Flanders Scott A, Kaufman Samuel R, Nallamothu Brahmajee K, Saint Sanjay
Hospitalist Program, Division of General Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA.
J Hosp Med. 2008 Jul;3(4):308-13. doi: 10.1002/jhm.342.
Clinical research has developed slowly in most academic hospitalist programs, possibly because of a failure to recognize the important role of specialists in the diagnosis and management of complex medical patients as well as their expertise in clinical research. Ideally, a successful hospital-based clinical research program will need to partner hospitalists with specialists.
The University of Michigan's Specialist-Hospitalist Allied Research Program (SHARP) was designed to jumpstart hospital-based clinical and translational research at a major academic medical center by pairing specialists and hospitalists to ask and answer novel research questions.
SHARP is codirected by a hospitalist and a subspecialist and includes key personnel such as a hospitalist investigator, a clinical research nurse, a research associate, and a clinical epidemiologist. The program is guided by an oversight committee that includes institutional research leadership. Two initial projects have already been supported. The first, a collaboration between infectious disease specialists and hospitalists, is a prospective trial of antiseptic agents and techniques to reduce false-positive blood cultures. The second pairs geriatricians and clinical pharmacists with hospitalists to prospectively study techniques to reduce medication errors around the time of hospital discharge. Although initial pilot projects are single-institution studies, SHARP's goal is to expand its clinical research to include multicenter investigation. Metrics to evaluate SHARP include the number of successfully completed projects, extramural grants submitted and funded, and peer-reviewed publications.
A successful hospital-based clinical research program combines hospitalists and specialists in a collaborative environment to identify optimal strategies for delivering inpatient care.
临床研究在大多数学术医院医师项目中发展缓慢，这可能是因为未能认识到专科医生在复杂内科患者诊断和管理中的重要作用以及他们在临床研究方面的专业知识。理想情况下，一个成功的基于医院的临床研究项目需要医院医师与专科医生合作。
密歇根大学的专科医生 - 医院医师联合研究项目（SHARP）旨在通过将专科医生和医院医师配对，提出并回答新的研究问题，在一所大型学术医疗中心启动基于医院的临床和转化研究。
SHARP由一名医院医师和一名亚专科医生共同指导，包括关键人员，如医院医师研究员、临床研究护士、研究助理和临床流行病学家。该项目由一个包括机构研究领导层的监督委员会指导。已经支持了两个初始项目。第一个项目是传染病专科医生和医院医师之间的合作，是一项关于减少血培养假阳性的防腐剂和技术的前瞻性试验。第二个项目将老年病学家和临床药剂师与医院医师配对，前瞻性研究减少出院时用药错误的技术。虽然最初的试点项目是单机构研究，但SHARP的目标是将其临床研究扩展到多中心调查。评估SHARP的指标包括成功完成的项目数量、提交并获得资助的外部资助以及同行评审出版物。
一个成功的基于医院的临床研究项目在协作环境中将医院医师和专科医生结合起来，以确定提供住院治疗的最佳策略。
