PA-20-070: Evaluating home healthcare agency and home healthcare professional responsiveness to safety threats during older adults' care transitions in the era of COVID-19

PA-20-070：评估家庭医疗保健机构和家庭医疗保健专业人员对 COVID-19 时代老年人护理过渡期间安全威胁的响应能力

• 批准号: 10172490
• 负责人: Alicia Ines Arbaje
• 金额: $ 48.52万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-08-01 至 2023-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10172490
• 关键词: PA; 20; 070; Evaluating; home

SHHC agencies are in a unique position to identify and address patient safety risks during the COVID-19 pandemic. SHHC providers are among the few personnel conducting in-person clinical evaluations and treatment during the pandemic. There are numerous challenges providing care in home environments, and pandemic- related guidance has focused on hospital or institutional settings. SHHC agencies need data characterizing changes to care transitions patterns, data on best practices, and guidance tailored to home health settings, SHHC organizational structures, and the specific needs of older adults to quickly identify and address patient safety during care transitions in the COVID-19 era. The goal of the supplement is to identify how the SARS-CoV-2 pandemic has impacted (1) care transitions experiences of older adults and home health providers' after coming home from the hospital, and (2) organizational structure and processes of participating SHHC agencies in two geographic areas impacted differently by the pandemic. The supplement leverages the expertise of grant personnel and study staff at the largest not-for-profit SHHC agency in the US located in New York City, and a large SHHC agency serving urban and suburban populations located in Baltimore, Maryland. Sub-aim 1d: Characterize the impact of the COVID-19 pandemic on older adults' care transitions patterns in two geographic regions impacted differently by the pandemic. We will collect the following measures at two large SHHC agencies serving as study sites in the parent study (Baltimore, Maryland, and New York City, New York) for a period of one year before and after the beginning of the pandemic: (1) changes in volume, acuity, characteristics, and 30-day ED visit or hospitalization of older adults being referred to SHHC, and (2) frequency and characteristics of patients refusing SHHC services. Sub-aim 1e: Compare and contrast best practices in SHHC agency and SHHC professionals' responses to patient safety threats across the two study sites. We will leverage our expertise with qualitative and human factors methods to conduct semi-structed interviews with SHHC administrators, staff, and front-line providers at the two study sites to (1) identify novel threats to older adults' safety during care transitions during the pandemic, and (2) identify best practices for how SHHC agencies and providers can adapt and respond to these threats. Study findings will allow for comparison across geographic sites, rapid identification of unmet needs and for development and dissemination of best practices to SHHC agencies for ensuring patient safety during the hospital-to-home health transition in the era of COVID-19. Findings will also provide critical knowledge regarding how SHHC agencies have adjusted care delivery, management, decision-making, and operations in response to the pandemic. This knowledge can inform future SHHC operations and care transitions improvement efforts.

SHHC机构处于独特的位置，可以识别和解决COVID-19期间患者安全风险 大流行。 SHHC提供者是进行面对面临床评估和治疗的少数人员之一 在大流行期间。在家庭环境中提供护理以及大流行的挑战 - 相关指导集中在医院或机构环境上。 SHHC机构需要数据表征 护理过渡模式的更改，最佳实践数据以及针对家庭健康环境量身定制的指导， SHHC组织结构以及老年人的特定需求快速识别和解决患者 在Covid-19时代的护理过渡期间的安全。 补充剂的目的是确定SARS-COV-2大流行如何影响（1）护理过渡 从医院回家后，老年人和家庭健康提供者的经历和（2） 在两个地理领域的参与SHHC机构的组织结构和过程 大流行的方式有所不同。该补充剂利用了赠款人员和学习人员的专业知识 美国最大的非营利性SHHC机构位于纽约市，以及为Urban服务的大型SHHC机构 和位于马里兰州巴尔的摩的郊区人口。 Sub-aim 1d：表征COVID-19的大流行对老年人护理过渡模式的影响 在两个地理区域，大流行对不同的影响。我们将在 两个大型SHHC机构在父母研究中充当研究地点（巴尔​​的摩，马里兰州和纽约市， 纽约）大流行开始前和之后的一年：（1）体积，敏锐度，敏锐度变化 特征和30天的ED访问或住院老年人被转介给SHHC，（2）频率 拒绝SHHC服务的患者的特征。 Sub-aim 1E：在SHHC代理和SHHC专业人员的回应中比较和对比最佳实践 在两个研究站点中对患者的安全威胁。我们将用定性和人类利用我们的专业知识 与SHHC管理员，员工和前线提供商进行半结构访谈的因素方法 （1）这两个研究地点在大流行期间确定对老年人的安全性的新威胁， （2）确定SHHC机构和提供商如何适应这些威胁的最佳实践。 研究发现将允许在地理地点进行比较，快速识别未满足的需求以及针对 向SHHC机构开发和传播最佳实践，以确保患者的安全 在Covid-19时代，医院到家庭的健康过渡。调查结果还将提供有关有关的关键知识 SHHC机构如何调整护理交付，管理，决策和运营 大流行。这些知识可以为未来的SHHC运营和护理转型提供改进的工作。