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2018 PAIR with PAIR Cycle

The inaugural Pitch an Idea for Research with PAIR (PAIR with PAIR) pilot program cycle yielded 38 applications from a diverse pool of clinicians, representing 8 clinical areas within the University of Pennsylvania Health System (UPHS). Clinicians proposed new and understudied patient, caregiver, and clinician-directed interventions to test in a range of treatment contexts and populations, with the ultimate goal of addressing barriers to providing high-quality serious illness care in the health system.

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2018 Pilot Awardee:

Implementing Early Goal-Directed Mobility in Critically Ill Patients with Acute Respiratory Failure

 

William D. Schweickert, MD

Juliane Jablonski, DNP, RN, CCRN, CCNS

 

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Acute respiratory failure (ARF) is associated with high mortality and prolonged morbidity.  Early mobilization (EM) in ARF patients has been observed to be safe and feasible, and evidence suggests that EM programs can lead to better patient-centered outcomes, as well as ICU and hospital length of stay and duration of mechanical ventilation. Among ambulatory patients across 14 UPHS intensive care units, this pilot will test a three-part, goal-directed mobilization intervention -- comprised of daily goal setting and inter-professional close-loop communication using a unit-based facilitator. The primary outcome for the study will be peak 24-hour patient activity level at ICU discharge. The researchers will also assess key secondary outcomes such as ICU and hospital length of stay, physical and neurological function, and safety.

2018 Pilot Awardee:

Improving the Quality and Frequency of Advance Care Planning Among Hospitalized Patients

 

Chris Jones, MD, MBA, HMDC, FAAHPM

 

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Advance Care Planning (ACP) is a process by which patients and families reflect on their goals, values, and preferences to inform decision-making about treatment in the event that patients cannot make decisions for themselves. Advance care planning often promotes documentation of patients’ care preferences through the completion of an advance directive, but the practice remains highly variable across health systems, and numerous barriers, including lack of infrastructure and insufficient public engagement, persist. Leveraging the novel, Penn Medicine-developed advance care planning online platform, Our Care Wishes, this pilot will test three approaches to ACP among hospitalized patients at UPHS. The goal of this pilot is to determine which ACP approach increases advance directive completion and documentation in patients’ electronic medical records, thus overcoming common engagement and infrastructure barriers.

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