Patient Centered Quality Reporting

以患者为中心的质量报告

• 批准号: 8446761
• 负责人: DANA B MUKAMEL
• 金额: $ 29.8万
• 依托单位: UNIVERSITY OF CALIFORNIA-IRVINE
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-09-30 至 2015-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8446761
• 关键词: Patient; Centered; Quality; Reporting

DESCRIPTION (provided by applicant): Quality report cards have become an important component of the American health care system in recent decades. The Centers for Medicare and Medicaid Services (CMS) publishes several web based report cards, including the Nursing Home Compare (NHC). It offers patients and their families' information about staffing, deficiencies, and 19 clinical quality measures (QMs). The objectives of these reports are to inform consumers' choice and improve quality of care. The evidence about their success in achieving these goals is mixed. Studies to-date suggests that many report cards are not widely used or not used at all. This is not surprising given both the complexity of the information and the fact that nursing home choices are typically made under both time constraints and in emotionally stressful situations, typically when the elder has to be discharged from the hospital. The objective of the proposed project is to develop and test a new e-coaching approach designed to take advantage of web technology and decision support software in order to facilitate and enhance access to and use of NHC. The Specific Aims of the project are: 1) To develop a consumer friendly web-based interface between NHC and an e-coaching/decision-aid tool. 2) To test its effectiveness through a randomized control trial. The project will be conducted at the University of California, Irvine Medical Center and will include medical and surgical patients identified by the attending as likely to be discharged to a nursing home. In year 1 we will develop a decision-aid tool, pilot test it with patients and families and build a web application that will integrate and interact with the NHC data guided by users' response to queries. In year 2 we will test the application we developed in the treatment group. The control group will continue with the usual discharge practice. Both groups will be surveyed. In year 3 survey data, data about the use patterns of the application, and data about the quality of nursing home destination facilities will be analyzed to test the study hypotheses. The lessons learned from this study will have direct application to improving the use of NHC by consumers. They may also be relevant to other report cards in the "Compare" series, Home Care Compare in particular. PUBLIC HEALTH RELEVANCE: Quality report cards are published by governments and private organizations with the expectation that they will inform consumers' choice of providers and increase the incentives for providers to improve quality. This study will enhance the ability of consumers to access the information in report cards and incorporate it into their decision making process. This in turn will increase the effectiveness of report cards.

描述（由申请人提供）：近几十年来，质量报告卡已成为美国医疗保健系统的重要组成部分。医疗保险和医疗补助服务中心 (CMS) 发布了多种基于网络的报告卡，包括疗养院比较 (NHC)。它为患者及其家属提供有关人员配备、缺陷和 19 项临床质量衡量标准 (QM) 的信息。这些报告的目的是为消费者的选择提供信息并提高护理质量。关于他们成功实现这些目标的证据好坏参半。 迄今为止的研究表明，许多成绩单并未得到广泛使用或根本没有使用。考虑到信息的复杂性以及疗养院的选择通常是在时间限制和情绪紧张的情况下（通常是当老年人必须出院时）做出的，这并不奇怪。 拟议项目的目标是开发和测试一种新的电子辅导方法，旨在利用网络技术和决策支持软件，以促进和增强 NHC 的访问和使用。 该项目的具体目标是： 1) 在 NHC 和电子辅导/决策辅助工具之间开发一个消费者友好的基于网络的界面。 2）通过随机对照试验来测试其有效性。 该项目将在加州大学欧文分校医学中心进行，将包括经主治人员确定可能出院到疗养院的内科和外科患者。当年 1 我们将开发一个决策辅助工具，对患者和家属进行试点测试，并构建一个网络应用程序，该应用程序将根据用户对查询的响应指导与 NHC 数据集成和交互。在第二年，我们将测试我们在治疗组中开发的应用程序。对照组将继续通常的出院做法。两组都将接受调查。在第 3 年的调查数据中，将分析有关应用程序使用模式的数据以及有关疗养院目的地设施质量的数据，以检验研究假设。 从这项研究中汲取的经验教训将直接应用于改善消费者对 NHC 的使用。它们也可能与“比较”系列中的其他成绩单相关，特别是家庭护理比较。 公共卫生相关性：质量报告卡由政府和私人组织发布，期望它们能够告知消费者对提供者的选择，并增加对提供者提高质量的激励。这项研究将增强消费者获取成绩单中的信息并将其纳入决策过程的能力。这反过来又会提高成绩单的有效性。