High-quality evidence has shown that prone positioning (PP), where a patient's chest faces down, can reduce short-term mortality associated with acute respiratory distress syndrome (ARDS), but many patients do not receive this life-saving therapy. Using an implementation science framework, the primary goal of this research is to understand the underlying factors driving the gap between research and clinical practice for PP among patients with ARDS. In order to identify barriers and facilitators for appropriate use of PP, the research team will conduct semi-structured interviews with attending ICU clinicians and patients and family members within 8 ICUs of two hospital systems, the University of Pennsylvania Health System (UPHS) and the University of Michigan Health System (UMHS). Using these findings, the research team will develop several preliminary implementation strategies with a stakeholder taskforce, as well as assess perceptions of feasibility and acceptability of these strategies. Evidence gathered from this study will be used to inform future pragmatic trials of scalable, real-world strategies to improve evidence-based practices among ICU patients with high morbidity and mortality.
National Institutes of Health, National Heart, Lung, and Blood Institute (NHLBI)