Identify, Teach and Treat (IT2): Automating clinical decision pathways for the care of women

识别、教导和治疗 (IT2)：自动化临床决策路径以护理女性

• 批准号: 10377834
• 负责人: KIMBERLY Sue KENTON
• 金额: $ 69.96万
• 依托单位: NORTHWESTERN UNIVERSITY AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-02-01 至 2025-01-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10377834
• 关键词: Identify; Teach; Treat; IT2; Automating

Project Summary: In this application, we describe a multi-level implementation strategy to systematically improve the identification of urinary incontinence (UI) among women seen in primary care, support patient-centered decision making for UI, and accelerate the uptake of evidence-based nonsurgical treatment modalities for UI. We expect to demonstrate how system-level changes aimed at improving UI care, when implemented in conjunction with a mature quality improvement and information technology infrastructure and combined with innovative patient- centered supports, can lead to transformative improvement. With 65 primary care practices and 327 primary care physicians, who provide care to over 279,000 individual women, Northwestern Medicine is the largest health system in Illinois and well suited to implement the latest patient-centered outcomes research evidence regarding nonsurgical treatment for UI in women. Meanwhile our trans-regional, integrated pelvic health program is already providing the full breadth of approved non-surgical treatments for UI. The linchpin of our proposal is our unique existing partnership with Wisercare© – a company with whom we have developed an evidence-based, shared decision-making module for UI that we will fully integrate into the primary care provider (PCP) workflow. Our approach begins with a set of strategies to equitably and systematically implement screening for UI on an annual basis in primary care practices in a way that is designed to reduce the burden on PCPs. Patients who screen positive will to learn more about UI through an online shared decision-making tool available in multiple languages. Patients who complete the Wisercare© shared decision-making module will be able to share their results directly with their PCP, prompting further counseling and treatment. Meanwhile, we will provide PCPs throughout the health system with education and clinical decision support on non-surgical options for treating UI and will use practice facilitation to onboard new workflows. The processes will be periodically audited and screening for UI will be added to physician performance metrics. We aim to study program impact by studying the historical under-identification of UI prior to implementing these changes; reporting on patient treatment preferences and satisfaction with the shared decision-making process; tracking changes in UI diagnosis, and utilization of non-surgical treatment for UI; and studying changes in PCP comfort and support around the identification and treatment of UI. Our reliance on implementing durable changes in care delivery should be sustainable and a model for other systems.

项目摘要： 在此应用程序中，我们描述了一种多级实施策略，以系统地改善标识 在初级保健中看到的妇女中的尿失禁（UI），支持以患者为中心的决策 UI，并加速了对UI的循证非手术治疗方式的吸收。我们希望 证明系统级变化如何与 成熟质量改进和信息技术基础设施，并与创新的患者结合使用 - 集中的支持，可以导致变革性的改进。 拥有65种初级保健实践和327位初级保健医生，他们为超过279,000个人提供护理 妇女，西北医学是伊利诺伊州最大的卫生系统，非常适合实施最新 以患者为中心的结果的研究证据有关女性UI的非手术治疗。同时我们 跨区域综合骨盆健康计划已经提供了批准的非手术的全部广度 UI治疗。我们提案的关键是我们与WiserCare© - 一家公司的独特现有合作伙伴关系 我们与谁一起开发了一个基于循证的，共享的UI共享决策模块，我们将充分 集成到初级保健提供商（PCP）工作流程中。 我们的方法始于一系列策略，以在 初级保健实践的年基础，旨在减少PCP的燃烧。患者 通过在线共享决策工具可用的屏幕正面意愿，以了解更多有关UI的信息 语言。完成WISERCARE©共享决策模块的患者将能够分享他们的 直接使用PCP结果，促使进一步的咨询和治疗。同时，我们将提供PCP 在整个卫生系统中，对非手术选择的教育和临床决策支持 UI并将使用练习设施在新的工作流程上。这些过程将经过定期审核，并且 UI的筛选将添加到身体性能指标中。 我们旨在通过研究UI的历史鉴定，然后在实施这些UI方面研究计划的影响 变化；报告患者治疗偏好和对共同决策过程的满意； 跟踪UI诊断的变化，并利用UI的非手术治疗；并研究PCP的变化 围绕UI的识别和处理的舒适和支持。我们保留实施耐用的 护理交付的变化应是可持续的，并且是其他系统的模型。