Improvement in Patients' Cognition and Relationship with SNF Quality Measures

通过 SNF 质量措施改善患者的认知和关系

基本信息

批准号：
10535460
负责人：
Brian Gregory Downer
金额：
$ 12.25万
依托单位：
UNIVERSITY OF TEXAS MED BR GALVESTON
依托单位国家：
美国
项目类别：
财政年份：
2019
资助国家：
美国
起止时间：
2019-01-01 至 2023-11-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10535460
关键词：
Address Admission activity Advanced Development Alzheimer&apos s disease related dementia Area Care given by nurses Career Mobility Caring Characteristics Clinical Cognition Cognitive Communities Data Data Files Decision Making Dementia Development Elderly Epidemiology Funding Gerontology Goals Health Health Policy Health care facility Hospitals Impaired cognition Incentives Intervention Knowledge Measures Medical Medical Care Team Medicare Mentors Methodology Nursing Homes Outcome Patient Admission Patients Performance Persons Physical Function Policies Polypharmacy Process Assessment Public Health Recovery Rehabilitation therapy Reporting Research Research Activity Research Personnel Research Project Grants Risk Adjustment Risk Factors Site Skilled Nursing Facilities Study Skills System Texas Training Training Activity Universities Variant acute care care outcomes career development cognitive control experience follow-up functional status improved large datasets leadership development modifiable risk nursing skill professor programs rehabilitation science skills

项目摘要

PROJECT SUMMARY/ABSTRACT I am an assistant professor in the Division of Rehabilitation Sciences at the University of Texas Medical Branch in Galveston, Texas. The purpose of this K01 proposal is to provide me with the knowledge, analytical skill, and experience necessary to become a successful investigator. To me, this means I will develop a funded research program that advances the quality of post-acute care for older adults, in particular for those with cognitive impairment, Alzheimer's disease and related dementias. My K01 application is focused on skilled nursing facilities (SNFs) because they are the most frequent post-acute care site for older adults. My training in gerontology has focused on analyzing cognitive data and using large data sets to identify potentially modifiable risk factors for cognitive impairment and dementia. During the K01 period, I will receive training in four areas that build upon my prior training in gerontology and expertise on the epidemiology of dementia: (1) Health characteristics, assessment process, quality outcomes and follow-up needs associated with older adults receiving SNF care; (2) Operational standards and regulatory (decision making) policies of SNFs; (3) Statistical skills for studying post-acute care outcomes using claims data; and (4) Career advancement and leadership development. Training in these areas will include coursework, shadowing interdisciplinary teams in clinical settings, and experiences accessing, managing, and analyzing Medicare files. This training will make me a researcher with a highly-informed view of healthcare policy and clinical context. My training activities have been integrated with a research project in which I will use national Medicare data files (2012-2014) to complete the following specific aims: (A) Evaluate the change in cognitive status during a SNF stay for older adults with impaired cognition on admission; (B) Examine the variation across SNFs in the percentage of patients with impaired cognition on admission whose cognitive status improves during a SNF stay; and (C) Assess the relationship between cognitive status on admission, improvement in cognitive status during a SNF stay, and performance on SNF quality measures. The expected findings of this research can inform clinical interventions that target patient- and facility-level characteristics associated with improved cognitive status. The findings can also inform healthcare policies meant to incentivize nursing homes to provide high-quality post-acute care. Completion of the K01 mentored training and research plans will provide me with the knowledge and skills necessary to develop a program of research that will advance the quality of post-acute care for older adults, in particular for older adults with cognitive impairment, Alzheimer's disease and related dementias.

项目摘要/摘要我是德克萨斯大学医学分公司康复科学系的助理教授在德克萨斯州加尔维斯顿。该K01提案的目的是为我提供知识，分析技能，并成为成功的调查员所必需的经验。对我来说，这意味着我将开发一个资助的为老年人的急性后护理质量提高的研究计划，特别是认知障碍，阿尔茨海默氏病和相关痴呆症。我的K01应用程序专注于熟练护理设施（SNF）是因为它们是老年人最常见的急性后护理网站。我的培训老年医学专注于分析认知数据并使用大型数据集来识别潜在的可修改认知障碍和痴呆症的危险因素。在K01期间，我将在四个领域接受培训这基于我先前在痴呆症流行病学方面的老年病学和专业知识的培训基础上：（1）健康与老年人相关的特征，评估过程，质量结果和后续需求接受SNF护理；（2）SNF的运营标准和监管（决策）政策；（3）统计使用索赔数据研究急性护理后结果的技能；（4）职业发展和领导力发展。在这些领域的培训将包括课程工作，在临床上阴影跨学科团队设置以及访问，管理和分析Medicare文件的体验。这种培训将使我成为对医疗保健政策和临床环境有高度信息的研究人员。我的培训活动有与一个研究项目集成了，我将使用国家医疗保险数据文件（2012-2014）完成以下具体目的：（a）评估SNF期间的认知状况的变化入学认知受损；（b）检查SNF的变异认知障碍在SNF停留期间的认知状况有所改善；（c）评估认知状况对入学的认知状况之间的关系，SNF停留期间认知状况的提高以及 SNF质量措施的性能。这项研究的预期发现可以为临床干预提供信息该针对患者和设施水平的特征与改善认知状况相关。发现可以还要通知旨在激励疗养院提供高质量急性护理的医疗保健政策。 K01指导培训和研究计划的完成将为我提供知识和技能制定一项研究计划所必需的，该计划将提高老年人急性后护理的质量特别适用于认知障碍，阿尔茨海默氏病和相关痴呆症的老年人。