Paula Tanabe, PhD, MSN, MPH, RN, FAEN, FAAN, associate professor for Duke University School of Nursing (DUSON) and Duke University School of Medicine, is the primary investigator for a grant from the Agency for Healthcare Research and Quality for more than $1.5 million. The study “Disseminating NIH Evidence-Based Sickle Cell Recommendations in North Carolina” will evaluate patient and system outcomes associated with providing decision support tools to primary care providers (PCP) and emergency department (ED) providers across North and South Carolina.

Tanabe has previously focused her research mainly on improving the health care that is delivered to patients with SCD in the emergency department. This includes the broader challenges faced by many patients with SCD that influence the setting in which they receive care, ultimately resulting in many unmet health care needs.

“With this grant, I have expanded my work beyond the emergency department to now include providing tools to outpatient providers so they become more comfortable taking care of persons with SCD,” said Tanabe.

Many PCPs and ED providers lack the tools to care for persons with SCD. As a result, these patients seek treatment for all of their health care needs in EDs or from SCD specialists. Needs that aren't related to SCD may go unmet, which then leads to poor health care overall for persons with SCD.

Through this study, Tanabe and her team members will distribute to PCPs and ED providers in North Carolina and parts of South Carolina a toolbox of decision support tools based on the National Heart, Lung and Blood Institute (NHLB) publication “Evidence-Based Management of Sickle Cell Disease: Expert Panel Report, 2014." These tools will help physicians, nurses and nurse practitioners in clinics and emergency departments provide evidence-based care to persons with SCD.

“This study will allow patients who require care in the emergency department to experience better care because EDs will have SCD-specific tools to support their practice,” Tanabe said. “Part of this study is our partnership with Community Care North Carolina (CCNC). This partnership will allow EDs to refer patients to a care manager affiliated with CCNC who can assist them with referrals and insurance needs and help problem solve other challenges such as filling prescriptions.”

Ultimately, this study will help patients obtain primary care from providers close to their homes rather than having to travel long distances to receive all specialty and primary care from sickle cell centers.

Others involved in the project include co-investigators Marian Earls, MD, director of Pediatric Programs for CCNC; Julie Kanter, MD, assistant professor for the Medical University of South Carolina; Nirmish Shah, MD, assistant professor of medicine and pediatrics for Duke University School of Medicine; Elizabeth “Beth” Merwin, PhD, RN, FAAN, Ann Henshaw Gardiner Professor of Nursing and executive vice dean for DUSON; Susan Silva, PhD, associate professor and statistician for DUSON; Hayden Bosworth, PhD, professor of Medicine and Psychiatry and Behavioral Sciences for Duke University and associate director of the Center for Health Services Research in Primary Care for the Durham VA Medical Center; and Santanu Datta, PhD, assistant professor of Medicine for Duke University School of Medicine and health services research scientist at the Center for Health Services Research in Primary Care for the Durham VA Medical Center.