled trials. Contemp Clin Trials 76:1-8
Weissman, Gary E; Kerlin, Meeta Prasad; Yuan, Yihao et al. (2018) Population Trends in Intensive Care Unit Admissions in the United States Among Medicare Beneficiaries, 2006-2015. Ann Intern Med :
Kohn, Rachel; Harhay, Michael O; Weissman, Gary E et al. (2018) Ward Capacity Strain: A Novel Predictor of Delays in Intensive Care Unit Survivor Throughput. Ann Am Thorac Soc :
Hart, Joanna L; Gabler, Nicole B; Cooney, Elizabeth et al. (2018) Are Demographic Characteristics Associated with Advance Directive Completion? A Secondary Analysis of Two Randomized Trials. J Gen Intern Med 33:145-147
Anesi, George L; Liu, Vincent X; Gabler, Nicole B et al. (2018) Associations of Intensive Care Unit Capacity Strain with Disposition and Outcomes of Patients with Sepsis Presenting to the Emergency Department. Ann Am Thorac Soc 15:1328-1335
Weissman, Gary E; Hubbard, Rebecca A; Ungar, Lyle H et al. (2018) Inclusion of Unstructured Clinical Text Improves Early Prediction of Death or Prolonged ICU Stay. Crit Care Med 46:1125-1132
Krutsinger, Dustin C; Halpern, Scott D; DeMartino, Erin S (2018) Conflicts of interest in intensive care medicine. Intensive Care Med 44:1765-1766
Anesi, George L; Gabler, Nicole B; Allorto, Nikki L et al. (2018) Intensive Care Unit Capacity Strain and Outcomes of Critical Illness in a Resource-Limited Setting: A 2-Hospital Study in South Africa. J Intensive Care Med :885066618815804
Coupet Jr, Edouard; Karp, David; Wiebe, Douglas J et al. (2018) Shift in U.S. payer responsibility for the acute care of violent injuries after the Affordable Care Act: Implications for prevention. Am J Emerg Med 36:2192-2196
Halpern, Scott D (2018) Using Default Options and Other Nudges to Improve Critical Care. Crit Care Med 46:460-464

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