Placing patient preferences at the center of care plans for older adults transitioning from the hospital to a skilled nursing facility

将患者偏好置于老年人从医院过渡到熟练护理机构的护理计划的中心

• 批准号: 10461863
• 负责人: James David Harrison
• 金额: $ 13.2万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-08-15 至 2026-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10461863
• 关键词: Adopted; Aging; American; Behavior; California; Caregivers; Caring; Clinical; Collaborations; Communication; Communities; Creativeness; Data; Elderly; Elements; Ensure; Ethnography; Family; Foundations; Future; Geriatrics; Goals; Health care facility; Health system; Home; Hospitals; Impairment; Individual; Institutional Practice; Intervention; Interview; Lead; Length of Stay; Medical; Mentored Research Scientist Development Award; Mentors; Mentorship; Methods; Outcome; Participant; Patient Preferences; Patient-Focused Outcomes; Patients; Perception; Pharmaceutical Preparations; Phase; Preparation; Process; Prospective Studies; Provider; Qualitative Research; Recovery; Research; Research Methodology; Research Personnel; San Francisco; Scientist; Series; Skilled Nursing Facilities; Techniques; Testing; Time; Training; Transitional Care Planning; Trust; Universities; Vision; Voice; Work; acceptability and feasibility; care delivery; career; design; expectation; experience; health communication; hospital readmission; human centered design; human old age (65+); implementation evaluation; implementation outcomes; implementation science; implementation strategy; implementation tool; improved; improved outcome; innovation; leadership development; patient engagement; patient oriented; patient-clinician communication; person centered; pilot test; post implementation; preference; professor; programs; research and development; satisfaction; skills; theories; therapy development; tool; user centered design

PROJECT SUMMARY / ABSTRACT This is an application for a K01 Award for Dr. James Harrison, an Assistant Professor at the University of California San Francisco. Dr. Harrison’s career goal is to become an independent researcher in aging who uses patient engagement and implementation science to improve the outcomes of older adults transitioning from the hospital to skilled nursing facilities (SNFs). Dr. Harrison’s aspiration is for health systems to place older adults at the center of innovation discovery and care redesign. This K01 Award will help make this aspiration a reality by providing him with the training and research experience needed to develop and implement care transition interventions that are patient-centered and sustained in real-world settings. To facilitate successful completion of these activities, Dr. Harrison has assembled a strong mentorship team. His primary mentor is Dr. Margaret Fang, a clinical outcomes researcher who focuses on medications for vulnerable older adults. His co-mentors are Dr Rebecca Sudore, an expert in developing and testing tools to facilitate health communication for diverse older adults; Dr. Audrey Lyndon, an expert in qualitative research methods focusing on communication and teamwork; Dr Andrew Auerbach, an expert implementation scientist. Older adults comprise 75% of all hospital discharges to SNFs each year. Transition care planning remains persistently medicalized, failing to be guided by patients’ own preferences for their recovery, and does not incorporate elements that support preferences related to independence, returning home and function, or factors that allow participation in family or community activities that provide a foundation for personal purpose. An intervention to support patient and provider communication around patient preferences that can guide SNF transition planning is needed. In Aim 1, Dr. Harrison will conduct a qualitative grounded theory study to explore how patients and caregivers anticipate and are prepared for a SNF discharge. This study will also examine care team behaviors and processes that impact on how preferences are incorporated into transition plans. Aim 2 will involve co-developing a SNF preparation tool (SNF-PT) and associated implementation strategy with stakeholders using human centered design techniques. The objective of the SNF-PT will be to facilitate communication and implementation of patient preferences into SNF transition plans. In Aim 3, the SNF-PT will be piloted focusing on implementation outcomes and preliminary impacts on patient outcomes. This data will inform future R01 type-applications evaluating the SNF-PT. Through a focused program of mentored training and coursework, Dr. Harrison will gain skills in 1) Core principles of geriatrics, 2) The theory and application of advanced qualitative research methods (e.g. grounded theory), 3) User-centered design techniques to intervention development for older adults, and 4) Research leadership development. This K01 Award will provide Dr. Harrison with the expertise and data to launch his career as an independent investigator in aging focused on the hospital to SNF care transition.

项目摘要 /摘要 这是该大学助理教授詹姆斯·哈里森（James Harrison）博士申请K01奖 加利福尼亚旧金山哈里森博士的职业目标是成为老龄化的独立研究员 使用患者参与和实施科学来改善老年人过渡的结果 从医院到熟练的护士设施（SNFS）。哈里森博士的愿望是让卫生系统放置 在创新发现和护理重新设计的中心的老年人。这个K01奖将有助于做到这一点 通过为他提供发展和研究经验来发展和 在现实世界中以患者为中心并维持的护理过渡干预措施。到 哈里森博士促进了成功完成这些活动的成功，已经组建了一个强大的心态团队。他的 主要导师是玛格丽特·法博士（Margaret Fang），他是临床成果研究人员，他专注于药物 脆弱的老年人。他的联赛是丽贝卡·苏多尔（Rebecca Sudore）博士，他是开发和测试工具的专家 促进潜水员老年人的健康交流；定性研究专家奥黛丽·林登（Audrey Lyndon）博士 专注于沟通和团队合作的方法；专家实施科学家Andrew Auerbach博士。 老年人每年占SNF的所有医院的75％。过渡护理计划 仍然可以持续医学化，未能受到患者自己康复的偏好的指导，并且确实 不合并支持与独立，返回家园和功能有关的偏好的元素，或 允许参加为个人目的提供基础的家庭或社区活动的因素。 一项干预措施，以支持患者和提供者围绕患者偏好的沟通，以指导SNF 需要过渡计划。在AIM 1中，哈里森博士将进行一项定性的理论研究以探索 患者和护理人员如何预期和准备SNF出​​院。这项研究还将检查 护理团队的行为和流程影响如何将偏好纳入过渡计划。目的 2将涉及共同开发SNF准备工具（SNF-PT）和相关的实施策略 利益相关者使用以人为中心的设计技术。 SNF-PT的目的是促进 沟通和将患者偏好实施到SNF过渡计划中。在AIM 3中，SNF-PT将 专注于实施结果和对患者预后的初步影响。这些数据将 告知未来R01评估SNF-PT的类型应用程序。 通过专注的指导培训和课程计划，哈里森博士将获得1）核心的技能 老年医学原理，2）高级定性研究方法的理论和应用（例如 理论），3）以用户为中心的设计技术为老年人干预开发，4）研究 领导力发展。该K01奖将为哈里森博士提供专业知识和数据，以启动他的 作为老龄化的独立调查员的职业专注于医院进行SNF护理过渡。