# Shock Patients: Interprofessional Communication to Enhance Diagnosis (SPICED)

> **NIH AHRQ R18** · NORTHWESTERN UNIVERSITY · 2024 · $499,998

## Abstract

PROJECT SUMMARY
Over 1.3 million Americans develop shock annually and 30-50% do not survive depending on the underlying
cause of shock. Most research has focused on recognizing shock but has stopped short of identifying the
cause of shock. Differentiating between causes of shock such as infection, heart failure, bleeding, dehydration,
or lack of stress hormone, is extremely challenging. The complex presentation of a patient in shock and the
many different potential causes of shock requires many expert interprofessional clinicians, such as nurses,
pharmacists, emergency medicine, critical care, infectious disease and cardiology doctors, to weigh in. Yet,
there is no way for these clinicians to actively share their assessments, build a shared understanding of the
cause of shock, and reach a consensus on treatment. Poor communication among clinicians is a leading
source of harm in acute care hospitals, yet remains extremely understudied. This application’s long-term
objective is to improve the safety of critical care medicine by addressing poor interprofessional communication.
The Specific Aims of this application will be to: 1) understand why interprofessional clinicians disagree on the
cause of shock; 2) design a systematic process for interprofessional clinicians to share information, their
assessments and build a shared understanding of the cause of shock; and 3) put into clinical practice and
measure how this systematic process improves agreement among clinicians as well as timeliness and
accuracy of the identification of the cause of shock. The central hypothesis is that creating a process, informed
by the interprofessional clinicians who would use it, to bring together all experts in order to determine the
cause of shock quickly after a patient shows signs of shock, can improve agreement among clinicians,
timeliness and accuracy in identifying the cause of shock. We will apply a variety of methods to test this
hypothesis including machine learning, critical incident technique, user-centered design, implementation
science and interrupted time series analysis. Identifying modifiable healthcare system factors that lead to
disagreement among clinicians can inform the design of a systematic process to identify the cause of shock,
determine how to treat it and reduce the high risk of death.

## Key facts

- **NIH application ID:** 10892841
- **Project number:** 5R18HS029483-02
- **Recipient organization:** NORTHWESTERN UNIVERSITY
- **Principal Investigator:** Andrew Barnden Lewis Berry
- **Activity code:** R18 (R01, R21, SBIR, etc.)
- **Funding institute:** AHRQ
- **Fiscal year:** 2024
- **Award amount:** $499,998
- **Award type:** 5
- **Project period:** 2023-08-01 → 2027-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10892841

## Citation

> US National Institutes of Health, RePORTER application 10892841, Shock Patients: Interprofessional Communication to Enhance Diagnosis (SPICED) (5R18HS029483-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10892841. Licensed CC0.

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