California Safety Net Institute Innovation and Dissemination Network

加州安全网研究所创新和传播网络

• 批准号: 8473341
• 负责人: Urmimala Sarkar
• 金额: $ 24.46万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-04-01 至 2016-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8473341
• 关键词: California; Safety; Net; Institute; Innovation

DESCRIPTION (provided by the applicant): Public hospitals in California (CA) are a ripe setting for the dissemination of evidence-based practices. These integrated delivery systems serve low-income, vulnerable patients with complex health needs, a majority of whom are un- or under-insured. Furthermore, incorporating evidence-based innovations consistently within and across such settings can be constrained by limitations in finances, technology, and human capital. However, recent health reform initiatives in CA offer new opportunities for all 21 public hospitals to transform themselves to yield significant public health benefits - particularly the CA 1115 Medicaid Waiver of 2010. Under the Delivery System Reform Incentive Program (DSRIP) in this Waiver, public hospitals, which deliver more than 10 million ambulatory visits annually, have come together to redesign care delivery to improve quality and population health outcomes while controlling costs. This 5-year DSRIP program is a pay-for-performance initiative, as each system will be paid according to specific metric improvements. As such, this is an unprecedented time to disseminate and implement evidence-based practices across systems statewide while also studying and understanding implementation processes. The UCSF Center for Vulnerable Populations at San Francisco General Hospital, which has an outstanding track record in developing innovations and in implementation sciences, and the California Healthcare Safety Net Institute, which has a deep understanding of successfully engaging public hospitals in change, have recently partnered to develop a network, DEPHI-Net, for spreading innovative best practices. This proposal would provide additional infrastructure support for a sustainable network. By applying the Consolidated Framework for Implementation Research, DEPHI-Net will also gain valuable insights into implementation processes generalizable to other safety net health systems and beyond. DEPHI-Net will defy commonly held beliefs about public hospitals being slow to change, insular, and highly bureaucratic organizations, and demonstrate that they not only are sources of innovation but also can become nimble and flexible learning organizations that rapidly take up, adapt, and implement evidence-based interventions to maximize population health.

描述（由申请人提供）：加利福尼亚州的公立医院（CA）是传播基于循证实践的成熟环境。这些综合输送系统可服务于具有复杂健康需求的低收入，脆弱的患者，其中大多数没有保险。此外，在此类环境内部和范围内始终如一地纳入基于证据的创新可能会受到财务，技术和人力资本的限制。但是，CA的最新健康改革计划为所有21家公立医院提供了新的机会，以改变自己，以产生巨大的公共卫生福利，尤其是CA 1115年的医疗补助豁免2010年。在此豁免的交付系统改革激励计划（DSRIP）下，公立医院每年进行超过1000万个门诊就诊，已聚集在一起，重新设计了护理服务，以提高质量和人口健康成果，同时控制成本。这个为期5年的DSRIP计划是一项绩效付费计划，因为每个系统将根据特定的度量改进支付。因此，这是 前所未有的时间，在全州范围内跨系统跨系统进行基于证据的实践，同时还研究和理解实施过程。旧金山综合医院的UCSF脆弱人群中心，该中心在开发创新和实施科学方面具有出色的记录，而加利福尼亚州医疗保健安全网研究所（California Healthcare Safety Net Institute）最近对成功吸引公立医院的变革有深刻的了解，最近与开发网络开发了一个网络，Dephi-net，用于扩展创新的最佳实践。该提案将为可持续网络提供额外的基础设施支持。通过将合并框架应用于实施研究，DePhi-NET还将获得对可推广到其他安全网卫生系统及其他地区的实施过程的宝贵见解。 DePhi-net将违背人们普遍认为公立医院的变化，孤立和高度官僚组织的速度缓慢，并证明它们不仅是创新的来源，而且还可以成为敏捷且灵活的学习组织，这些组织可以快速占据，适应和实施基于证据的干预措施，以最大程度地提高人口健康。