Developing Quality Indicators to Improve the Care in Elderly Surgery Patients

制定质量指标以改善老年手术患者的护理

• 批准号: 7085270
• 负责人: CLIFFORD KO
• 金额: $ 18.77万
• 依托单位: UNIVERSITY OF CALIFORNIA LOS ANGELES
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-06-01 至 2008-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7085270
• 关键词: automated medical record system; behavioral /social science research tag; clinical research; data collection methodology /evaluation; geriatrics; health care personnel; health care personnel performance; health care policy; health care quality; health services research tag; hospital personnel; human old age (65+); human subject; interdisciplinary collaboration; outcomes research; patient care management; posthospitalization care; postoperative state; statistics /biometry; surgery

DESCRIPTION (provided by applicant): The population is aging and increasing numbers of elderly patients are predicted to undergo surgery. In this regard, this application's overarching aim is to improve the quality of care delivered to elderly patients who undergo surgery. More specifically, this project will develop quality indicators that may be used to evaluate and improve the quality of care for elderly patients undergoing inpatient surgical procedures (i.e. any surgical procedure that has a planned postoperative stay). This application builds on prior pilot work funded through a Dennis W. Jahnigen Career Development Scholars Award from the American Geriatrics Society (ACS). In that project, we were able to develop quality indicators for elderly patients specifically undergoing abdominal surgery. Based on those findings, we now hypothesize that a single set of elderly-specific indicators may be identified that are universally applicable to virtually all disciplines of inpatient surgery (e.g. cardiothoracic, colorectal, general, gynecology, orthopedic, urology, and vascular surgery). Using the RAND/UCLA Appropriateness Methodology, which is a validated technique for identifying quality indicators, we will first develop a list of valid quality indicators. We will then further rate the indicators based on priority/importance in order to identify an implementable set (e.g. n=10-15) of indicators. We will develop a standardized medical record abstraction form so data can be reliably and accurately collected from the medical record. Finally, we will perform an evaluation of the quality of elderly surgical care in a convenience sample of two different clinical settings. While quality indicators are becoming increasingly utilized in our healthcare environment to measure and improve the quality of care for medical conditions (e.g. acute myocardial infarction, heart failure, pneumonia), extremely little work has been performed targeting surgery. Developing quality indicators in this regard will likely prove useful for improving the quality of care in this vulnerable population. We expect that this single set of quality indicators will be universal to all surgical disciplines, and be a novel, easy, and useful mechanism for evaluating, benchmarking, and improving the quality of care for elderly surgical patients. Importantly, these aims align well with the National Institute of Aging Geriatric Branch's focus on health issues, multiple morbidity, and disability.

描述（由申请人提供）：人口正在老龄化，预计将有越来越多的老年患者接受手术。在这方面，该应用程序的首要目标是提高接受手术的老年患者的护理质量。更具体地说，该项目将制定质量指标，可用于评估和改善接受住院外科手术（即任何有计划术后住院的外科手术）的老年患者的护理质量。该应用程序建立在之前的试点工作的基础上，该试点工作由美国老年病学会 (ACS) 的 Dennis W. Jahnigen 职业发展学者奖资助。在该项目中，我们能够为专门接受腹部手术的老年患者制定质量指标。基于这些发现，我们现在假设可以确定一组针对老年人的指标，这些指标普遍适用于住院手术的几乎所有学科（例如心胸外科、结直肠外科、普通外科、妇科、骨科、泌尿科和血管外科）。使用兰德/加州大学洛杉矶分校适当性方法（一种用于识别质量指标的经过验证的技术），我们将首先制定有效质量指标列表。然后，我们将根据优先级/重要性进一步对指标进行评级，以确定一组可实施的指标（例如n=10-15）。我们将开发标准化的病历摘要表，以便能够可靠、准确地从病历中收集数据。最后，我们将在两种不同临床环境的便利样本中对老年手术护理的质量进行评估。虽然我们的医疗保健环境中越来越多地利用质量指标来衡量和提高医疗状况（例如急性心肌梗死、心力衰竭、肺炎）的护理质量，但针对手术开展的工作却很少。制定这方面的质量指标可能有助于提高这一弱势群体的护理质量。我们预计这套质量指标将适用于所有外科学科，并成为一种新颖、简单且有用的机制，用于评估、基准测试和提高老年外科患者的护理质量。重要的是，这些目标与国家老龄化研究所老年科对健康问题、多种发病率和残疾的关注非常一致。