# Sickle Cell Improvement: ENhancing Care in the Emergency Department (SCIENCE)

> **NIH NIH U01** · NEMOURS CHILDREN'S HOSPITAL, DELAWARE · 2024 · $824,402

## Abstract

PROJECT SUMMARY
Sickle cell disease (SCD) is an inherited blood disorder affecting approximately 36,000 children in the United
States, approximately 90% of whom are Black. The disease is characterized by recurrent, severe pain crises
which result in high rates of emergency department visits and hospitalizations, and decreased quality of life.
The National Heart, Lung and Blood Institute, as well as the American Society of Hematology, have endorsed
pain management guidelines regarding the timeliness of care for children presenting with these acute pain
crises. These evidence based guidelines are infrequently followed, resulting in increased pain and
hospitalizations. In additional to other barriers to following the guideline, structural racism has been proposed
as a significant contributor and the New England Journal of Medicine recently called for the institution of SCD-
specific pain management protocols to combat structural racism and reduce time to opioid administration.
Our long-term goal is to improve the care and health outcomes of children with acute painful vaso-occlusive
crisis treated in the emergency department. Our overall aim is to test a care pathway using multifaceted
implementation strategies to increase guideline adherent care for children in the emergency department with
acute painful vaso-occlusive crisis. Our primary aims are: 1) To compare the primary implementation outcomes
of Reach, Adoption, and Implementation for the care pathway for treatment of children with acute painful vaso-
occlusive crisis in the emergency department, between control and intervention groups and 2) To compare the
primary clinical outcomes of guideline adherent care for opioid dose timing, hospitalization rates, and pain
scores for the care pathway for the treatment of children with acute painful vaso-occlusive crises in the
emergency department between control and intervention groups. We will test these aims using a randomized,
multicenter stepped wedge design to conduct a type III hybrid effectiveness-implementation trial of the care
pathway. Our proposal will institute the care pathway across seven emergency departments with the goal of
improving guideline adherent care for children with SCD presenting with an acute pain crisis, thereby improving
pain, decreasing hospitalizations and improving quality of life for this vulnerable population.

## Key facts

- **NIH application ID:** 10896246
- **Project number:** 5U01HL159850-04
- **Recipient organization:** NEMOURS CHILDREN'S HOSPITAL, DELAWARE
- **Principal Investigator:** Amanda M Brandow
- **Activity code:** U01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $824,402
- **Award type:** 5
- **Project period:** 2021-09-01 → 2026-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10896246

## Citation

> US National Institutes of Health, RePORTER application 10896246, Sickle Cell Improvement: ENhancing Care in the Emergency Department (SCIENCE) (5U01HL159850-04). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10896246. Licensed CC0.

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