# CHANGE OF GRANTEE INSTITUTION K23 HL146890 A Systems Approach to Align ICU Care with Patient Treatment Goals

> **NIH NIH K23** · UNIVERSITY OF WISCONSIN-MADISON · 2021 · $167,783

## Abstract

ABSTRACT
The support of this career development award will help Jacqueline M Kruser, MD MS become an independent
physician-investigator with the training and experience necessary to improve communication and treatment
decision making for patients with critical illness. Dr. Kruser will use this award to build on her existing
foundation in health services and outcomes research to achieve two career development goals: (1) Develop
expertise in the application of systems engineering principles and methods in healthcare, and (2) Gain
knowledge and experience in the conduct of clinical trials of complex behavioral interventions. These skills will
expand Dr. Kruser's research focus beyond individual-level interventions to address the complex, system-level
factors that influence treatment decision making and end-of-life care for patients with life-threatening illness,
specifically in chronic critical illness. Dr. Kruser will achieve these career objectives through a 5-year career
development plan that involves structured didactics, patient-oriented experiential research, and intensive
mentoring. Dr. Kruser's career development will be mentored by Jane L Holl MD MPH, a physician with
experience in applying systems engineering methods in healthcare, with over 20 years of sustained extramural
funding, and an outstanding record of mentorship. The co-mentors of this award are experts in clinical trials
and outcomes research in critical care (Richard G Wunderink, MD), and end-of-life decision making and
behavioral intervention development (Margaret Schwarze, MD MPP). Dr. Kruser's career development will be
supported by the exceptional institutional environment of Northwestern University, including the (1) Dedicated
resources from the Division of Pulmonary and Critical Care Medicine and Department of Medicine, (2) Strong
research infrastructure of the interprofessional Center for Healthcare Studies (directed by Dr. Holl), and (3)
Established, productive collaborations between the McCormick School of Engineering and the Feinberg School
of Medicine. Nearly 400,000 people in the US develop chronic critical illness each year, and most older adults
with this condition will not survive beyond one year. Studies suggest that many older adults with chronic critical
illness who are near the end of life receive unwanted care that does not reflect their goals, values, or
preferences, referred to as “goal-discordant” care. Thus, the overall research objective of this award is to apply
the tools of systems engineering to adapt an existing individual-level communication tool, “Best Case/Worst
Case,” to reduce goal-discordant care in older adults at risk for chronic critical illness. Specific Aim 1 will
identify the most impactful ICU system failures in communication and treatment decision-making through a
Failure Mode, Effects, and Criticality Analysis. Next, Specific Aim 2 will use user-centered design engineering
and simulation testing to adapt “Best Case/Worst Case” to the ...

## Key facts

- **NIH application ID:** 10324027
- **Project number:** 7K23HL146890-03
- **Recipient organization:** UNIVERSITY OF WISCONSIN-MADISON
- **Principal Investigator:** Jacqueline Marie Kruser
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $167,783
- **Award type:** 7
- **Project period:** 2020-05-01 → 2024-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10324027

## Citation

> US National Institutes of Health, RePORTER application 10324027, CHANGE OF GRANTEE INSTITUTION K23 HL146890 A Systems Approach to Align ICU Care with Patient Treatment Goals (7K23HL146890-03). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10324027. Licensed CC0.

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