Determining Key Organizational Health Communication Practices in Complex Patients

确定复杂患者的关键组织健康沟通实践

• 批准号: 9253778
• 负责人: Kerri Cavanaugh
• 金额: $ 14.22万
• 依托单位: VANDERBILT UNIVERSITY MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-04-01 至 2020-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9253778
• 关键词: Address; Administrator; Advocacy; Age; Behavior; Benchmarking; Blood Vessels; Caring; Cessation of life; Characteristics; Clinical; Cohort Studies; Communication; Communication Research; Complex; Country; Development; Dialysis procedure; Dietitian; Dimensions; Discipline; Educational Activities; End stage renal failure; Ensure; Environment; Epidemiology; Evaluation; Frequencies; Future; Goals; Health; Health Communication; Health Personnel; Health Status; Health system; Healthcare; Healthcare Systems; Hemodialysis; Hospitalization; Incentives; International; Intervention; Leadership; Life; Measurement; Measures; Medical; Methodology; Methods; Monitor; Nephrology; Nurses; Outcome; Patient Care; Patient Outcomes Assessments; Patient-Centered Care; Patient-Focused Outcomes; Patients; Pattern; Perception; Personal Satisfaction; Phenotype; Physicians; Process; Provider; Quality of life; Race; Reporting; Research; Research Infrastructure; Research Personnel; Resources; Role; Self-Examination; Social Sciences; Social Workers; Specific qualifier value; Surveys; System; Technology; Testing; Training Programs; Trust; United States Centers for Medicare and Medicaid Services; Variant; clinical care; cohort; experience; health care quality; health literacy; high risk; improved; improved outcome; individual patient; mortality; multidisciplinary; novel; novel strategies; operation; patient oriented; patient population; payment; programs; prospective; Address; Administrator; Advocacy; Age; Behavior; Benchmarking; Blood Vessels; Caring; Cessation of life; Characteristics; Clinical; Cohort Studies; Communication; Communication Research; Complex; Country; Development; Dialysis procedure; Dietitian; Dimensions; Discipline; Educational Activities; End stage renal failure; Ensure; Environment; Epidemiology; Evaluation; Frequencies; Future; Goals; Health; Health Communication; Health Personnel; Health Status; Health system; Healthcare; Healthcare Systems; Hemodialysis; Hospitalization; Incentives; International; Intervention; Leadership; Life; Measurement; Measures; Medical; Methodology; Methods; Monitor; Nephrology; Nurses; Outcome; Patient Care; Patient Outcomes Assessments; Patient-Centered Care; Patient-Focused Outcomes; Patients; Pattern; Perception; Personal Satisfaction; Phenotype; Physicians; Process; Provider; Quality of life; Race; Reporting; Research; Research Infrastructure; Research Personnel; Resources; Role; Self-Examination; Social Sciences; Social Workers; Specific qualifier value; Surveys; System; Technology; Testing; Training Programs; Trust; United States Centers for Medicare and Medicaid Services; Variant; clinical care; cohort; experience; health care quality; health literacy; high risk; improved; improved outcome; individual patient; mortality; multidisciplinary; novel; novel strategies; operation; patient oriented; patient population; payment; programs; prospective

DESCRIPTION (provided by applicant): Effective communication is an essential component of patient-centered care. Emerging evidence suggests that favorable organizational communication, or the health communication practices within and between constituents of a healthcare system, is essential to the delivery of high quality, reliable and safe patient- centere care. Advancing research to determine the relationship between organizational communication and patient outcomes is necessary and critical to promote the integration of communication assessment into routine health system self-evaluation and quality monitoring. The goal of this proposal is to advance the assessment and understanding of the practices, determinants and associated patient outcomes of health- related organizational communication practices. End-stage renal disease (ESRD) and the provision of life- sustaining dialysis treatment provides a unique and robust environment to examine dialysis facility organizational communication and its impact on patient outcomes. Patients with ESRD are at significantly higher risk for mortality, hospitalization, and poor quality of life. Despite advances in the technology of dialysis care, outcomes are persistently poor indicating opportunities for novel strategies to improve patient healthcare. Overall, we hypothesize that organizational communication contributes significantly to individual patient outcomes, facility-level quality metrics, and also may overcome disparities in outcomes among vulnerable patient populations. As part of this proposal we will leverage the resources of the Dialysis Outcomes and Practice Patterns Study (DOPPS), a representative prospective international cohort study since 1996, in 21 countries, aimed to identify modifiable practices associated with improved patient outcomes. To address our hypothesis, the aims of this proposal are: 1) To characterize the quality of organizational communication in dialysis facilities by adapting, administering and validating an existing measure in 100 facilities and 700 hemodialysis patients; 2) To examine in a prospective cohort the association of organizational communication with clinical and patient-reported outcomes in 465 dialysis facilities and 15,000 patients worldwide; and 3) To determine if dialysis facility organizational communication modifies associations of age, race, or health-literacy related disparities and clinical or patient-reported outcomes. We are an integrated, diverse research team well equipped and uniquely poised to efficiently leverage existing infrastructure to significantly advance health communication research. Importantly, we are also connected to a deep network of national and international resources to ensure dissemination of our findings to a broad audience. This research will serve future research by advancing methodology of communication assessment and also our understanding of mechanisms of organizational communication in dialysis care. Most importantly, this research will inform the future development and testing of efficient and effective multi-level interventions to connect patients, providers and health systems to optimize quality programs and patient-centered care.

描述（由申请人提供）：有效的沟通是以患者为中心的护理的重要组成部分。新兴的证据表明，有利的组织沟通或医疗保健系统组成部分内部和之间的健康传播实践对于提供高质量，可靠和安全的患者的服务至关重要。进行研究以确定组织沟通与患者结果之间的关系是必要和至关重要的，对于促进沟通评估与常规卫生系统自我评估和质量监测的整合。该提案的目的是提高对健康相关组织沟通实践的实践，决定因素和相关患者结果的评估和理解。末期肾脏疾病（ESRD）和维持透析治疗的提供提供了独特而健壮的环境，以检查透析设施的组织沟通及其对患者结果的影响。 ESRD患者的死亡率，住院和生活质量差的风险显着更高。尽管透析护理技术取得了进步，但结果持续很差，这表明新型策略改善患者医疗保健的机会持续很差。总体而言，我们假设组织沟通对个别患者的结果，设施级别的质量指标产生了重大贡献，并且可能会克服脆弱患者人群的结果差异。作为该提案的一部分，我们将利用透析结果和实践模式研究的资源（DOPPS），这是自1996年以来代表的前瞻性国际队列研究，旨在确定与改善患者结果相关的可修改实践。为了解决我们的假设，该提案的目的是：1）通过适应，管理和验证100个设施和700名血液透析患者的现有措施来表征透析设施中组织传播的质量； 2）在预期的队列中检查组织沟通与465个透析设施中的临床和患者报告的结果和全球15,000名患者的临床和患者报告的结合； 3）确定透析设施的组织沟通是否会改变与临床，临床或患者报告的结果相关的年龄，种族或健康列表的关联。我们是一个综合，多元化的研究团队，能够有效地利用现有的基础设施来大大提高健康沟通研究。重要的是，我们还与国家和国际资源的深层网络联系在一起，以确保将我们的发现传播给广泛的受众。这项研究将通过推进沟通评估方法以及我们对透析护理中组织沟通机制的理解来为未来的研究提供服务。最重要的是，这项研究将为未来的开发和测试，并测试有效，有效的多层干预措施，以连接患者，提供者和卫生系统，以优化优质计划和以患者为中心的护理。