The Role of Behavioral Economic Interventions to Promote Utilization of Lung Protective Ventilation

Over a million Americans undergo invasive mechanical ventilation each year. Mechanical ventilation can be life-saving but can also be harmful, sometimes leading to direct lung injury with artificially delivered breaths. A growing body of evidence has demonstrated that a specific strategy of "lung-protective ventilation," defined by setting low tidal volumes and limiting plateau pressures, can improve outcomes of mechanically ventilated patients; the strategy is best suited for patients with acute respiratory distress syndrome (ARDS). Despite the wealth of literature demonstrating clear benefits to LPV in ARDS and possible benefit and at least no harm from LPV in other mechanically ventilated patients, many patients who undergo mechanical ventilation do not receive this life-saving therapy. The goal of this research is to develop implementation strategies to improve the utilization of LPV and the outcomes of patients who undergo mechanical ventilation. Through semi-structured interviews with clinicians, we will assess the perceived benefits and burdens of different EHR-based strategies grounded in behavioral economic theory. These findings will provide preliminary data to inform a future pragmatic trial of how such strategies may increase LPV utilization among all mechanically ventilated patients.

Sponsors

• ATS Foundation Research Grants